| Formulary Chapter 6: Endocrine system - Full Chapter
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| Notes: |
This chapter is mostly updated. The section still outstanding is 6.4.1.1 (oestrogens and HRT).
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| Chapter Links... |
 BSSE APC Risk assessment- High strength insulins/ Biosimilars/ Fixed combination |
| Gender dysphoria: Primary Care Responsibilities in Prescribing and Monitoring Hormone Therapy for Transgender and Non-Binary Adults (updated) |
| Guidelines for the use of blood glucose meters, test strips and lancets in diabetes |
| Insulin pen needles (June 2018) |
| Details... |
| 06.01 |
Drugs used in diabetes |
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| 06.01.01.01 |
Short-acting insulins |
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Insulin (Actrapid®)
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Formulary
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Insulin (Humulin® S)
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Formulary
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Insulin (Insuman® Rapid)
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Formulary
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Insulin Aspart (Fiasp®)
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Formulary
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- For use only in gestational diabetes only
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Insulin Aspart (NovoRapid®)
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Formulary
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Insulin Glulisine (Apidra®)
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Formulary
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Insulin Lispro 100 units/mL (Humalog 100 units/mL ®)
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Formulary
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| 06.01.01.02 |
Intermediate- and long-acting insulins |
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Insulin detemir (Levemir®)
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Formulary
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Insulin glargine 100 units/mL biosimilar (Abasaglar®)
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Formulary
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Prescribe by brand as recommended by MHRA.
First line for new patients initiated on insulin glargine 100 units/mL
Substitution and automatic switching from Lantus® to Abasaglar®CANNOT BE UNDERTAKEN.
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Answers to commonly asked questions about biosimilar versions of insulin glargine
Risk Assessment- High Strength Insulins/ Biosimilars/ Fixed Combination
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Insulin glargine 100 units/mL (Lantus®)
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Formulary
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£
Prescribe by brand
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Insulin glargine 300 units/mL (Toujeo®)
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Formulary
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Prescribe by brand
Reconsidered and approved in April 2017
Specialist initiation.
Supported by RICaD
For patients who require more than 80 units of insulin glargine per day and who are troubled by nocturnal hypos. Transfer to Primary Care should not happen until specialists can demonstrate reduction in nocturnal hypos (e.g. after 3-4 months).
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Risk Assessment- High Strength Insulins/ Biosimilars/ Fixed Combination
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Isophane Insulin (Humulin® I)
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Formulary
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Isophane Insulin (Insulatard®)
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Formulary
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Isophane Insulin (Insuman® Basal)
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Formulary
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Insulin degludec 100 units/mL (Tresiba®)
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Formulary
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- To avoid the use of an insulin pump in patients with Type 1 diabetes who have nocturnal/severe hypoglycaemia as defined in NICE TA 151 OR recurrent DKA despite good compliance with current insulin regime
- Specialist initiation
- Supported by a RICaD, see link below.
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RICaD: Insulin degludec
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Insulin degludec 100 units/mL (Tresiba®)
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Formulary
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- Specialist use only
- For the treatment of patients with Type 2 diabetes who have nocturnal / severe hypoglycaemia or those with recurrent hypoglycaemic episodes requiring hospital admission
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| 06.01.01.02 |
Biphasic insulins |
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Biphasic Insulin Aspart (NovoMix® 30)
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Formulary
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Biphasic Insulin Lispro (Humalog® Mix)
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Formulary
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Humalog Mix25
Humalog Mix50
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Biphasic Isophane Insulin (Humulin® M3)
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Formulary
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Biphasic Isophane Insulin (Insuman® Comb)
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Formulary
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Insuman Comb 15
Insuman Comb 25
Insuman Comb 50
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| 06.01.02 |
Antidiabetic drugs |
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| 06.01.02.01 |
Sulphonyureas |
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Gliclazide
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First Choice
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Gliclazide M/R
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Second Choice
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Glibenclamide
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Formulary
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For patients who do not want to move to insulin but not responding to metformin
Use in pregnancy as per NICE
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NICE NG 3: Diabetes in pregnancy: management of diabetes and its complications from preconception to the postnatal period
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Glimepiride
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Formulary
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Metformin
(Standard release tablets)
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First Choice
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UKMI Q&A: Metformin for hirsutism in polycystic ovary syndrome
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Metformin M/R
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Second Choice
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Only for patients intolerant of slowly titrated standard release metformin
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Metformin oral solution SF
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Second Choice
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For patients with swallowing difficulties £££
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| 06.01.02.03 |
Other antidiabetic drugs |
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| 06.01.02.03 |
DPP-4 inhibitors |
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| 06.01.02.03 |
Alpha glucosidase inhibitors |
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| 06.01.02.03 |
GLP-1 mimetics |
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| 06.01.02.03 |
DPP4 inhibitors (gliptins) |
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Alogliptin (Vipidia▼®)
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First Choice
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Linagliptin (Trajenta®)
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Formulary
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In line with NICE
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Sitagliptin (Januvia®)
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Formulary
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In line with NICE
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| 06.01.02.03 |
SGLT2 inhibitors |
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Canagliflozin (Invokana▼®)
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Formulary
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SGLT2 inhibitors: updated advice on the risk of diabetic ketoacidosis
In line with NICE
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NICE TA315: Canagliflozin in combination therapy for treating type 2 diabetes (June 2014)
NICE TA390: Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes (May 2016)
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Dapagliflozin (Forxiga▼®)
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Formulary
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SGLT2 inhibitors: updated advice on the risk of diabetic ketoacidosis
In line with NICE
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NICE TA288: Dapagliflozin in combination therapy for treating type 2 diabetes (June 2013)
NICE TA390: Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes (May 2016)
NICE TA418: Dapagliflozin in triple therapy for treating type 2 diabetes (November 2016)
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Empagliflozin (Jardiance▼®)
(![]())
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Formulary
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SGLT2 inhibitors: updated advice on the risk of diabetic ketoacidosis
In line with NICE
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NICE TA336: Empagliflozin in combination therapy for treating type 2 diabetes (Mar 2015)
NICE TA390: Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes (May 2016)
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| 06.01.02.03 |
GLP1 agonists |
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Dulaglutide (Trulicity®)
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Formulary
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NOT for monotherapy
NOT in combination with insulin
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Exenatide (Byetta®)
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Formulary
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In line with NICE guidance
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NICE NG28: Type 2 diabetes in adults: management (Dec 2015)
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Exenatide prolonged release (Bydureon®)
|
Formulary
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NICE NG28:Type 2 diabetes in adults: management (Dec 2015)
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Liraglutide (Victoza®)
|
Formulary
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For the treatment of type 2 diabetes ONLY.
In line with NICE
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NICE NG28: Type 2 diabetes in adults: management (Dec 2015)
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Lixisenatide (Lyxumia®)
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Formulary
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1st line GLP1 for co-prescribing with insulin
Supported by a RICaD (in development)
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Repaglinide
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Formulary
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| 06.01.02.03 |
SGL2 inhibitors |
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| 06.01.02.03 |
Thiazolidinediones |
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Pioglitazone
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Formulary
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| 06.01.02.05 |
Glucagon-like peptide-1 receptor agonists - once weekly |
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| 06.01.02.07 |
Other antidiabetic drugs |
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| 06.01.03 |
Diabetic ketoacidosis |
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| 06.01.04 |
Treatment of hypoglycaemia |
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Glucagon (GlucaGen® HypoKit)
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Formulary
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GlucoGel®
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Formulary
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Treatment of hypoglycaemia (Rapilose® gel)
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Formulary
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| 06.01.04 |
Chronic hypoglycaemia |
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| 06.01.05 |
Treatment of diabetic nephropathy and neuropathy |
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| 06.01.05 |
Diabetic nephropathy |
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| 06.01.05 |
Diabetic neuropathy |
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| 06.01.06 |
Diagnostic and monitoring agents for diabetes mellitus |
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| 06.01.06 |
Blood glucose monitoring |
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Blood Glucose Meters
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Formulary
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Guideline for the choice of blood glucose meters, test strips and lancets in diabetes
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| 06.01.06 |
Urinalysis |
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| 06.01.06 |
Oral glucose tolerance test |
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| 06.02 |
Thyroid and Antithyroid drugs |
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| 06.02.01 |
Thyroid hormones |
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Levothyroxine
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Formulary
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Liothyronine
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Formulary
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Tablets
Injection
|
 Patient information leaflet
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| 06.02.02 |
Antithyroid drugs |
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Carbimazole
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Formulary
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Propylthiouracil
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Formulary
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Iodine and Iodide
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Formulary
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- Potassium iodide tablets 65mg
- Potassium iodate 85mg
- Aqueous Iodine Oral solution
- Also known as Lugol's Iodine
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| 06.03 |
Corticosteroids |
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| 06.03.01 |
Replacement therapy |
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Fludrocortisone
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Formulary
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| 06.03.02 |
Glucocorticoid therapy |
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Betamethasone
(parenteral)
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Formulary
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Dexamethasone
|
Formulary
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Tablets £££
Oral solution SF £££
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Dexamethasone phosphate injection
|
Formulary
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Hydrocortisone
|
Formulary
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Standard release tablets only
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Hydrocortisone sodium succinate (Solu-Cortef®)
|
Formulary
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Methylprednisolone acetate injection (Depo-Medrone® )
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Formulary
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See chapter 10
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Methylprednisolone sodium succinate injection (Solu-Medrone ®)
|
Formulary
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Methylprednisolone tablets
|
Formulary
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In line with NICE
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NICE CG186: Multiple Sclerosis in adults; management
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Prednisolone
|
Formulary
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Plain tablets
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UKMI Q&A: Is there any evidence to support the use of enteric coated (EC) over uncoated prednisolone tablets?
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Triamcinolone (Kenalog®)
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Formulary
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See Chapter 10
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| 06.03.02 |
Disadvantages of corticosteroids |
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| 06.03.02 |
Use of corticosteroids |
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| 06.03.02 |
Pregnancy and breastfeeding |
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| 06.03.02 |
Withdrawal of corticosteroids |
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| 06.04.01 |
Female sex hormones and their modulators |
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| 06.04.01.01 |
Oestrogens and HRT |
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Tibolone (Livial®)
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Formulary
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Second line
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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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For induction of puberty in female patients who cannot tolerate or are allergic to first-line patches.
2 mcg- unlicensed special
10 mcg ££
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Raloxifene Hydrochloride (Evista®)
|
Formulary
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In line with NICE
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NICE TA160: quick reference guide on osteoporosis
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Medroxyprogesterone Acetate
|
Formulary
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Climanor®
Provera®
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Norethisterone
|
Formulary
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Progesterone (Crinone®)
(vaginal gel)
|
Formulary
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Progesterone (Cyclogest®)
(pessaries)
|
Formulary
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Recurrent miscarriage (off label use)
Fertility (off label use)
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Progesterone (micronised) (Utrogestan®)
|
Formulary
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Supported by a RICaD
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Ulipristal acetate (Esmya®)
|
Formulary
|
July 2018 - Traffic light status amended to RED in light of EMA update. See 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).
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EMA June 2018: Esmya new measures to mimimise risk of rare but serious liver injury
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| 06.04.02 |
Male sex hormones and antagonists |
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Testosterone gel
(Transdermal preparations)
|
Formulary
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Testim
Testogel
Tostran
use in women with low libido approved by APC (unlicensed). Specialist to initiate and issue first supply.
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Testosterone injection (Sustanon 250®)
|
Formulary
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Testosterone undecanoate injection
|
Formulary
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Testosterone undecanoate oral (Restandol Testocaps®)
|
Formulary
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For paediatric directorate only
For induction of puberty
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Testosterone implants
|
Formulary
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Finasteride (5mg tablets)
|
Formulary
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In men only
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Dutasteride (Avodart®)
|
Formulary
|
supported by a RICaD (in development)
When finasteride has failed or is contraindicated/not tolerated
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Cyproterone Acetate
|
Formulary
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Finasteride (1mg tablets)
|
Formulary
|
- for Hyperandrogenism in women (unlicensed)
- Black listed in NHS primary care
|
Link to section 13.9
|
| 06.04.03 |
Anabolic steroids |
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Nandrolone (Deca-Durabolin®)
|
Formulary
|
Hospital only
|
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Oxandrolone Tablets 2.5 mg
|
Formulary
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|
| 06.04.04 |
Gender dysphoria |
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| 06.05 |
Hypothalamic and pituitary hormones and anti-oestrogens |
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| 06.05.01 |
Hypothalamic and anterior pituitary hormones and anti-oestrogens |
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Clomifene Citrate
|
Formulary
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For ovulation induction
On specialist recommendation
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| 06.05.01 |
Anterior pituitary hormones |
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Choriogonadotropin Alfa (Ovitrelle®)
|
Formulary
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Hospital only
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Human Chorionic Gonadotrophin
|
Formulary
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Human Menopausal Gonadotrophins
(menotrophin)
|
Formulary
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Somatropin
|
Formulary
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|
NICE TA188: Human growth hormone (somatropin) for the treatment of growth failure in children (review)
NICE TA64: Growth hormone deficiency (adults) - human growth hormone
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Tetracosactide (Synacthen®, Synacthen Depot® )
|
Formulary
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| 06.05.01 |
Hypothalmic hormones |
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Protirelin (TRH)
|
Formulary
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| 06.05.02 |
Posterior pituitary hormones and antagonists |
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| 06.05.02 |
Posterior pituitary hormones |
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Desmopressin
|
Formulary
|
Tablets
Melts (60mcg, 120mcg and 240mcg only)£££
Nasal solution
Nasal spray (10mcg/dose)
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| 06.05.02 |
Antidiuretic hormone antagonists |
|
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Demeclocycline (capsules)
|
Formulary
|
in the treatment of hyponatraemia resulting from inappropriate secretion of antidiuretic hormone. UNLICENSED
|
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Tolvaptan (Jinarc®)
|
Formulary
|
In line with NICE
|
NICE TA 358:Tolvaptan for treating autosomal dominant polycystic kidney disease
|
Tolvaptan (Samsca®)
|
Formulary
|
Currently NOT ROUTINELY COMMISSIONED BY NHS ENGLAND for the treatment of adult patients with hyponatraemia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH).
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Drug safety update: tolvaptan (Samsca) -risk of liver injury
MHRA Warning
|
| 06.06 |
Drugs affecting bone metabolism |
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| 06.06.01 |
Calcitonin and parathyroid hormone |
|
|
Calcitonin (salmon) / Salcatonin
|
Formulary
|
Injection
Nasal spray
|
|
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Parathyroid Hormone
|
Formulary
|
Injection
|
|
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Teriparatide (Forsteo®)
|
Formulary
|
In line with NICE
|
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| 06.06.02 |
Bisphosphonates and other drugs affecting bone metabolism |
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Alendronic Acid tablets
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First Choice
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Risedronate
|
Second Choice
|
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|
|
Alendronic Acid (Binosto®)
(70mg effervescent tablets)
|
Formulary
|
£££
Third line option in individuals who have not tolerated first line alendronate tablets and second line risedronate tablets and in whom a bone-sparing agent is still considered clinically necessary.
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|
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Disodium Pamidronate
|
Formulary
|
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|
|
Ibandronic Acid 150mg
|
Formulary
|
Supported by an ESCA (in development)
|
|
|
Ibandronic Acid 50mg
|
Formulary
|
For skeletal events in metastatic breast cancer.
Supported by an ESCA, see link below.
|
ESCA: Ibandronic acid 50mg
|
Ibandronic Acid injection
|
Formulary
|
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|
|
Sodium Clodronate
|
Formulary
|
For the management of osteolytic lesions, bone pain and hypercalcaemia associated with multiple myeloma or breast cancer.
Supported by an ESCA, see link below.
|
ESCA: Sodium clodronate
|
Zoledronic Acid
|
Formulary
|
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Denosumab (Prolia®)
|
Formulary
|
Use in postmenopausal osteoporosis is supported by an ESCA, see link below.
|
ESCA: Denosumab
NICE TA204: Osteoporotic fractures - denosumab
|
Denosumab (XGEVA®)
|
Formulary
|
|
NICE TA265: Bone metastases from solid tumours - denosumab
|
| 06.06.02 |
Strontium renelate |
|
|
| 06.07 |
Other endocrine drugs |
|
|
| 06.07.01 |
Bromocriptine and other dopaminergic drugs |
|
|
Bromocriptine
|
Formulary
|
|
|
|
Cabergoline
|
Formulary
|
|
|
|
Quinagolide
|
Formulary
|
|
|
|
| 06.07.02 |
Drugs affecting gonadotrophins |
|
|
Cetrorelix (Cetrotide®)
|
Formulary
|
|
|
|
Danazol
|
Formulary
|
For hereditary angioedema (off label use)
|
|
|
|
|
| 06.07.02 |
Gonadorelin analogues |
|
|
Buserelin
|
Formulary
|
For assisted conception
|
|
|
Buserelin nasal spray
|
Formulary
|
For assisted conception
|
|
|
Goserelin
|
Formulary
|
For assisted conception
|
|
|
Goserelin
|
Formulary
|
For endometriosis or breast cancer
Specialist initiation
|
CKS guideline: Management of confirmed endometriosis- Secondary Care treatments
|
Leuprorelin
|
Formulary
|
For endometrosis or breast cancer
Specialist initiation
|
CKS guideline: Management of confirmed endometriosis- Secondary Care treatments
|
Triptorelin
|
Formulary
|
For endometriosis
Specialist initiation
|
CKS guideline: Management of confirmed endometriosis- Secondary Care treatments
|
| 06.07.02 |
Breast pain (mastalgia) |
|
|
|
|
Metyrapone (Metopirone®)
|
Formulary
|
|
|
|
| 06.07.04 |
Somatomedins |
|
|
Mecasermin (Increlex®)
|
Formulary
|
NHSE commissioned.
|
|
|
| .... |
| Non Formulary Items |
Acarbose (Glucobay®)
|
Non Formulary
|
For existing patients only. |
|
|
Alendronic Acid
(oral solution )
|
Non Formulary
|
Removed from formulary in December 2016, replaced by effervescent tablets. |
|
|
Alendronic Acid with colecalciferol (Fosavance®)
|
Non Formulary
|
|
|
|
Alogliptin / metformin (Vipdomet®)
|
Non Formulary
|
|
|
|
Alogliptin / pioglitazone (Incresync®)
|
Non Formulary
|
|
|
|
Armour thyroid®
|
Non Formulary
|
|
Patient Information Leaflet
UKMI Q&A: What clinical evidence is there to support the use of “Armour thyroid” or desiccated thyroid extract?
|
Biphasic Isophane Insulin (Hypurin® Porcine 30/70 Mix)
|
Non Formulary
|
For existing patients only |
|
|
Chlorpropamide
|
Non Formulary
|
|
|
|
Combination test strips
|
Non Formulary
|
|
|
|
Corifollitropin Alfa (Elonva®)
|
Non Formulary
|
|
|
|
Cortisone Acetate
|
Non Formulary
|
|
|
|
Dapagliflozin / metformin (Xigduo®)
|
Non Formulary
|
|
|
|
Deflazacort (Calcort®)
|
Non Formulary
|
|
|
|
Desmopressin (Noqdirna ®)
|
Non Formulary
|
25mcg, 50mcg oral lyophilisate |
|
|
Desmopressin (Octim®)
|
Non Formulary
|
|
|
|
Diazoxide (Eudemine®)
|
Non Formulary
|
|
|
|
Dienogest
|
Non Formulary
|
|
|
|
Dydrogesterone (Duphaston®)
|
Non Formulary
|
|
|
|
Dydrogesterone (Duphaston® HRT)
|
Non Formulary
|
|
|
|
Flash glucose monitoring system (FreeStyle Libre®)
|
Non Formulary
|
|
BSOL CCG Policy for the prescribing of Flash Glucose Monitoring
|
Follitropin Alfa (Gonal-F®)
|
Non Formulary
|
|
|
|
Follitropin Alfa and Beta (Puregon®)
|
Non Formulary
|
|
|
|
Ganorelix (Orgalutran®)
|
Non Formulary
|
|
|
|
Gestrinone (Dimetriose®)
|
Non Formulary
|
|
|
|
Glipizide
|
Non Formulary
|
|
|
|
Gliquidone (Glurenorm®)
|
Non Formulary
|
|
|
|
Glucose (Clinistix®)
|
Non Formulary
|
|
|
|
Glucose (Clinitest®)
|
Non Formulary
|
|
|
|
Glucose (Diabur-Test® 5000)
|
Non Formulary
|
|
|
|
Glucose (Diastix®)
|
Non Formulary
|
|
|
|
Glucose test strips
|
Non Formulary
|
|
|
|
Human Menopausal Gonadotrophins (Menogon®)
|
Non Formulary
|
|
|
|
Hydrocortisone MR (Plenadren)
|
Non Formulary
|
|
|
|
Hydrocortisone sodium phosphate (Efcortesol®)
|
Non Formulary
|
|
|
|
Insulin (Exubera®)
|
Non Formulary
|
|
|
|
Insulin (Pork Actrapid®)
|
Non Formulary
|
|
|
|
Insulin (Velosulin®)
|
Non Formulary
|
|
|
|
Insulin 500 units in 1mL (Humulin R®)
|
Non Formulary
|
|
|
|
Insulin bovine (Hypurin® Bovine Neutral)
|
Non Formulary
|
For existing patients only |
|
|
Insulin degludec 200 units/mL (Tresiba®)
|
Non Formulary
|
|
|
|
Insulin degludec and liraglutide (Xultophy®)
|
Non Formulary
|
|
|
|
Insulin Lispro 200 units/mL (Humalog 200 units/mL ®)
|
Non Formulary
|
|
|
|
Insulin porcine (Hypurin® Porcine Neutral)
|
Non Formulary
|
For existing patients only |
|
|
Insulin Zinc suspension (Hypurin®Bovine Lente)
|
Non Formulary
|
For existing patients only |
|
|
Isophane Insulin (Hypurin® Bovine Isophane)
|
Non Formulary
|
For existing patients only |
|
|
Isophane Insulin (Hypurin® Porcine Isophane)
|
Non Formulary
|
For existing patients only |
|
|
Isophane Insulin (Pork Insulatard®)
|
Non Formulary
|
|
|
|
Ketones (Ketur Test®)
|
Non Formulary
|
|
|
|
Ketones test strips
|
Non Formulary
|
|
|
|
Linagliptin/ metformin (Jentadueto®)
|
Non Formulary
|
|
|
|
Liraglutide (Saxenda®)
|
Non Formulary
|
For weight loss/ obesity
No application received by APC yet |
|
|
Lutropin Alfa (Luveris®)
|
Non Formulary
|
|
|
|
Mesterolone (Pro-Viron®)
|
Non Formulary
|
|
|
|
Metformin & pioglitazone (Competact®)
|
Non Formulary
|
|
|
|
Nafarelin
|
Non Formulary
|
|
|
|
Nateglinide (Starlix®)
|
Non Formulary
|
For existing patients only |
|
|
Norethisterone (Micronor® HRT)
|
Non Formulary
|
|
|
|
Pasireotide
|
Non Formulary
|
|
|
|
Pegvisomant (Somavert®)
|
Non Formulary
|
|
|
|
Pioglitazone and Metfomin (Competact®)
|
Non Formulary
|
|
|
|
Prednisone MR
|
Non Formulary
|
|
|
|
Protamine Zinc Insulin (Hypurin® Bovine Protamine Zinc)
|
Non Formulary
|
For existing patients only |
|
|
Protein (Medi-Test® Protein 2)
|
Non Formulary
|
|
|
|
Protein test strips (Albustix®)
|
Non Formulary
|
|
|
|
Rosiglitazone (Avandia®)
|
Non Formulary
|
|
|
|
Rosiglitazone and Metformin (Avandamet®)
|
Non Formulary
|
|
|
|
Saxagliptin (Onglyza®)
|
Non Formulary
|
|
|
|
Saxagliptin and metformin (Komboglyze®)
|
Non Formulary
|
|
|
|
Sermorelin (Geref 50®)
|
Non Formulary
|
|
|
|
Sitagliptin and Metformin (Janumet®)
|
Non Formulary
|
|
|
|
Strontium Ranelate
|
Non Formulary
|
Discontinued August 2017 |
Discontinuation of Protelos (strontium ranelate) 2g granules for oral suspension
|
Test Strips (Combur 9®)
|
Non Formulary
|
|
|
|
Test Strips (Combur5® )
|
Non Formulary
|
|
|
|
Test Strips (Combur7®)
|
Non Formulary
|
|
|
|
Test Strips (Diastix®)
|
Non Formulary
|
|
|
|
Test Strips (Keto-Diastix®)
|
Non Formulary
|
|
|
|
Test Strips (Multistix 10 SG®)
|
Non Formulary
|
|
|
|
Test Strips (Multistix 8SG®)
|
Non Formulary
|
|
|
|
Test Strips (Multistix SG®)
|
Non Formulary
|
|
|
|
Test Strips (Multistix®)
|
Non Formulary
|
|
|
|
Testosterone and Esters
|
Non Formulary
|
|
|
|
Testosterone and Esters (Andropatch®)
|
Non Formulary
|
|
|
|
Testosterone and Esters (Intrinsa®)
|
Non Formulary
|
|
|
|
Testosterone and Esters (Striant® SR)
|
Non Formulary
|
|
|
|
Testosterone and Esters (Sustanon 100®)
|
Non Formulary
|
|
|
|
Testosterone and Esters (Virormone®)
|
Non Formulary
|
|
|
|
Thyrotropin Alfa (Thyrogen®)
|
Non Formulary
|
|
|
|
Tiludronic Acid (Skelid®)
|
Non Formulary
|
|
|
|
Tolbutamide
|
Non Formulary
|
|
|
|
Trilostane (Modrenal®)
|
Non Formulary
|
|
|
|
Urinalysis (Clinitest®)
|
Non Formulary
|
|
|
|
Urofollitropin
|
Non Formulary
|
|
|
|
Vasopressin (Pitressin®)
|
Non Formulary
|
|
|
|
Vildagliptin
|
Non Formulary
|
|
|
|
| |
Key |
|
|
|
|
Cytotoxic Drug
|
|
|
Controlled Drug
|
|
High Cost Medicine
|
|
Cancer Drugs Fund
|
|
NHS England |
|
Homecare |
|
CCG |
|
Traffic Light Status Information
| Status |
Description |
|
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. |
|
Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate, or initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.
Some amber medicines require agreement with the local (internal) medicines committee prior to initiation; others may require a framework to support safe transfer and maintenance of care such as a RICaD or ESCA. The Formulary will be annotated to reflect these requirements. |
|
Medicines for initiation and maintenance prescribing by Specialists only |
|
Non-formulary medicines- medicines not recommended for routine primary care prescribing. |
|
Positive NICE TA and /or awaiting local clarification on place in therapy ; Please contact your Medicines Optimisation team for more information. |
|
|
|
