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Joint Formulary
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 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.09  Expand sub section  Antiplatelet drugs
Aspirin
(Antiplatelet)
View adult BNF View SPC online View childrens BNF
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:
    • See NCL JFC summary of antiplatelet options in cardiovascular disease for specific indications
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: Summary of antiplatelet options in cardiovascular disease
Link  NICE TA210: Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events
   
Cangrelor
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Restricted Drug Restricted

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Primary percutaneous coronary intervention (PPCI) who are intubated and cannot tolerate oral antiplatelets (JFC October 2017)
  • RNOH:
    • Non-formulary
  • UCLH:
    • Non-formulary
  • WH:
    • Non-formulary
 
Link  NICE TA351 (not recommended): Cangrelor for reducing atherothrombotic events in people undergoing percutaneous coronary intervention or awaiting surgery requiring interruption of anti‑platelet therapy (terminated appraisal)
   
Clopidogrel
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Formulary

See NICE TA for eligibility

Provider notes

  • NMUH:
    • To be prescribed as per NICE guidelines - see links below for further details
  • RFL:
    • To be prescribed in line with NICE
    • See NCL summary for information on preferred choices for specific indications
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: Summary of antiplatelet options in cardiovascular disease
Link  NICE TA210: Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events
   
Dipyridamole
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Formulary

See NICE TA for eligibility

Provider notes

  • NMUH:
    • This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary when used  in line with NICE recommendations and/or Local Trust Guidelines.
  • RFL:
    • See NCL JFC summary of antiplatelet options in cardiovascular disease for advice on specific indications
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: Summary of antiplatelet options in cardiovascular disease
Link  NICE TA210: Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events
   
Eptifibatide (Integrilin)
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Formulary

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
   
Prasugrel
(Acute coronary syndrome)
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Restricted Drug Restricted

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

See NICE TA for eligibity.

Provider notes

  • NMUH:
    • Check for MHRA Drug Safety Updates
  • RFL:
    • In line with NICE guidance
    • See NCL JFC summary of antiplatelet options in cardiovascular disease for specific indications and alternatives
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • 10mg tablets available. Approved for stat dose (60mg) to be given to patients prior to transfer for PCI.
 
Link  NCL JFC: Summary of antiplatelet options in cardiovascular disease
Link  NICE TA317: Acute coronary syndrome - prasugrel
   
Prasugrel
(Intracranial stents)
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Restricted Drug Restricted

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Approved in combination with aspirin to minimise risk of thromboembolic complications in patients undergoing endovascular therapy of unruptured intracranial aneurysms (JFC March 2017)

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Approved in combination with aspirin to minimise risk of thromboembolic complications in patients undergoing endovascular therapy of unruptured intracranial aneurysms (JFC Mar 2017).
 
   
Ticagrelor
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Restricted Drug Restricted

See NICE TA for eligibity criteria

Provider notes

  • NMUH:
    • To be prescribed as per NICE guidelines - see links below for further details
  • RFL:
    • As per NICE guidance
    • See NCL JFC summary of antiplatelet options in cardiovascular disease for more information on agreed indications
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: Summary of antiplatelet options in cardiovascular disease
Link  NICE TA236: Ticagrelor for the treatment of acute coronary syndromes
Link  NICE TA420: Ticagrelor for preventing atherothrombotic events after myocardial infarction
   
Tirofiban
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Restricted Drug Restricted

Approved following MI undergoing PCI in place of abciximab as GPI of choice (May 2015)

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • Restricted to cardiology only.
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Tirofiban is available for prescribing at DMR level and above as per protocol for acute coronary syndrome
 
   
 ....
 Non Formulary Items
Abciximab

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Non Formulary
 
Dipyridamole + Aspirin

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Non Formulary
 
Vorapaxar  (Zontivity)

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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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