| Formulary Chapter 2: Cardiovascular system - Full Chapter
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| 02.08.01 |
Parenteral anticoagulants |
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Argatroban
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 Restricted
 
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Anticoagulation in adult patients with heparin-induced thrombocytopenia (HIT) type II who require parenteral antithrombotic therapy and have renal failure (February 2013)
Provider notes
- NMUH:
- RFL:
- As per restrictions above
- Haemophilia recommendation only
- RNOH:
- Requires Haematologist approval. See restriction above.
- UCLH:
- Restricted to consultant haematologists. For patients with severe renal impairment (CrCl<30ml/min)
- WH approval:
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| 02.08.01 |
Heparin |
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Heparin sodium
(Anticoagulation)
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Formulary
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NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications.
Provider notes
- NMUH:
- RFL:
- RNOH:
- UCLH:
- WH:
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 NMUH: Trust Guideline on Management of Suspected and Confirmed Venous Thromboembolism in adult inpatients
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Heparin calcium
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Formulary
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Provider notes
- NMUH:
- RFL:
- RNOH:
- UCLH:
- WH:
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NMUH: Trust Guideline on management of suspected and confirmed venousthromcoembolism in adult inpatients
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| 02.08.01 |
Low molecular weight heparins |
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Enoxaparin
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Restricted
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(hospital only prescribing) for defined course thromboprophylaxis and patients requiring treatment doses in line with NCL guidance (see Section 3.1)
 for long-term thromboprophylaxis and patients requiring treatment doses in line with NCL guidance (see Section 3.3)
Provider notes
- NMUH:
- RFL:
- Prophylaxis - only whilst tinzaparin shortage
- Treatment - haemophilia recommendation only
- RNOH:
- UCLH:
- WH:
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NCL JFC: Low molecular weight heparin use
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Tinzaparin
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Formulary
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(hospital only prescribing) for defined course thromboprophylaxis and patients requiring treatment doses in line with NCL guidance (see Section 3.1)
for long-term thromboprophylaxis and patients requiring treatment doses in line with NCL guidance (see Section 3.3)
Provider notes
- NMUH:
- Tinzaparin is FORMULARY when used for the treatment of suspected/confirmed DVT/PE & for Thromboprophylaxis.
- See links below
- RFL:
- RNOH:
- UCLH:
- WH:
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NCL JFC: Low molecular weight heparin use
 NMUH: Letter to be sent to primary care when transferring patients on low molecular weight heparins (LMWH), where the supply and monitoring is to continue in primary care
NMUH: Trust Guideline on Management of Suspected and Confirmed Venous Thromboembolism in Adult inpatients
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| 02.08.01 |
Heparinoids |
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Danaparoid
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Restricted
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Provider notes
- NMUH:
- RFL:
- As per local protocol only
- RNOH:
- UCLH:
- WH:
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| 02.08.01 |
Hirudins |
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Bivalirudin
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Restricted
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Provider notes
- NMUH:
- This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary but may NOT be routinely stocked in pharmacy. This medicine will be ordered if use is as per local Trust Guideline or is approved by the Trust Medicines Management Committee. Contact pharmacy medicines information on ext 2417 for further information
- RFL:
- RNOH:
- UCLH:
- WH:
- NICE TA230 applies. Not routinely stocked at WH.
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 NICE TA230: Bivalirudin for the treatment of ST-segment-elevation myocardial infarction (STEMI)
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| 02.08.01 |
Heparin flushes |
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Heparin sodium
(Flush - 10 units / mL)
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Formulary
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NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications.
Provider notes
- NMUH:
- RFL:
- RNOH:
- UCLH:
- WH:
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| 02.08.01 |
Epoprostenol |
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Epoprostenol
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Restricted
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Approved for pulmonary hypertension (November 2013) Provider notes - NMUH:
- Restricted for ICU use only.
- Check MHRA for Drug Safety Updates
- RFL:
- Restricted to ITU and pulmonary hypertension
- RNOH:
- UCLH:
- Approved for primary pulmonary hypertension: functional grades III + IV
- Approved for Inhibition of platelet aggregation during renal dialysis
- WH approvals:
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| 02.08.01 |
Fondaparinux |
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Fondaparinux
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Restricted
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Provider notes - NMUH:
- Restricted to use for patients with Unstable Angina / NSTEMI.
- See Trust Guideline on use
- RFL:
- Restricted to use for patients with Unstable Angina / NSTEMI
- RNOH:
- UCLH:
- WH:
- Restricted for use in unstable angina and NSTMEI
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| Non Formulary Items |
Dalteparin
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Non Formulary
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(hospital only prescribing) for defined course thromboprophylaxis and patients requiring treatment doses in line with NCL guidance (see Section 3.1)
for long-term thromboprophylaxis and patients requiring treatment doses in line with NCL guidance (see Section 3.3) |
NCL JFC: Low molecular weight heparin use
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Key |
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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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CCG |
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Traffic Light Status Information
| Status |
Description |
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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. |
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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. |
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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. |
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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. |
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Medicines on hospital formularies which have not been reviewed for suitability in primary care. |
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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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