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Joint Formulary  
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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
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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)

Secondary care notes

  • NMUH approval:
    • Not applicable
  • RFL approval:
    • Not applicable
  • RNOH approval:
    • Restricted Item Requires Haematologist approval. See restriction above.
  • UCLH approval:
    • Restricted Item Restricted to consultant haematologists. For patients with severe renal impairment (CrCl<30ml/min)
  • WH approval:
    • Not applicable
 
   
02.08.01  Expand sub section  Heparin
Heparin sodium
(Anticoagulation)
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Formulary
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Secondary care notes

  • NMUH approvals:
    • See links below
  • RFL approvals:
    • See links below
  • RNOH approvals:
    • Nil
  • UCLH approvals:
  • WH approvals:
    • Nil
 
Link  NMUH: Trust Guideline on Management of Suspected and Confirmed Venous Thromboembolism in adult inpatients
Link  RFL: Anticoagulation guidelines
Link  RFL: Unfractionated heparin IV administration protocol
   
Heparin calcium
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Formulary
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Secondary care notes

  • NMUH approvals:
    • See links below
  • RFL approvals:
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
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
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Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • For the treatment of acute coronary syndrome only Low molecular weight heparin protocol
  • RNOH approvals
    • Nil
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
Link  RFL: Anticoagulation guidelines
Link  RFL: Low molecular weight heparin protocol
   
Tinzaparin
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Formulary
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Not approved for anticoagulation in renal failure/obesity (JFC March 2013)

Secondary care notes

  • NMUH approvals:
    • Tinzaparin is FORMULARY when used for the treatment of suspected/confirmed DVT/PE & for Thromboprophylaxis.
    • See links below
  • RFL approvals:
    • See links below
  • RNOH approvals
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Nil
 
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
Link  RFL: Anticoagulation guidelines
Link  RFL: Low molecular weight heparin protocol
   
02.08.01  Expand sub section  Heparinoids
Danaparoid
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Not Applicable
  • RFL approvals:
    • See links below
  • RNOH approvals
    • Not Applicable
  • UCLH approvals:
  • WH approvals:
    • Not Applicable
 
Link  RFL: Anticoagulation guidelines
Link  RFL: Danaparoid protocol
   
02.08.01  Expand sub section  Hirudins to top
Bivalirudin
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Restricted Drug Restricted
GP - Red
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Secondary care notes

  • NMUH approvals:
    • 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 approvals:
    • Restricted to use in the Cardiology Cath Lab only.
  • RNOH approvals:
    • Restricted Item Restricted
  • UCLH approvals:
  • WH approvals:
    • 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
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 Secondary care notes

  • NMUH approvals:
    • Nil
  • RFL approvals:
    • Nil
  • RNOH approvals:
  • UCLH approvals:
  • WH approvals:
    • Nil
 
   
02.08.01  Expand sub section  Epoprostenol
Epoprostenol
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Restricted Drug Restricted
GP - Red
High Cost Medicine
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Approved for pulmonary hypertension (November 2013)

Secondary care notes

  • NMUH approvals
    • Restricted for ICU use only.
    • Check MHRA for Drug Safety Updates
  • RFL approvals:
    • Restricted to ITU and pulmonary hypertension
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
    • Approved for primary pulmonary hypertension: functional grades III + IV
    • Approved for Inhibition of platelet aggregation during renal dialysis
  • WH approvals:
    • Nil
 
   
02.08.01  Expand sub section  Fondaparinux
Fondaparinux
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Restricted to use for patients with Unstable Angina / NSTEMI.
    • See Trust Guideline on use
  • RFL approvals:
    • Restricted - only to be used under the advice of the haemophilia consultant
  • RNOH approvals
    • Nil
  • UCLH approvals:
  • WH approvals:
    • Restricted for use in unstable angina and NSTMEI
 
   
 ....
 Non Formulary Items
Dalteparin

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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
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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