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 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.05.01  Expand sub section  Vasodilator antihypertensive drugs
Ambrisentan
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Restricted Drug Restricted
GP - Red
High Cost Medicine
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Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Prior funding approval required. Restricted to the treatment of pulmonary hypertension
  • RNOH approvals
    • Nil
  • UCLH approvals:
  • WH approvals:
    • Non Applicable
 
   
Bosentan
(Pulmonary hypertension)
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Restricted Drug Restricted
GP - Red
High Cost Medicine
NHS England
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Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Prior funding approval required
    • Restricted to the treatment of pulmonary hypertension
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
Link  NHSE A11/P/c: Targeted Therapies for use in Pulmonary Hypertension in Adults
   
Bosentan
(Digital ulceration)
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Restricted Drug Restricted
GP - Red
High Cost Medicine
NHS England
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Approved for digital ulceration in systemic sclerosis in line with NHSE Clinical Commissioning Policy A13/P/e (May 2015)

Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • See restrictions on use
    • Prior funding approval required
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
Link  NHSE A13/P/e: Sildenafil and bosentan for the treatment of digital ulceration in systemic sclerosis
   
Hydralazine
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Formulary
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 Primary care notes

GP-Red Red Hydralazine injection is for hospital prescribing only

Secondary care notes

  • NMUH approvals:
    • Nil
  • RFL approvals:
    • Nil
  • RNOH approvals
    • Nil
  • UCLH approvals:
  • WH approvals:
    • Nil
 
   
Iloprost injection
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Restricted Drug Restricted
GP - Red
High Cost Medicine
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Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • For ITU use only
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Available on named patient basis only.  Contact pharmacy for further information
 
   
Minoxidil
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Restricted Drug Restricted
GP - Red
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Secondary care notes

  • NMUH approvals:
    • Nil
  • RFL approvals:
    • Nil
  • RNOH approvals
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Minoxidil is available for the treatment of hypertension resistant to other drugs.  
    • Tablet formulation only
 
   
Sildenafil
(Pulmonary hypertension)
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Restricted Drug Restricted
GP - Red
NHS England
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Secondary care notes

  • NMUH approvals:
    • Not applicable  
  • RFL approvals:
    • Nil
  • RNOH approvals
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
Link  NHSE A11/P/c: Targeted Therapies for use in Pulmonary Hypertension in Adults
   
Sildenafil
(Digital ulceration)
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Restricted Drug Restricted
GP - Red

Approved for digital ulceration in systemic sclerosis in line with NHSE Clinical Commissioning Policy A13/P/e (May 2015)

 

  • WH approvals
    • Not applicable

 

 
Link  NHSE A13/P/e: Sildenafil and bosentan for the treatment of digital ulceration in systemic sclerosis
   
Sodium nitroprusside
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Formulary
GP - Red
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Secondary care notes

  • NMUH approvals:
    • Nil
  • RFL approvals:
    • Nil
  • RNOH approvals
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Injection 50mg/5ml (unlicensed product)
 
   
 ....
 Non Formulary Items
Diazoxide  (Eudemine®)

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Non Formulary
 
Iloprost nebules  (Vantavis)

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Non Formulary
 
Macitentan

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Non Formulary
GP - Red
High Cost Medicine
 
Minioxidil  (Loniten®)

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Non Formulary
 
Riociguat

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Non Formulary
GP - Red
High Cost Medicine

Approved for Pulmonary Arterial Hypertension in line with the NHSE Commissioning Policy (JFC May 2017)

Secondary care notes

  • NMUH approvals:
    • Check for MHRA Drug Safety Updates
  • RFL approvals:
    • Not applicable
  • RNOH approvals
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
Link  NHSE 16055/P: Riociguat for pulmonary arterial hypertension
 
Selexipag

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Non Formulary
GP - Red

Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Not applicable
  • RNOH approvals
    • Approved for pulmonary Hypertension for compassionate use and in patients from Wales and Northern Ireland for whom the drug is funded following positive recommendations from AWMSG and SMC respectively (RFL only; JFC October 2018)
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
Sitaxentan Sodium  (Thelin)

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Non Formulary
 
Tadalafil
(Pulmonary hypertension)

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Non Formulary
GP - Red
NHS England

Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Not Applicable
  • RNOH approvals
    • Not Applicable
  • UCLH approvals:
  • WH approvals:
    • Not Applicable
Link  NHSE A11/P/c: Targeted Therapies for use in Pulmonary Hypertension in Adults
 
Tolazoline

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Non Formulary
 
Treprostinil

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Non Formulary
GP - Red
 
  
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
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

GP - 1st

Medicines suitable for first-line use within primary care.

Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.

  

GP - 2nd

Medicines suitable for second-line use within primary care.

Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.

  

GP - Amber

Medicines that should be initiated by a specialist. Prescribing can be transferred to primary care once the patient has been stabilised.

Shared care: For drugs with regular, ongoing need for monitoring and/or assessment of efficacy or toxicity. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the North Central London JFC.

Fact sheet: For drugs with some concerns surrounding safety or efficacy but do not require regular monitoring and/or monitoring of effectiveness/toxicity.

  

GP - Red

Medicines which should normally be prescribed by specialists only (hospital only).

For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.

  

GP - Grey

Medicines on hospital formularies which have not been reviewed for suitability in primary care.  

Black

Medicines not recommended for routine use in primary or secondary care.

Medicines, which the North Central London JFC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.

  

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