A position statement and prescribing guide is available for amiodarone on Clarity: https://teamnet.clarity.co.uk/Library/ViewItem/52be791a-4f9d-4f79-9544-ad4100a4e485 

PARENTERAL FORMULATION IS FOR HOSPITAL PRESCRIBING ONLY

Parenteral Formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

A position statement and prescribing guide is available for dronedarone on Clarity: https://teamnet.clarity.co.uk/Library/ViewItem/7953bf79-a25e-4237-84cf-ad4100a56a64 

Parenteral formulation is for Hospital Prescribing Only.

As per the national recommendations from the 2017 NHSE consultation on Medicines of Limited Value, Lidocaine Medicated-Plasters are HOSPITAL ONLY, EXCEPT for post herpetic neuralgia (PHN) only for which they are AMBER.

All medicinal formulations are formulary EXCEPT plasters which are not licensed.  

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

For modified-release preparations - Brand Prescribing is Required.

Parenteral Formulation is for Hospital Prescribing Only.

Unlicensed indication - Vascular Ehlers Danlos Syndrome (vEDS)

SPECIALIST INTIATION - May be CONTINUED to be prescribed in Primary Care with no Shared Care Guideline (AMBER DRUG status).

Licensed indication - Hypertension

Celiprolol is Non-Formulary for routine hypertension as other drugs should be tried first. Where formulary options are unsuitable and there is an exception, celiprolol may be continued where clinically appropriate.

Brand Prescribing is REQUIRED

As per the national recommendations from the 2017 NHSE consultation on Medicines of Limited Value, Doxazosin Modified-Release preparations are for HOSPITAL PRESCRIBING ONLY.

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

Standard-release preparations are AMBER on the Tower Hamlets CCG formulary, and require recommendation from a Specialist.

Modified-release preparations are GREEN and therefore can be initiated in Primary Care, if clinically appropriate for the individual patient. 

BRAND PRESCRIBING IS REQUIRED.

To be initiated by Barts Health Hypertension Clinic. Only to be continued in Primary Care once stable.

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

For modified-release preparations - Brand Prescribing is Required.

Parenteral formulation is for Hospital Prescribing Only.

Sildenafil is Hospital Only in the following situations:

• Raynauds Disease (unlicensed)
• ALL Parenteral formumations 

Tadalafil is NON-FORMULARY for Benign Prostatic Hyperplasia.

As per the national recommendations from the 2017 NHSE consultation on Medicines of Limitted Value, Once Daily Tadalafil is not recommended for prescribing in Primary Care. Once daily use for POST-PROSTATECTOMY, is for HOSPITAL ONLY prescribing.

Tadalafil use in Erectile Dysfunction is formulary, for WHEN REQUIRED (PRN) use, ONLY after generic sildenafil has been tried.

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

Indication: Neuropathic postural hypotension.
Click here for summary of product characteristics

Standard-release preparations are AMBER on the Tower Hamlets CCG formulary, and require recommendation from a Specialist.

Modified-release preparations are GREEN and therefore can be initiated in Primary Care, if clinically appropriate for the individual patient. 

BRAND PRESCRIBING IS REQUIRED.

Primary Care Prescriber Information fact sheets are available for all NOACs here: https://teamnet.clarity.co.uk/Topics/ViewItem/2912bdc6-65e7-409a-b824-abd001039291

NOACs may be initiated in Primary Care by suitably accredited clinicians, for low risk patients with non-valvular Atrial Fibrillation.

This must only be undertaken by clinicians who have attended the study day held by the Barts Health Anticoagulation Team and are accredited to provide initiation services.

Primary Care Prescriber Information fact sheets are available for all NOACs here: https://teamnet.clarity.co.uk/Topics/ViewItem/2912bdc6-65e7-409a-b824-abd001039291

NOACs may be initiated in Primary Care by suitably accredited clinicians, for low risk patients with non-valvular Atrial Fibrillation.

This must only be undertaken by clinicians who have attended the study day held by the Barts Health Anticoagulation Team and are accredited to provide initiation services.

Primary Care Prescriber Information fact sheets are available for all NOACs here: https://teamnet.clarity.co.uk/Topics/ViewItem/2912bdc6-65e7-409a-b824-abd001039291

NOACs may be initiated in Primary Care by suitably accredited clinicians, for low risk patients with non-valvular Atrial Fibrillation.

This must only be undertaken by clinicians who have attended the study day held by the Barts Health Anticoagulation Team and are accredited to provide initiation services.

Enoxaparin is a biological medicine where biosimilars are available. Therefore enoxaparin must be prescribed by brand name and the brand name specified on the prescription should be dispensed in order to avoid inadvertent switching.

January 2021: Clexane is the brand of choice at Barts Health, for treatment indications where CrCl>30ml/min. For Shared Care the brand to be prescribed should be communicated at the point of initiation.

If it is for the specific condition you are asked to continue treatment for and you are happy to prescribe in accordance with the guideline, then take over the agreed responsibilities including prescribing. Please ensure the document is scanned into the patient's electronic records.

Click here for the Shared Care Guideline Repository

If sufficient information has not been provided and if you do not feel happy to continue to prescribe, it is advisable to refer the patient back to the specialist clinic and complete and send as soon as possible an 'inappropriate prescribing request communication form' .   

NICE technology appraisal (TA) 607 (17 October 2019)

Summary guidance can be found on the Portal

Primary Care Prescriber Information fact sheets are available for all NOACs here: https://teamnet.clarity.co.uk/Topics/ViewItem/2912bdc6-65e7-409a-b824-abd001039291

NOACs may be initiated in Primary Care by suitably accredited clinicians, for low risk patients with non-valvular Atrial Fibrillation.

This must only be undertaken by clinicians who have attended the study day held by the Barts Health Anticoagulation Team and are accredited to provide initiation services.

If it is for the specific condition you are asked to continue treatment for and you are happy to prescribe in accordance with the guideline, then take over the agreed responsibilities including prescribing. Please ensure the document is scanned into the patient's electronic records.

Click here for the Shared Care Guideline Repository

If sufficient information has not been provided and if you do not feel happy to continue to prescribe, it is advisable to refer the patient back to the specialist clinic and complete and send as soon as possible an 'inappropriate prescribing request communication form' . 

Parenteral formulation is for Hospital Prescribing Only.

Please note FORMULARY options are generic modified-release tablets only.

LIPID MANAGEMENT PATHWAY WILL BE REVIEWED ACROSS NORTH EAST LONDON CCG TO INFORM THE PLACE OF THERAPY OF INCLISIRAN WITH OTHER LIPID-LOWERING AGENTS. PLEASE SEEK SPECIALIST INPUT IF CONSIDERING PRESCRIBING IN PRIMARY CARE FOR A PATIENT THAT MEETS THE NICE CRITERIA. 

PLEASE REFER PATIENTS TO THE CVD RISK AND LIPID ADVICE AND GUIDANCE PATHWAY

FURTHER INFORMATION ON LIPID MANAGEMENT PATHWAY WILL FOLLOW.

Inclisiran is recommended as an option for treating primary hypercholesterolaemia (heterozygous familial and non-familial) or mixed dyslipidaemia as an adjunct to diet in adults. It is recommended only if:

• there is a history of any of the following cardiovascular events:
• • acute coronary syndrome (such as myocardial infarction or unstable angina needing hospitalisation)
  • coronary or other arterial revascularisation procedures
  • coronary heart disease
  • ischaemic stroke or
  • peripheral arterial disease, and
• low-density lipoprotein cholesterol (LDL-C) concentrations are persistently 2.6 mmol/l or more, despite maximum tolerated lipid-lowering therapy, that is:
• • maximum tolerated statins with or without other lipid-lowering therapies or,
  • other lipid-lowering therapies when statins are not tolerated or are contraindicated

Further information on NICE TA733: https://www.nice.org.uk/guidance/TA733

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

Use in Type 1 Diabetes and Heart Failure

Dapagliflozin is  HOSPITAL INITIATION when prescribed for use in the following indications: 

with reduced ejection fraction - HOSPITAL INITIATION ONLY

Type 1 Diabetes - manufacturer has withdrawn license for use in Type 1 diabetes  and subsequently NICE TA 597 has been withdawn.

• For existing patients, Barts Health will liaise with GPs to continue treatment as "off-label"using existing transfer of care documents available on portal  and if GP refuses, this will be stopped.

• No new patients are expected to be initiated,  and if so, GPs would be contacted by specialist to discuss further whether prepared to prescribe if treatment started by hospital. Evidence base remains unchanged, and license withdrawal was due to commerical reasons - not due to any concerns around safety. 

Treatment of symptomatic chronic heart failure with reduced ejection fraction: 

following initiation by specialist and review from hospital, and can be prescribed in Primary care. The indication is in line with NICE TA 679.

Dapagliflozin is amber on the formulary for use in heart failure and may be initated at the recommendation of a Specialist.

Use is in line with recommendations from the NICE TA (see links for further detail); supporting resources are available on Clarity.

• Dapagliflozin for treating chronic heart failure with reduced ejection fraction - NICE TA 679
  •  Supporting resources available on Clarity here

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

For oral preparations: modified-release preparations are Formulary Only.

Sacubitril with valsartan [Entresto®] is to be initiated in secondary care under the direction of a specialist.
  
The prescribing and monitoring is to be undertaken in secondary care until the stabilisation of treatment for a period of up to 3 months. Following this, prescribing may be transferred to primary care. The pathway for transfer of prescribing to primary care is being finalised.

Click here for the summary of product characteristcs

Click here for more product information from the European Medicines Agency

Parenteral Formulation is for Hospital Prescribing Only.

Brand Prescribing is REQUIRED

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

Standard-release preparations are AMBER on the Tower Hamlets CCG formulary, and require recommendation from a Specialist.

Modified-release preparations are GREEN and therefore can be initiated in Primary Care, if clinically appropriate for the individual patient. 

BRAND PRESCRIBING IS REQUIRED.

Parenteral formulation is for Hospital Prescribing Only.

Parenteral formulation is for Hospital Prescribing Only.

For modified-release preparations - Brand Prescribing is Required.

Enoxaparin is a biological medicine where biosimilars are available. Therefore enoxaparin must be prescribed by brand name and the brand name specified on the prescription should be dispensed in order to avoid inadvertent switching.

January 2021: Clexane is the brand of choice at Barts Health, for treatment indications where CrCl>30ml/min. For Shared Care the brand to be prescribed should be communicated at the point of initiation.

If it is for the specific condition you are asked to continue treatment for and you are happy to prescribe in accordance with the guideline, then take over the agreed responsibilities including prescribing. Please ensure the document is scanned into the patient's electronic records.

Click here for the Shared Care Guideline Repository

If sufficient information has not been provided and if you do not feel happy to continue to prescribe, it is advisable to refer the patient back to the specialist clinic and complete and send as soon as possible an 'inappropriate prescribing request communication form' .   

Parenteral formulation is for Hospital Prescribing Only.

For oral preparations: modified-release preparations are Formulary Only.