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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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Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
   
Nateglinide
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Restricted Drug Restricted
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Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Nateglinide is available for the use of Dr Barnard only
 
   
Pioglitazone
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Formulary
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Provider notes

  • NMUH:
    • See link below
  • RFL:
    • See link below
  • RNOH:
    • Requires initiation by a Diabetes Specialist
    • Check MHRA Drug Safety Updates
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
   
Repaglinide
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Restricted Drug Restricted
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Provider notes

  • NMUH:
    • See link below
  • RFL:
    • See link below
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
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

Provider notes

  • NMUH:
    • See link below
  • RFL:
    • Restricted to initiation by endocrinology only
    • See link below
  • RNOH:
    • Restricted Requires initiation by a Diabetes Specialist
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
   
Saxagliptin
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Restricted Drug Restricted
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Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Restricted to endocrinology
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
   
06.01.02.03  Expand sub section  GLP1 agonists
Semaglutide subcutaneous injection
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Formulary
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Semaglutide is the preferred GLP-1 receptor agonist for type 2 diabetes, when used in line with the NCL Fact sheet (JFC April 2019).

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Restricted to initiation by endocrinology only for Type 2 diabetes
    • See above for eligibility criteria 
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • As above
 
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes Antihyperglycaemic agents for Type 2 diabetes
Link  NCL JFC: Fact sheet - Subcutaneous semaglutide, dulaglutide and liraglutide 1.2mg for the Treatment of Type 2 Diabetes Mellitus
   
Dulaglutide
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Restricted Drug Restricted
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Semaglutide is the preferred GLP-1 receptor agonist for type 2 diabetes, when used in line with the NCL Fact sheet (JFC August 2019).

Dulaglutide should only be initiated for patients (JFC August 2019):

  • who are needle-phobic and cannot use the semaglutide pen device.
  • with impaired manual dexterity (e.g. due to severe arthritis) and cannot use the semaglutide pen device.
  • with learning difficulty or mental health issues and require GLP-1 receptor agonist administration by a third-party as the dulaglutide device minimises the risk of needle-stick injury

 

Provider notes

  • NMUH:
    • Non-formulary but see link below
  • RFL:
    • Restricted to initiation by endocrinology only for Type 2 diabetes
    • See above for detailed eligibility criteria
  • RNOH:
    • Requires initiation by a Diabetes Specialist
  • UCLH:
  • WH:
    • As above
 
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
Link  NCL JFC: Fact sheet - Subcutaneous semaglutide, dulaglutide and liraglutide 1.2mg for the Treatment of Type 2 Diabetes Mellitus
   
Liraglutide (Victoza)
(Type 2 diabetes)
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Restricted Drug Restricted
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Semaglutide is the preferred GLP-1 receptor agonist for type 2 diabetes, when used in line with the NCL Fact sheet (JFC August 2019).

Liraglutide 1.2mg should only be initiated for patients with concurrent gastrointestinal conditions e.g. inflammatory bowel disease (JFC August 2019).

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

Provider notes

  • NMUH:
    • See links below
  • RFL:
    • Restricted to initiation by endocrinology only for Type 2 diabetes
    • See above for detailed eligibility criteria
  • RNOH:
    • Requires initiation by a Diabetes Specialist
  • UCLH:
  • WH:
    • Initiation restricted to endocrinology
 
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
Link  NCL JFC: Fact sheet - Subcutaneous semaglutide, dulaglutide and liraglutide 1.2mg for the Treatment of Type 2 Diabetes Mellitus
   
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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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.
    • See links below
    • Only on the recommendation of the Diabetes Team.
    • Check MHRA Drug Safety Alerts
  • RFL:
    • Restricted to Endocrinology
    • See links below
  • RNOH:
    • Requires initiation by a Diabetes Specialist
    • Check MHRA Drug Safety Updates
  • UCLH:
  • WH:
    • No restriction stated
    • Check MHRA Drug Safety Updates
 
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
(Type 2 diabetes)
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Restricted Drug Restricted
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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:
    • 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:
    • Restricted to Endocrinology
    • See links below
  • RNOH:
    • Requires initiation by a Diabetes Specialist
    • Check MHRA Drug Safety Updates
  • UCLH:
  • WH:
    • No restriction stated
    • Check MHRA Drug Safety Updates
 
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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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.
    • See links below
    • Only on the recommendation of the Diabetes Team.
    • Check MHRA Drug Safety Alerts
  • RFL:
    • Restricted to Endocrinology
    • See links below
  • RNOH:
    • Requires initiation by a Diabetes Specialist
    • Check MHRA Drug Safety Updates
  • UCLH:
  • WH:
    • No restriction stated
    • Check MHRA Drug Safety Updates
 
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
   
Ertugliflozin tabs
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Formulary
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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. 
    • See link below
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • As per NICE TA
 
Link  NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
Link  NICE TA572: Ertugliflozin as monotherapy or with metformin for treating type 2 diabetes
Link  NICE TA583: Ertugliflozin with metformin and a dipeptidyl peptidase-4 inhibitor 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
(Type 1 diabetes)

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Non Formulary

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 eligibility criteria

 

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
    • Non-formulary
  • WH:
    • Non-formulary
Link  NICE TA597: Dapagliflozin with insulin for treating type 1 diabetes
 
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
 
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)

 

 
Exenatide twice-daily

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Non Formulary
Black

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

 
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 + 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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