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 Formulary Chapter 6: Endocrine system - Full Chapter
06.01.02.03  Expand sub section  Other antidiabetic drugs
Acarbose
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Formulary
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Secondary care notes

  • NMUH approvals:
    • See link below
  • RFL approvals:
    • Nil
  • RNOH approvals
    • Nil
  • UCLH approvals:
  • WH approvals:
    • Nil
 
Link  NCL JFC: NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
   
Nateglinide
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Nil
  • RNOH approvals
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Nateglinide is available for the use of Dr Barnard only
 
   
Pioglitazone
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Formulary
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Secondary care notes

  • NMUH approvals:
    • See link below
  • RFL approvals:
    • Nil
  • RNOH approvals:
    • Requires initiation by a Diabetes Specialist
    • Check MHRA Drug Safety Updates
  • UCLH approvals:
  • WH approvals:
    • Nil
 
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
   
Repaglinide
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • See link below
  • RFL approvals:
    • Not applicable
  • RNOH approvals
    • Nil
  • UCLH approvals:
  • WH approvals:
    • Nil
 
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
   
06.01.02.03  Expand sub section  Alpha glucosidase inhibitors
06.01.02.03  Expand sub section  DPP4 inhibitors (gliptins)
Sitagliptin
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Restricted Drug Restricted
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Sitagliptin is the only DPP-4i 'gliptin' on the NCL Formulary. See NCL guidance

Secondary care notes

  • NMUH approvals:
    • See link below
  • RFL approvals:
    • Restricted to initiation by endocrinology only
  • RNOH approvals
    • Restricted Requires initiation by a Diabetes Specialist
  • UCLH approvals:
  • WH approvals:
    • Nil
 
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
   
06.01.02.03  Expand sub section  GLP1 agonists
Dulaglutide
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Restricted Drug Restricted
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Liraglutide and dulaglutide are  the preferred GLP-1RAs for type 2 diabetes, when used in line with the NCL Fact sheet (JFC July 2018)

Secondary care notes

  • NMUH approvals:
    • Non-formulary but see link below
  • RFL approvals:
    • Restricted to Endocrinology only
  • RNOH approvals
    • Requires initiation by a Diabetes Specialist
  • UCLH approvals:
  • WH approvals:
    • As above
 
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
Link  NCL JFC: Fact sheet - Liraglutide 1.2mg and dulaglutide for type 2 diabetes
   
Liraglutide
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Liraglutide 1.2mg and dulaglutide are the preferred GLP-1RAs for type 2 diabetes, when used in line with the NCL Fact sheet.

Liraglutide 1.8mg is not recommended (JFC July 2018).

Secondary care notes

  • NMUH approvals:
    • See links below
  • RFL approvals:
    • Restricted to endocrinology.
  • RNOH approvals
    • Requires initiation by a Diabetes Specialist
  • UCLH approvals:
  • WH approvals:
    • The use of liraglutide is restricted to Diabetology
 
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
Link  NCL JFC: Fact sheet - Liraglutide 1.2mg and dulaglutide for type 2 diabetes
   
06.01.02.03  Expand sub section  Meglitinides to top
06.01.02.03  Expand sub section  SGL2 inhibitors
Canagliflozin
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Restricted Drug Restricted
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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 when used in line with NICE recommendations and/or Local Trust Guidelines.
    • See links below
    • Only on the recommendation of the Diabetes Team.
    • Check MHRA Drug Safety Alerts
  • RFL approvals:
    • Restricted to Endocrinology
  • RNOH approvals
    • Requires initiation by a Diabetes Specialist
    • Check MHRA Drug Safety Updates
  • UCLH approvals:
  • WH approvals:
    • Nil
 
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
Link  NICE TA315: Canagliflozin for type 2 diabetes
Link  NICE TA390: Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes
   
Dapagliflozin
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Restricted Drug Restricted
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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 when used in line with NICE recommendations and/or Local Trust Guidelines.
    • See links below
    • Only on the recommendation of the Diabetes Team.
    • Check MHRA Drug Safety Alerts
  • RFL approvals:
    • Restricted to Endocrinology
  • RNOH approvals
    • Requires initiation by a Diabetes Specialist
    • Check MHRA Drug Safety Updates
  • UCLH approvals:
  • WH approvals:
    • Nil
 
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
Link  NICE TA288: Dapagliflozin in combination therapy for treating type 2 diabetes
Link  NICE TA390: Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes
Link  NICE TA418: Dapagliflozin in triple therapy for treating type 2 diabetes
   
Empagliflozin
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Restricted Drug Restricted
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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 when used in line with NICE recommendations and/or Local Trust Guidelines.
    • See links below
    • Only on the recommendation of the Diabetes Team.
    • Check MHRA Drug Safety Alerts
  • RFL approvals:
    • Restricted to Endocrinology
  • RNOH approvals
    • Requires initiation by a Diabetes Specialist
    • Check MHRA Drug Safety Updates
  • UCLH approvals:
  • WH approvals:
    • Nil
 
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
Link  NICE TA336: Empagliflozin for type 2 diabetes
Link  NICE TA390: Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes
   
06.01.02.03  Expand sub section  Thiazolidinediones
 ....
 Non Formulary Items
Albiglutide

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Non Formulary
 
Alogliptin

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Non Formulary
 
Alogliptin + Metformin  (Vipdomet)

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Non Formulary
 
Alogliptin + Pioglitazone  (Incresync)

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Non Formulary
 
Canagliflozin + Metformin  (Vokanamet)

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Non Formulary
 
Dapagliflozin + Metformin  (Xigduo)

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Non Formulary
 
Empagliflozin + linagliptin  (Glyxambi)

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Non Formulary
 
Empagliflozin + Metformin  (Synjardy)

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Non Formulary
 
Ertugliflozin tabs

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Non Formulary

Secondary care notes

  • NMUH approvals:
  • RFL approvals:
  • RNOH approvals:
  • UCLH approvals:
  • WH approvals:
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
Link  NICE TA572: Ertugliflozin as monotherapy or with metformin for treating type 2 diabetes
 
Exenatide prolonged release

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Non Formulary
Black

Not recommended for type 2 diabetes; liraglutide and dulaglutide are preferred (JFC June 2016, July 2018)

Secondary care notes

  • NMUH approvals:
    • The NICE TA for this product has been withdrawn therefore this has been withdrawn from the formulary. 
  • RFL approvals:
    • Not applicable
  • RNOH approvals
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
Exenatide twice-daily

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Non Formulary
Black

Not recommended for Type 2 diabetes (JFC September 2013 and June 2016)

Secondary care notes

  • NMUH approvals:
    • The NICE TA for this product has been withdrawn therefore this has been withdrawn from the formulary. 
  • RFL approvals:
    • Not applicable
  • RNOH approvals
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
Linagliptin

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Non Formulary
Black

Not approved for Type 2 diabetes, with or without renal impairment (June 2016)

 
Linagliptin + Metformin  (Jentadueto)

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Non Formulary
 
Lixisenatide

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Non Formulary
Black

Not recommended for Type 2 diabetes (September 2013, May 2014 & June 2016)

 
Pioglitazone + Metfomin  (Competact)

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Non Formulary
 
Saxagliptin

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Non Formulary
 
Saxagliptin + Metformin  (Komboglyze)

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Non Formulary
 
Sitagliptin + Metformin  (Janumet)

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Non Formulary
 
Vildagliptin

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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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