| Formulary Chapter 6: Endocrine system - Full Chapter
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| 06.01.02.03 |
Other antidiabetic drugs |
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Acarbose
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Formulary
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Provider notes
- NMUH:
- RFL:
- RNOH:
- UCLH:
- WH:
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Nateglinide
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 Restricted
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Provider notes - NMUH:
- RFL:
- RNOH:
- UCLH:
- WH:
- Nateglinide is available for the use of Dr Barnard only
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Pioglitazone
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Formulary
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Provider notes
- NMUH:
- RFL:
- RNOH:
- Requires initiation by a Diabetes Specialist
- Check MHRA Drug Safety Updates
- UCLH:
- WH:
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 NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
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Repaglinide
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Restricted
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Provider notes
- NMUH:
- RFL:
- RNOH:
- UCLH:
- WH:
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NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
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| 06.01.02.03 |
Alpha glucosidase inhibitors |
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| 06.01.02.03 |
DPP4 inhibitors (gliptins) |
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Sitagliptin
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Restricted
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Sitagliptin is the only DPP-4i 'gliptin' on the NCL Formulary. See NCL guidance
Provider notes
- NMUH:
- RFL:
- Restricted to initiation by endocrinology only
- See link below
- RNOH:
- Restricted Requires initiation by a Diabetes Specialist
- UCLH:
- WH:
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NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
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Saxagliptin
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Restricted
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Provider notes
- NMUH:
- RFL:
- Restricted to initiation by endocrinology only
- RNOH:
- UCLH:
- WH:
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| 06.01.02.03 |
GLP1 agonists |
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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:
- Restricted to initiation by endocrinology only for Type 2 diabetes
- See above for detailed eligibility criteria
- RFL:
- Restricted to initiation by endocrinology only for Type 2 diabetes
- See above for eligibility criteria
- RNOH:
- Initiation on advice of Diabetes Specialist team only
- UCLH:
- WH:
- As above
- Initiation restricted to endocrinology
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NCL JFC: Antihyperglycaemic agents for Type 2 diabetes Antihyperglycaemic agents for Type 2 diabetes
NCL JFC: Fact sheet - Subcutaneous semaglutide, dulaglutide and liraglutide 1.2mg for the Treatment of Type 2 Diabetes Mellitus
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Dulaglutide
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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
- Initiation restricted to endocrinology
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NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
NCL JFC: Fact sheet - Subcutaneous semaglutide, dulaglutide and liraglutide 1.2mg for the Treatment of Type 2 Diabetes Mellitus
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Liraglutide
(Victoza®)
(Type 2 diabetes)
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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:
- Restricted to initiation by endocrinology only for Type 2 diabetes
- See above for detailed eligibility criteria
- 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
- Initiation restricted to endocrinology
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NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
NCL JFC: Fact sheet - Subcutaneous semaglutide, dulaglutide and liraglutide 1.2mg for the Treatment of Type 2 Diabetes Mellitus
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| 06.01.02.03 |
Meglitinides |
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| 06.01.02.03 |
SGL2 inhibitors |
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Canagliflozin
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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
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NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
 NICE TA315: Canagliflozin for type 2 diabetes
NICE TA390: Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes
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Dapagliflozin
(Type 2 diabetes)
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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
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NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
NICE TA288: Dapagliflozin in combination therapy for treating type 2 diabetes
NICE TA390: Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes
NICE TA418: Dapagliflozin in triple therapy for treating type 2 diabetes
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Dapagliflozin
(Type 1 diabetes)
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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.
See NICE TA for eligibility criteria
Provider notes
- NMUH:
- RFL:
- RNOH:
- UCLH:
- WH:
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NICE TA597: Dapagliflozin with insulin for treating type 1 diabetes
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Empagliflozin
(Type 2 diabetes)
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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
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NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
NICE TA336: Empagliflozin for type 2 diabetes
NICE TA390: Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes
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Ertugliflozin tabs
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Formulary
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Provider notes
- NMUH:
- Not stocked at NMUH - use alternative SGLT2 inhibitor
- RFL:
- RNOH:
- UCLH:
- WH:
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NCL JFC: Antihyperglycaemic agents for Type 2 diabetes
NICE TA572: Ertugliflozin as monotherapy or with metformin for treating type 2 diabetes
NICE TA583: Ertugliflozin with metformin and a dipeptidyl peptidase-4 inhibitor for treating type 2 diabetes
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| 06.01.02.03 |
Thiazolidinediones |
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| .... |
| Non Formulary Items |
Albiglutide
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Non Formulary
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Alogliptin
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Non Formulary
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Alogliptin + Metformin
(Vipdomet®)
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Non Formulary
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Alogliptin + Pioglitazone
(Incresync®)
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Non Formulary
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Canagliflozin + Metformin
(Vokanamet®)
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Non Formulary
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Dapagliflozin + Metformin
(Xigduo®)
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Non Formulary
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Empagliflozin + linagliptin
(Glyxambi®)
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Non Formulary
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Empagliflozin + Metformin
(Synjardy®)
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Non Formulary
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Exenatide prolonged release
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Non Formulary
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Not recommended for type 2 diabetes; liraglutide and dulaglutide are preferred (JFC June 2016, July 2018)
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Exenatide twice-daily
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Non Formulary
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Not recommended for Type 2 diabetes (JFC September 2013 and June 2016) |
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Linagliptin
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Non Formulary
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Not approved for Type 2 diabetes, with or without renal impairment (June 2016) |
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Linagliptin + Metformin
(Jentadueto®)
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Non Formulary
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Lixisenatide
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Non Formulary
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Not recommended for Type 2 diabetes (September 2013, May 2014 & June 2016) |
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Pioglitazone + Metfomin
(Competact®)
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Non Formulary
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Saxagliptin + Metformin
(Komboglyze®)
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Non Formulary
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Semaglutide tabs
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Non Formulary
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NCL JFC: Antihyperglycaemic agents for Type 2 diabetes Antihyperglycaemic agents for Type 2 diabetes
NCL JFC: Fact sheet - Subcutaneous semaglutide, dulaglutide and liraglutide 1.2mg for the Treatment of Type 2 Diabetes Mellitus
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Sitagliptin + Metformin
(Janumet®)
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Non Formulary
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Sotagliflozin
(Type 1 diabetes)
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Non Formulary
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See NICE TA for eligibility criteria
Provider notes
- NMUH:
- RFL:
- RNOH:
- UCLH:
- WH:
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NICE TA622: Sotagliflozin with insulin for treating type 1 diabetes
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Vildagliptin
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Non Formulary
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Key |
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Traffic Light Status Information
| Status |
Description |
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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. |
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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 |
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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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