| 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... |
| 02.05 |
Drugs affecting the renin-angiotensin system and some other antihypertensive drugs |
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Ambrisentan
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Formulary
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Macitentan (Opsumit®)
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Formulary
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NHS England commissioned
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Metirosine
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Formulary
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Milrinone (Primacor®)
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Formulary
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| 02.05.01 |
Vasodilator antihypertensive drugs |
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Hydralazine
(tablets)
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Formulary
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Minoxidil (Loniten®)
(Tablets)
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Formulary
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Use on specialist advice only
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Bosentan
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Formulary
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Iloprost
(Injection)
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Formulary
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Iloprost nebules (Vantavis®)
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Formulary
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NHS England commissioned
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Sildenafil
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Formulary
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Sodium nitroprusside
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Formulary
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Injection (Secondary Care only)
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| 02.05.02 |
Centrally acting antihypertensive drugs |
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Clonidine Hydrochloride (Catapres®)
(tablets)
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Formulary
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Use only on advice of specialist
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Clonidine Liqiud
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Formulary
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Methyldopa
(Tablets)
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Formulary
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Moxonidine
(Tablets)
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Formulary
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| 02.05.03 |
Adrenergic neurone blocking drugs |
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| 02.05.04 |
Alpha-adrenoceptor blocking drugs |
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Doxazosin
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Formulary
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 Patient Information: Changes to doxazosin prescribing
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| 02.05.04 |
Phaeochromocytoma |
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Phenoxybenzamine
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Formulary
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| 02.05.05 |
Drugs affecting the renin-angiotensin system |
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| 02.05.05 |
Heart Failure |
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Sacubitril valsartan (Entresto®)
(film coated tablets)
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Formulary
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Use current status at Place/Trust
Sandwell
 Supported by RICaD
Sacubatril valsartan(Entresto) RICaD -Sandwell only
Wolverhampton
Walsall
Dudley
Entresto-Implementation of Entresto (Sacubitril/Valsartan) in Dudley Health Economy
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NICE TA388:Sacubitril valsartan for treating symptomatic chronic heart failure with reduced ejection fraction
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| 02.05.05.01 |
Angiotensin-converting enzyme inhibitors (ACE inhibitors) |
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Perindopril erbumine
(Tablets)
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Formulary
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DO NOT PRESCRIBE as perindopril arginine salt-Perindopril arginine is Black on the formulary
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Ramipril
(Capsules, Tablets)
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Formulary
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Prescribe as capsules
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Lisinopril
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Formulary
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Captopril
(tablets)
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Formulary
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For existing patients and Paediatric use
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| 02.05.05.02 |
Angiotensin-II receptor antagonists |
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Candesartan cilexetil
(Tablets)
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Formulary
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Irbesartan
(Tablets)
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Formulary
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Losartan
(Tablets)
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Formulary
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Valsartan
(Capsules)
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Formulary
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| 02.05.05.03 |
Renin inhibitors |
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Aliskiren (Rasilez®)
(Tablets)
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Formulary
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Guidance for CCGs: Items which should not be routinely prescribed in primary care
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| Non Formulary Items |
Atenolol with nifedipine
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Non Formulary
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Azilsartan
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Non Formulary
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Captopril and Hydrochlorothiazide (Capozide®)
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Non Formulary
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Captopril and Hydrochlorothiazide (Co-zidocapt®)
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Non Formulary
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Cilazapril (Vascace®)
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Non Formulary
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Co-flumactone
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Non Formulary
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Co-tenidone (atenolol and chlortalidone)
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Non Formulary
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Cozaar- Comp®
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Non Formulary
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Enalapril
(tablets)
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Non Formulary
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For existing patients only |
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Enalapril Meleate and Hydrochlorothiazide (Innozide®)
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Non Formulary
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Ephedrine
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Non Formulary
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Eprosartan (Teveten®)
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Non Formulary
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Fosinopril Sodium
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Non Formulary
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Guanethidine Monosulphate
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Non Formulary
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Hydralazine Hydrochloride (Apresoline®)
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Non Formulary
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Hydrochlorothiazide
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Non Formulary
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Imidapril Hydrochloride (Tanatril®)
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Non Formulary
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Indoramin (Baratol®)
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Non Formulary
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Indoramin (Doralese®)
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Non Formulary
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Irbesartan with hydrochlorothiazide
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Non Formulary
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Lisinopril (Zestril®)
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Non Formulary
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Lisinopril and Hydrochlorothiazide (Carace® Plus, Lisicostad®, Zestoretic®)
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Non Formulary
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Losartan with hydrochlorothiazide
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Non Formulary
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Moexipril Hydrochloride (Perdix®)
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Non Formulary
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Olmesartan (Sevikar®)
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Non Formulary
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Olmesartan with amlodipine
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Non Formulary
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Olmesartan with amlodipine and hydrochlorothiazide
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Non Formulary
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Olmesartan with hydrochlorothiazide
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Non Formulary
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Perindopril
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Non Formulary
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Perindopril Arginine (Coversyl® Arginine)
(Tablets)
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Non Formulary
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In line with NHS England's Guidance for CCGs: Items which should not routinely be prescribed in primary care (Dec 2017)
Click here to access guidance |
Patient Information: Changes to perindopril arginine prescribing
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Perindopril arginine with indapamide
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Non Formulary
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Phentolamine
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Non Formulary
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Prazosin
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Non Formulary
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Prazosin (Hypovase®)
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Non Formulary
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Quinapril
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Non Formulary
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Quinapril and Hydrochlorothiazide
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Non Formulary
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Ramipril and Felodipine (Triapin®)
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Non Formulary
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Rasitro®
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Non Formulary
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Sevikar HCT®
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Non Formulary
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Sitaxentan Sodium (Thelin®)
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Non Formulary
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Tadalafil
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Non Formulary
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Non formulary for:
- Lower urinary tract symptoms in benign prostatic hyperplasi |
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Tadalafil (Adcirca®)
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Non Formulary
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Telmisartan
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Non Formulary
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Telmisartan with hydrochlorothiazide
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Non Formulary
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Terazosin
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Non Formulary
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Terazosin (Hytin®)
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Non Formulary
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Timolol with amiloride and hydrochlorothiazide
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Non Formulary
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Timolol with bendroflumethiazide
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Non Formulary
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Tolazoline
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Non Formulary
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Trandolapril (Gopten®)
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Non Formulary
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Trandolapril and Verapamil (Tarka®)
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Non Formulary
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Treprostinil
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Non Formulary
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Triamterene with chlortalidone
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Non Formulary
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Valsartan with hydrochlorothiazide
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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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