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North Central London
Joint Formulary
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 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.08.01  Expand sub section  Parenteral anticoagulants
02.08.01  Expand sub section  Heparin
02.08.01  Expand sub section  Low molecular weight heparins
Enoxaparin
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Restricted Drug Restricted
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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
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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
02.08.01  Expand sub section  Hirudins to top
02.08.01  Expand sub section  Heparin flushes
02.08.01  Expand sub section  Epoprostenol
02.08.01  Expand sub section  Fondaparinux
 ....
 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
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
Homecare
Homecare

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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