netFormulary Coventry and Warwickshire Area Prescribing Committee NHS
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 Formulary Chapter 2: Cardiovascular system - Full Chapter
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02.01  Positive inotropic drugs
02.01.01  Cardiac glycosides
Digoxin tablets
(Heart failure & AF)
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Preferred
 
   
Digoxin elixir
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Second Line
Treatment of heart failure and atrial fibrillation and flutter
use liquid for swallowing difficulties
 
   
Digoxin injection
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Red SO

 Emergency parenteral digitilisation

 
   
02.01.01  Digoxin-specific antibody
Digoxin specific antibody fragments (DigiFab®)
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Red SO
High Cost Medicine
Life threatening digoxin toxicity
 
   
02.01.02  Phosphodiesterase type-3 inhibitors
Enoximone
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Red SO
Treatment of congestive heart failure
 
   
Milrinone
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Red SO
Treatment of heart failure
 
   
02.02  Diuretics to top
02.02.01  Thiazides and related diuretics
Chlortalidone tablets
(Hypertension)
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Preferred
 
   
Indapamide standard release tablets
(Hypertension)
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Preferred
 
   
Bendroflumethiazide tablets
(Hypertension)
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Second Line
 
   
Metolazone
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Red SO
Treatment of fluid overload in patients with heart failure
 
   
02.02.02  Loop diuretics
Furosemide tablets
(Hypertension & Oedema)
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Preferred
 
   
Bumetanide tablets
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Second Line
Treatment of oedema
 
   
Furosemide liquid
(licensed strengths)
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Second Line
Treatment of oedema and resistant hypertension
use liquid for swallowing difficulties
 
   
Furosemide injection
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Red SO

 when immediate diuresis required

 
   
02.02.03  Potassium-sparing diuretics and aldosterone antagonists
02.02.03  Aldosterone antagonists
Eplerenone
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Green SI
Adjunct in stable patients with left ventricular dysfunction with evidence of heart failure, following myocardial infarction, adjunct in chronic mild heart failure
 
Link  NICE CG108: Chronic heart failure
   
02.02.04  Potassium-sparing diuretics with other diuretics to top
02.02.05  Osmotic diuretics
Mannitol infusion
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Red SO
For use as an osmotic diuretic
 
   
02.02.06  Mercurial diuretics
02.02.07  Carbonic anhydrase inhibitors
02.02.08  Diuretics with potassium
02.03  Anti-arrhythmic drugs to top
02.03.01  Management of arrhythmias
02.03.02  Drugs for arrhythmias
02.03.02  Supraventricular arrhythmias
Dronedarone
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Amber SC
Clinically stable patients with previous or current non-permanent AF
 
Link  Dronedarone - shared care agreement
Link  Dronedarone - Drug Positionng Statement
Link  NICE TA197: Dronedarone for the treatment of non-permanent atrial fibrillation
   
Adenosine
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Red SO
Rapid conversion to a normal sinus rhythm of paroxysmal supraventricular tachycardias. Aid to diagnosis of broad or narrow complex supraventricular tachycardias
 
   
Neostigmine
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Red SO
Treatment of paroxysmal supraventricular tachycardia
 
   
02.03.02  Supraventricular and ventricular arrhythmias
Amiodarone
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Green SA
Treatment of cardiac arrhythmias
 
   
Disopyramide
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Green SA
Treatment of cardiac arrhythmias
 
   
Flecainide
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Green SA
Treatment of cardiac arrhythmias
 
   
Propafenone
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Amber SC
Treatment of arrhythmias 
Link  Propafenone - shared care agreement
   
02.03.02  Ventricular arrhythmias to top
Lidocaine intravenous injection
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Red SO
Treatment of ventricular arrhythmias
 
   
02.04  Beta-adrenoceptor blocking drugs
Bisoprolol tablets
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Green SA

Treatment of moderate to severe heart failure

Preferred-

 
   
Carvedilol tablets
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Green SA

Adjunct in the treatment of heart failure

Preferred-

 
   
Sotalol
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Green SI
Treatment of cardiac arrhythmias 
   
Atenolol tablets
(Hypertension & stable angina)
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Preferred
 
   
Bisoprolol tablets
(Hypertension & stable angina)
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Preferred
 
   
Nebivolol tablets
(Heart failure)
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Preferred
 
   
Labetalol tablets
(Hypertension & stable angina)
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Second Line
In pregnancy 
   
Metoprolol
(Hypertension & stable angina)
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Second Line
For migraine prophylaxis, adjunct in hyperthyroidism, arrhythmias 
   
Propranolol
(Hypertension & stable angina)
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Second Line
For hyperthyroid patients, patients with anxiety or increased sympathetic drive 
   
Esmolol
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Red SO
Treatment of supraventricular arrhythmias and peri-operative tachycardia and hypertension
 
   
Labetalol injection
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Red SO
Treatment of severe hypertension when rapid control of blood pressure is essential, anaesthesia when a hypotensive technique is indicated and hypertensive episodes following acute myocardial infarction
 
   
02.05  Drugs affecting the renin-angiotensin system and some other antihypertensive drugs
02.05.01  Vasodilator antihypertensive drugs
Ambrisentan
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Red SO
Treatment of pulmonary arterial hypertension
 
   
Bosentan
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Red SO
Treatment of pulmonary arterial hypertension and to reduce the number of new digital ulcers in patients with systemic sclerosis and ongoing digital ulcer disease
 
   
Hydralazine Injection
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Red SO
Treatment of hypertensive emergencies
 
   
Iloprost nebules
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Red SO
Treatment of pulmonary arterial hypertension
 
   
Macitentan
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Red SO
Treatment of pulmonary arterial hypertension
 
   
Riociguat (Adempas®)
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Red SO
Treatment of pulmonary arterial hypertension and thromboembolic pulmonary hypertension
 
   
Selexipag
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Red SO
Treatment of pulmonary arterial hypertension
 
   
Sildenafil
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Red SO
Pulmonary arterial hypertension
 
   
Tadalafil
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Red SO
Treatment of pulmonary arterial hypertension
 
   
02.05.02  Centrally acting antihypertensive drugs
02.05.03  Adrenergic neurone blocking drugs to top
02.05.04  Alpha-adrenoceptor blocking drugs
02.05.04  Phaeochromocytoma
02.05.05  Drugs affecting the renin-angiotensin system
Sacubitril & valsartan
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Green SI

Treatment of symptomatic chronic heart failure with reduced ejection fraction.

Specialist to complete SIDC

 
Link  Entresto - Drug Positioning Statement
Link  Entresto - Specialist Inititated Drug Checklist
Link  NICE TA388: Sacubitril valsartan for treating symptomatic chronic heart failure with reduced ejection fraction
   
02.05.05  Heart Failure
02.05.05.01  Angiotensin-converting enzyme inhibitors (ACE inhibitors) to top
Enalapril
(All licensed indications)
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Preferred
 
   
Lisinopril tablets
(All licensed indications)
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Preferred
 
   
Perindopril erbumine tablets
(All licensed indications)
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Preferred
 
   
Ramipril capsules/tablets
(All licensed indications)
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Preferred
 
   
Captopril 50 mg tablets TDS
(All licensed indications)
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Second Line
Overt nephropathy in Type 1 diabetes mellitus 
   
02.05.05.02  Angiotensin-II receptor antagonists
Losartan tablets
(All licensed indications)
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Preferred
 
   
Candesartan tablets
(All licensed indications)
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Preferred
 
   
Irbesartan tablets
(All licensed indications)
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Second Line
Nephropathy co-morbidity in diabetic patients 
   
Valsartan capsules
(All licensed indications)
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Second Line
Post MI with LVF or LVSD as adjunct 
   
02.05.05.03  Renin inhibitors
Aliskiren
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Formulary Use as fourth or fifth line option 
Link  Aliskiren - Drug Positioning Statement
   
02.06  Nitrates, calcium-channel blockers, and potassium-channel activators
02.06  Angina
02.06.01  Nitrates to top
Glyceryl trinitrate injection
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Red SO
Reduction of blood pressure during surgical procedures, control of myocardial ischaemia during and after cardiovascular surgery, treatment of unresponsive congestive heart failure and unstable angina
 
   
Glyceryl Trinitrate Spray
(Angina )
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Preferred
 
   
Isosorbide Mononitrate MR
(Angina)
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Preferred
 
   
Isosorbide Mononitrate standard release
(Angina)
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Second Line
 
   
02.06.02  Calcium-channel blockers
Amlodipine
(Hypertension & stable angina)
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Preferred
 
   
Verapamil tablets
(Hypertensioin & stable angina)
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Second Line
Also used insupraventricular arrhythmias 
   
Diltiazem modified release
(Hypertension & stable angina)
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Second Line
Intolerance/adverse reactions to amlodipine


Advice:
Prescribe modified release by brand, consult prescribing advisor for most cost effective brands 

   
Lercanidipine
(Hypertension & stable angina)
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Second Line
Intolerance/adverse reactions to amlodipine

Advice: Prescribe modified release by brand, consult prescribing advisor for most cost effective brands  

   
Nifedipine modified release
(Hypertension & stable angina)
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Second Line
Intolerance/adverse reaction to amlodipine if B Blocker co-prescribed



Advice:
Prescribe modified release by brand, consult prescriber advisor for most cost effective brands 

   
Nimodipine
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Red SO
Prevention of ischaemic neurological deficits following aneurysmal subarachnoid haemorrhage
 
   
Verapamil injection
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Red SO
Treatment of cardiac arrhythmias
 
   
02.06.03  Other anitanginal drugs
Ivabradine
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Green SA
Treatment of angina in patients in normal sinus rhythm
 
Link  Ivabradine [Chronic heart failure] - Drug Positioning Statement
Link  NICE TA267: Chronic heart failure - ivabradine
   
Ranolazine
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Green SA
Add-on therapy for the treatment of angina who are inadequately controlled or intolerant to first-line antianginal therapies
 
   
02.06.04  Peripheral vasodilators and related drugs
02.06.04  Other preparations used in peripheral vascular disease
02.07  Sympathomimetics to top
Midodrine
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Green SI
Treatment of severe orthostatic hypotension due to autonomic dysfunction
 
Link  Midodrine -Drug Positioning Statement
   
02.07.01  Inotropic sympathomimetics
Dobutamine
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Red SO
Inotropic support and cardiac stress testing
 
   
Dopamine
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Red SO
Treatment of cardiogenic shock in infarction or cardiac surgery
 
   
Dopexamine
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Red SO
Inotropic support and vasodilator in exacerbations of chronic heart failure and in heart failure associated with cardiac surgery
 
   
02.07.02  Vasoconstrictor sympathomimetics
Ephedrine injection
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Red SO
Reversal of low blood pressure resulting from spinal or epidural anaesthesia
 
   
Noradrenaline/norepinephrine
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Red SO
On-going treatment of hypotensive emergencies with escalating noradrenaline dose requirements
 
   
Phenylephrine injection
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Red SO
Treatment of hypotension
 
   
02.07.03  Cardiopulmonary resuscitation
02.08  Anticoagulants and protamine
Idarucizumab
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Red SO
Rapid reversal of anticoagulant effects of dabigatran etexilate
 
   
02.08.01  Parenteral anticoagulants to top
Argatroban
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Red SO
Anticoagulation in patients with heparin-induced thrombocytopenia type II who require parenteral antithrombotic therapy
 
   
02.08.01  Heparin
02.08.01  Low molecular weight heparins
Dalteparin
(Unlicensed indication)
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Amber SC
Prophylaxis and treatment of thrombosis and embolism in pregnancy - see links below
 
   
Dalteparin
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Green SA
In most scenarios (e.g. DVT prophylaxis in surgical settings)
LMWHs are within tariff and therefore acute provider should supply
 
   
Dalteparin
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Red SO
Surgical prophylaxis
 
   
Enoxaparin
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Red SO
Surgical prophylaxis
 
   
Enoxaparin
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Green SA
In most scenarios (e.g. DVT prophylaxis in surgical settings)
LMWHs are within tariff and therefore acute provider should supply
 
   
Enoxaparin
(Unlicensed indication)
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Amber SC
Prophylaxis and treatment thrombosis and embolism in pregnancy - see links below 
   
Tinzaparin
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Green SA
In most scenarios (e.g. DVT prophylaxis in surgical settings)
LMWHs are within tariff and therefore acute provider should supply
 
   
Tinzaparin
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Red SO
Surgical prophylaxis
 
   
Tinzaparin
(Unlicensed indication)
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Amber SC
Prophylaxis and treatment of thrombosis and embolism in pregnancy - see links below 
   
02.08.01  Heparinoids
Danaparoid
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Red SO
Prevention of deep vein thrombosis in general or orthopaedic surgery.Treatment of thrombo-embolic disorders in history of heparin-induced thrombocytopenia
 
   
02.08.01  Hirudins
Bivalirudin
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Red SO
Anticoagulation in patients undergoing percutaneous coronary intervention and treatment of unstable angina/non-ST segment elevation myocardial infarction
 
Link  NICE CG94: Unstable angina and NSTEMI
Link  NICE TA230 : Bivalirudin for the treatment of STEMI, 2011
   
02.08.01  Heparin flushes to top
02.08.01  Epoprostenol
Epoprostenol (prostacyclin)
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Red SO
Inhibition of platelet aggregation during renal dialysis and treatment of primary pulmonary hypertension resistant to other treatments
 
   
02.08.01  Fondaparinux
Fondaparinux sodium
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Red SO
Prophylaxis and treatment of venous thromboembolic events, treatment of unstable angina and ST-segment and non-ST-segment elevation myocardial infarction
 
   
02.08.02  Oral anticoagulants
02.08.02  Stroke prevention in AF
Apixaban
(AF)
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Formulary
Green SA

Treatment and prevention of thromboembolic events, and stroke prevention in atrial fibrillation

Specialist to complete SIDC

 
Link  Apixaban - Specialist Intiated Drug Checklist
Link  Apixaban (AF) - Drug Positioning Statment
Link  NICE TA275: Stroke and systemic embolism (prevention, non-valvular atrial fibrillation) - apixaban
   
Dabigatran
(AF)
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Formulary
Green SA

Treatment and prevention of thromboembolic events, and stroke prevention in atrial fibrillation

Specialist to complete SIDC

 
Link  Dabigatran - Specialist Initated Drug Checklist
Link  Dabigatran (AF) - Drug Positioning Statement
Link  NICE TA249: Dabigatran for Stroke prevention in AF
   
Edoxaban
(AF)
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Green SA

Treatment and prevention of thromboembolic events, and stroke prevention in atrial fibrillation

Specialist to complete SIDC

 
Link  Edoxaban - Specialist Initated Drug Checklist
Link  Edoxaban (AF) - Drug Positioning Statement
Link  NICE TA355: Edoxaban for preventing stroke and systemic embolism in people with non-valvular atrial fibrillation
   
Rivaroxaban
(AF)
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Green SA

Treatment and prevention of thromboembolic events, and stroke prevention in atrial fibrillation

Specialist to complete SIDC

 
Link  Rivaroxaban - Specialist Initated Drug Checklist
Link  Rivaroxaban (AF) - Drug Positioning Statement
Link  NICE TA256: Rivaroxaban for AF
Link  NICE TA335: Rivaroxaban for preventing adverse outcomes after acute management of acute coronary syndrome
   
02.08.02  Atrial Fibrillation to top
02.08.02  VTE treatment
02.08.02  VTE prophylaxis in hip/knee surgery
Apixaban
(VTE)
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Red SO
Prophylaxis of venous thromboembolism following knee or hip surgery -
full course to be given post operation by provider

 
Link  Apixaban (VTE) - Drug Positioning Statement
Link  NICE TA245: Venous thromboembolism apixaban (hip & knee surgery)
Link  NICE TA341: Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism
   
Dabigatran
(VTE)
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Red SO
Prophylaxis of venous thromboembolism following knee or hip surgery -
full course to be given post operation by provider

 
Link  Dabigatran (VTE) - Drug Positioning Statement
Link  NICE TA157: Venous thromboembolism - dabigatran
Link  NICE TA327: Dabigatran etexilate for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism
   
Edoxaban
(VTE)
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Red SO
Prophylaxis of venous thromboembolism following knee or hip surgery -
full course to be given post op by provider
 
Link  Edoxaban (VTE) - Drug Positioning Statement
Link  NICE TA354: Edoxaban for treating and for preventing deep vein thrombosis and pulmonary embolism
   
Rivaroxaban
(VTE)
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Formulary
Red SO
Prophylaxis of venous thromboembolism following knee or hip surgery -
full course to be given post operation by provider
 
Link  NICE TA287: Rivaroxaban for treating PE and preventing recurrent venous thromboembolism
Link  Rivaroxaban (VTE) - Drug Positioning Statement
Link  Rivaroxaban for treatment of DVT
   
02.08.02  VTE Prophylaxis
02.08.03  Protamine sulphate
Protamine sulphate
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Red SO
Used to counteract the anticoagulant effects of heparin
 
   
02.09  Antiplatelet drugs to top
Aspirin 75 mg dispersible tablets
(antiplatelet)
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Preferred
 
   
Clopidogrel
(All licensed indications)
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Second Line
 
   
Dipyridamole modified release
(All licensed indications)
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Second Line
 
   
Prasugrel
(All licensed indications)
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Formulary
Green SI

Prevention of atherothrombotic events in patients with acute coronary syndrome undergoing percutaneous coronary intervention

SecondLine-

 
Link  NICE TA317: Prasugrel with percutaneous coronary intervention for treating acute coronary syndromes (review of technology appraisal guidance 182)
   
Ticagrelor (Brilique®)
(All licensed indications)
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Formulary
Green SI

Prevention of atherothrombotic events in patients with Acute Coronary Syndrome - Use in combination with aspirin for 12 months only

SecondLine-

 
Link  Ticagrelor - Drug Positioning Statement
Link  NICE TA236: Acute coronary syndromes - ticagrelor
   
Tirofiban
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Red SO
Treatment of myocardial infarction
 
   
Abciximab
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Red SO
Prevention of ischaemic cardiac complications in patients undergoing percutaneous coronary intervention. Short-term prevention of myocardial infarction in patients with unstable angina not responding to conventional treatment and who are scheduled for percutaneous coronary intervention
 
   
Cangrelor
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Red SO
Reduction of thrombotic cardiovascular events in patients with coronary artery disease undergoing percutaneous coronary intervention
 
   
Eptifibatide (Integrilin®)
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Red SO
Prevention of early myocardial infarction in unstable angina or non-ST-segment-elevation myocardial infarction
 
   
02.10  Stable angina, acute coronary syndromes, and fibrinolysis
02.10.01  Management of stable angina and acute coronary syndromes
02.10.02  Fibrinolytic drugs
Alteplase
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Formulary
Red SO
Thrombolytic treatment in acute myocardial infarction or acute massive pulmonary embolism or occluded central venous access devices, fibrinolytic treatment of acute ischaemic stroke
 
Link  NICE TA264: Ischaemic stroke (acute) - alteplase
   
Streptokinase
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Red SO
Treatment of acute myocardial infarction, deep vein thrombosis, pulmonary embolism, acute arterial thromboembolism and central retinal thrombosis
 
   
Tenecteplase
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Red SO
Treatment of acute myocardial infarction
 
   
Urokinase
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Red SO
Lysis of blood clots in thrombosed intravascular catheters and cannulae, extensive acute proximal deep vein thrombosis, acute massive pulmonary embolism, acute occlusive peripheral arterial disease with limb threatening ischemia
 
   
02.11  Antifibrinolytic drugs and haemostatics
Eftrenonacog alfa
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Red SO
Treatment and prophylaxis of bleeding in haemophilia B (congenital factor IX deficiency)
 
   
Fibrinogen
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Red SO
Treatment of haemorrhage in congenital hypofibrinogenaemia or afibrinogenaemia
 
   
Human coagulation factor X
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Red SO
Treatment and prophylaxis in hereditary factor X deficiency
 
   
Tranexamic Acid
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Red SO
Prevention and treatment of haemorrhages due to general or local fibrinolysis
 
   
Turoctocog alfa
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Formulary
Red SO
Treatment and prophylaxis of bleeding in haemophilia A
 
   
02.11  Blood-related products to top
Albutrepenonacog alfa
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Red SO
Treatment and prophylaxis of bleeding in patients with haemophilia B
 
   
Dried prothrombin complex
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Red SO
Treatment and prophylaxis of bleeding in deficiency of prothrombin complex coagulation factors and any of the vitamin K dependent coagulation factors
 
   
Factor VIIa recombinant with eptacog alfa
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Formulary
Red SO
Treatment and prophylaxis of haemorrhage in patients with haemophilia A or B with inhibitors to factors VIII or IX, acquired haemophilia, factor VII deficiency, or Glanzmann’s thrombasthenia
 
   
Factor VIII Inhibitor Bypassing Fraction
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Formulary
Red SO
Treatment and prophylaxis of haemorrhage in patients with congenital factor VIII deficiency (haemophilia A) and factor VIII inhibitors
Treatment of haemorrhage in non-haemophiliac patients with acquired factor VIII inhibitors
 
   
Factor XIII Fraction, Dried
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Formulary
Red SO
Treatment of congenital Factor XIII deficiency
 
   
Human coagulation factor IX
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Formulary
Red SO
Treatment and prophylaxis of bleeding in haemophilia B
(congenital factor IX deficiency)
 
   
Human coagulation factor VIII, octocog alpha
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Formulary
Red SO
Treatment and prophylaxis of bleeding in patients with haemophilia A
(congenital factor VIII deficiency)
 
   
Human plasma protein
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Formulary
Red SO
Treatment of coagulation factor deficiencies, rapid reversal of oral anticoagulants,haemorrhage treatment during fibrinolytic therapy, therapeutic plasma exchange
 
   
Nonacog alpha Factor IX fraction
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Formulary
Red SO
Treatment and prophylaxis of bleeding in patients with haemophilia B
(congenital factor IX deficiency) 
   
Nonacog gamma
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Formulary
Red SO
Treatment and prophylaxis of bleeding in patients with haemophilia B
 
   
Protein C Concentrate (Ceprotin®)
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Formulary
Red SO
Treatment and prophylaxis of protein C deficiency
 
   
Susocotog alfa
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Formulary
Red SO
Treatment of bleeding episodes in patients with acquired haemophilia caused by antibodies to Factor VIII
 
   
02.12  Lipid-regulating drugs
Alirocumab
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Formulary
Red SO
High Cost Medicine
BlueTeq

Treatment of primary hypercholesterolemia and mixed dyslipidaemia

 
Link  NICE TA393: Alirocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia
   
Evolocumab
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Formulary
Red SO
High Cost Medicine
BlueTeq

Treatment of primary hypercholesterolaemia and mixed dyslipidaemia

 
Link  NICE TA394: Evolocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia
   
Lomitapide
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Formulary
Red SO
Adjunct to a low-fat diet and other lipid-lowering medicinal products with or without low density lipoprotein apheresis in adult patients with homozygous familial hypercholesterolaemia
 
   
02.12  Bile acid sequestrants
Colesevelam (Cholestagel®)
(Unlicensed indication)
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Formulary
Amber SC
Bile acid malabsorption  
Link  Colesevelam - shared care agreement
   
02.12  Ezetimibe
Ezetimibe (Ezetrol®)
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Formulary
Second Line
 
Link  NICE TA385: Ezetimibe for treating primary heterozygous-familial and non-familial hypercholesterolaemia
   
02.12  Fibrates
02.12  Statins to top
Atorvastatin tablet
(All licensed indications)
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Formulary
Preferred
 
   
Pravastatin tablets
(All licensed indications)
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Formulary
Preferred
 
   
Simvastatin tablets
(All licensed indications)
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Formulary
Preferred
 
   
Rosuvastatin tablets
(All licensed indications)
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Formulary
Second Line
For use in exceptional circumstances such as HIV co-mobidity and adverse reaction to preferred choices 
   
02.12  Nicotinic acid group
02.12  Omega-3 fatty acid compounds
Omega-3-Acid Ethyl Esters
(Unlicensed indication)
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Formulary
Green SI
Management of hypertriglyceridaemia, reducing the risk of pancreatitis
 
   
02.12  Other lipid modifying agents
02.13  Local sclerosants
 ....
 Non Formulary Items
Acebutolol  (Sectral®)

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Non Formulary
Non Formulary
In all forms
 
Acipimox  (Olbetam®)

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Non Formulary
Black BL
Not recommended by NICE
Link  Lipid Modification guidelines
 
Amlodipine & Valsartan  (Exforge®)

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Non Formulary
Black BL

Combination not cost-effective

Advice: Prescribe formulary choice of ACE Inhibitor (or Angiotensin Receptor Blocker if not appropriate) with separate amlodipine

 
Amlodipine besilate

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Non Formulary
Non Formulary
 
Aspirin ec

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Non Formulary
Non Formulary
 
Atenolol/Nifedipine combination  (Tenif®)

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Non Formulary
Black BL

Combination not cost-effective

Advice: Prescribe as separate ingredients.
Amlodipine preferred to nifedipine

 
Atorvastatin 30 mg, 60 mg & chewable tablets

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Non Formulary
Non Formulary
 
Azilsartan  (Edarbi®)

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Non Formulary
Not Recommended

Not recommended by the APC, consider formulary ACE inhibitor or angiotensin Receptor Blocker if ACE is inappropriate

Link  Azilsartan - Drug Positioning Statement
 
Bumetanide liquid

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Non Formulary
Non Formulary
 
Captopril & Hydrochlorothiazide

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Non Formulary
Non Formulary
 
Celiprolol

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Non Formulary
Non Formulary
In all forms
 
Chlorothiazide
(Hypertension)

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Non Formulary
Non Formulary
 
Cilostazol  (Pletal®)

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Non Formulary
Not Recommended

Not as clinically effective compared with placebo as naftidrofuryl oxalate, consider naftidrofuryl if drug required and review effect

 
Clonidine  (Catapres®)
(Hypertension)

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Non Formulary
Black BL

BNF: Less suitable for prescribing

Advice: Consider alternative formulary antihypertensive agents

 
Clopidogrel hydrogen sulfate

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Non Formulary
Non Formulary
 
Co-tenidone
((Atenolol & chlortalidone))

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Non Formulary
Non Formulary

In all forms

 
Cyclopenthiazide  (Navidrex®)

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Non Formulary
Non Formulary
 
Dipyridamole standard release

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Non Formulary
Non Formulary
 
Doxazosin
(All brands of modified release)

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Non Formulary
Black BL

No therapeutic advantage over immediate release

Advice: Use immediate release doxazosin

 
Enalapril & Hydrochlorothiazide  (Innozide®)

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Non Formulary
Non Formulary
 
Eprosartan  (Teveten®)

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Non Formulary
Non Formulary
In all forms
 
Felodipine

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Non Formulary
Non Formulary
 
Fluvastatin

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Non Formulary
Non Formulary
 
Fosinopril

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Non Formulary
Non Formulary
 
Furosemide + Potassium  (Diumide-K Continus®)

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Non Formulary
Black BL

BNF: Less suitable for prescribing

Advice: Prescribe as separate ingredients, however additional potassium not usually required.
Amiloride preferable to potassium supplements

 
Glyceryl trinitrate 2% ointment

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Non Formulary
Non Formulary
Prophylaxis of angina
 
Glyceryl trinitrate patches

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Non Formulary
Non Formulary
 
Glyceryl Trinitrate sub-lingual tablets
(GTN)

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Non Formulary
Black BL

Short expiry once opened. GTN sprays preferred as longer shelf life once opened

Advice: GTN spray

 
Guanethidine Monosulphate  (Ismelin®)

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Non Formulary
Not Recommended
Control of hypertensive crises and to obtain more rapid blood pressure control
 
Imidapril  (Tanatril®)

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Non Formulary
Non Formulary
 
Indapamide  (Natrilix®)

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Non Formulary
Non Formulary
 
Indapamide  (Natrilix-SR®)

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Non Formulary
Non Formulary
 
Inositol Nicotinate  (Hexopal®)

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Non Formulary
Not Recommended

Not as clinically effective compared with placebo as Naftidrofuryl Oxalate (NICE TA223 - May 2011.

Consider naftidrofuryl for PVD if drug required and review effect. 

For use as a vitamin - use recommended vitamin B products

 
Irbesartan & hydrochlorothiazide

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Non Formulary
Non Formulary
 
Isosorbide dinitrate

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Non Formulary
Non Formulary
In all forms
 
Lacidipine

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Non Formulary
Non Formulary
 
Lisinopril & Hydrochlorothiazide

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Non Formulary
Non Formulary
 
Metoprolol LA
(All brands)

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Non Formulary
Non Formulary
 
Moexipril  (Perdix®)

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Non Formulary
Non Formulary
 
Moxisylyte  (Opilon®)

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Non Formulary
Black BL

BNF: Less suitable for prescribing

Advice: Consider nifedipine for Reynaud's

 
Nifedipine SR

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Non Formulary
Non Formulary
 
Olmesartan  (Sevikar®)

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Non Formulary
Non Formulary
In all forms
 
Olmesartan & hydrochlorothiazide

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Non Formulary
Non Formulary
In all forms
 
Omega-3-Acid Ethyl Esters

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Non Formulary
Black BL

Blacklisted item except for reducing the risk of pancreatitis (unlicensed indication) - view above sub-chapter

Advice: Food supplement: intended for patient to purchase

 
Oxerutins  (Paroven®)

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Non Formulary
Black BL

BNF: Less suitable for prescribing

Advice: Naftidrofuryl is the only suitable alternative in PVD

 
Pentoxifylline  (Trental®, Neotren MR®, Pentofin®)

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Non Formulary
Not Recommended

Not as clinically effective compared with placebo as Naftidrofuryl Oxalate, consider naftidrofuryl if drug required and review effect

 
Perindopril arginine  (Coversyl® Arginine)

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Non Formulary
Black BL

No advantage over erbumine salt

Advice: Prescribe as erbumine salt - 4 mg erbumine = 5 mg arginine

 
Perindopril arginine with indapamide  (Coversyl Arginine Plus®)

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Non Formulary
Black BL

No advantage over erbumine salt. Combinations not cost-effective

Advice: Prescribe perindopril as erbumine and indapamide 2.5 mg tablets. 4 mg erbumine = 5 mg arginine

 
Pindolol

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Non Formulary
Non Formulary
In all forms
 
Pindolol & Clopamide  (Viskaldix®)

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Non Formulary
Non Formulary

In all forms

 
Propranolol LA
(Cardivascular indication)

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Non Formulary
Non Formulary
 
Quinapril  (Accupro®)

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Non Formulary
Non Formulary
In all forms
 
Quinapril & Hydrochlorothiazide

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Non Formulary
Non Formulary
 
Ramipril & Felodipine  (Triapin®)

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Non Formulary
Black BL

Expensive combination

Advice: Prescribe felodipine and ramipril separately. Amlodipine preferred to felodipine

 
Simvastatin  (Zocor®)

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Non Formulary
Black BL
Prescribe generically
 
Simvastatin with Ezetimibe  (Inegy®)

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Non Formulary
Black BL

Combination not cost-effective

Advice: Review the need for ezetimibe in line with lipid modification guidelines.
If both drugs appropriate, prescribe separately

 
Telmisartan

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Non Formulary
Non Formulary
In all forms
 
Telmisartan & hydrochlorothiazide

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Non Formulary
Non Formulary
In all forms
 
Timolol

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Non Formulary
Non Formulary
In all forms
 
Timolol Maleate and Bendroflumethiazide  (Prestim®)

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Non Formulary
Non Formulary
In all forms
 
Torasemide

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Non Formulary
Non Formulary
 
Trandolapril  (Gopten®)

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Non Formulary
Non Formulary
In all forms
 
Trandolapril & Verapamil  (Tarka®)

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Non Formulary
Black BL

Combination not cost-effective

Advice: Consider formulary ACE inhibitor and prescribe verapamil separately

 
Valsartan & hydrochlorothiazide

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Non Formulary
Non Formulary

In all forms

 
Verapamil MR

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Non Formulary
Non Formulary
 
Xipamide  (Diurexan®)

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Non Formulary
Non Formulary
 
  
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
Blueteq
High Cost Drug Approval System

Traffic Light Status Information

Status Description

Preferred

Clinicians are free to prescribe these drugs. They are regarded as cost effective choices which have evidence to support their use.  

Second Line

These drugs should only be prescribed in the scenarios described in the formulary after preferred drug(s) have been ruled out.  

Non Formulary

Non-formulary choice - the vast majority of a patient’s needs should be met by use of formulary preferred choices and second line options when appropriate. Therefore the Clinician should only use a non-formularly drug if this can be justified and it is recommended that all such instances are recorded in the patient record.  

Green SA

Specialist Advised – Specialists may simply advise a patient’s GP to initiate these drugs themselves after they have made an initial assessment. Note: SA drugs can be initiated by the specialist according to patient need and also depending on local commissioning arrangements which may mandate, through the contract between provider and commissioner, that all SA drugs are treated as SI.  

Green SI

Specialist Initiation - These drugs must be initiated, i.e. the first dose prescribed, by the specialist and then may be continued when appropriate by the patient’s GP following communication from the specialist.  

Amber SC

Shared Care - Responsibility for prescribing may be transferred from secondary to primary care with the agreement of an individual GP and when agreed shared care arrangements have been established. The specialist MUST stabilize the patient before asking for care to be transferred. Only specialists should initiate these drugs. Prescribing should be transferred to GPs according to an Shared Care Agreement [SCA]   

Red SO

Specialist Only - These drugs are deemed to be not appropriate for prescribing by GPs. Specialists should not ask GPs to prescribe these drugs.   

Black BL

Black Listed Medicines - These drugs are considered inappropriate for prescribing in Coventry & Warwickshire as they are either not cost-effective or of proven benefit or both.   

Not Recommended

Not Recommended - These are specialist drugs that are not recommended for use.  

netFormulary