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 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.08.01  Expand sub section  Parenteral anticoagulants
Argatroban
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Restricted Drug Restricted
GP - Red

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:
    • Non-formulary
  • 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:
    • Non-formulary
 
   
02.08.01  Expand sub section  Heparin
Heparin sodium
(Anticoagulation)
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Formulary
GP - Red

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:
    • See links below
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NMUH: Trust Guideline on Management of Suspected and Confirmed Venous Thromboembolism in adult inpatients
   
Heparin calcium
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Formulary
GP - Red

Provider notes

  • NMUH:
    • See links below
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NMUH: Trust Guideline on management of suspected and confirmed venousthromcoembolism in adult inpatients
   
02.08.01  Expand sub section  Low molecular weight heparins
Enoxaparin
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Restricted Drug Restricted

Red (hospital only prescribing) for defined course thromboprophylaxis and patients requiring treatment doses in line with NCL guidance (see Section 3.1)

Amber for long-term thromboprophylaxis and patients requiring treatment doses in line with NCL guidance (see Section 3.3)

 

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Prophylaxis - only whilst tinzaparin shortage
    • Treatment - haemophilia recommendation only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NCL JFC: Low molecular weight heparin use
   
Tinzaparin
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Formulary

Red (hospital only prescribing) for defined course thromboprophylaxis and patients requiring treatment doses in line with NCL guidance (see Section 3.1)

Amber 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:
    • No restriction stated
  • RNOH:
    • As per local guidelines
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: Low molecular weight heparin use
Link  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
Link  NMUH: Trust Guideline on Management of Suspected and Confirmed Venous Thromboembolism in Adult inpatients
   
02.08.01  Expand sub section  Heparinoids
Danaparoid
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Restricted Drug Restricted

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • As per local protocol only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
   
02.08.01  Expand sub section  Hirudins to top
Bivalirudin
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Restricted Drug Restricted
GP - Red

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:
    • Non-formulary
  • RNOH:
    • Restricted
  • UCLH:
  • WH:
    • NICE TA230 applies. Not routinely stocked at WH.
 
Link  NICE TA230: Bivalirudin for the treatment of ST-segment-elevation myocardial infarction (STEMI)
   
02.08.01  Expand sub section  Heparin flushes
Heparin sodium
(Flush - 10 units / mL)
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Formulary

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:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
  • UCLH:
  • WH:
    • No restriction stated
 
   
02.08.01  Expand sub section  Epoprostenol
Epoprostenol
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Restricted Drug Restricted
GP - Red
High Cost Medicine

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:
    • Non-formulary
  • UCLH:
    • Approved for primary pulmonary hypertension: functional grades III + IV
    • Approved for Inhibition of platelet aggregation during renal dialysis
  • WH approvals:
    • No restriction stated
 
   
02.08.01  Expand sub section  Fondaparinux
Fondaparinux
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Restricted Drug Restricted

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:
    • No restriction stated
  • UCLH:
  • WH:
    • Restricted for use in unstable angina and NSTMEI
 
   
 ....
 Non Formulary Items
Dalteparin

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Non Formulary

Red (hospital only prescribing) for defined course thromboprophylaxis and patients requiring treatment doses in line with NCL guidance (see Section 3.1)

Amber for long-term thromboprophylaxis and patients requiring treatment doses in line with NCL guidance (see Section 3.3)

Link  NCL JFC: Low molecular weight heparin use
 
  
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.

See link for the complete NCL Red List https://www.ncl-mon.nhs.uk/wp-content/uploads/2017/08/ncl_red_list.pdf

  

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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