netFormulary NHS
Southampton Joint Formulary
 Search
 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.01  Positive inotropic drugs
02.01.01  Cardiac glycosides
Digoxin
(tablet/liquid)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Digoxin
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
02.01.01  Digoxin-specific antibody
Digoxin specific antibody fragments (Digifab«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
   
02.01.02  Phosphodiesterase type-3 inhibitors
Milrinone (Primacor«)
(injection)
View adult BNF View childrens BNF
Formulary
Red

Restricted Item  Critical Care only

 
   
Levosimendan
(injection)
View adult BNF
Restricted Drug Restricted
Red

unlicensed Unlicensed

Restricted Item Specialist use only in cardiac surgery patients for:

 - Life threatening post-operative low cardiac output syndrome where the patient is on maximum therapy (catecholamines) and phosphodiesterase inhibitors are contra-indicated/not tolerated.

 - Rarely pre-operatively for patients with very low cardiac output/ejection fraction (e.g. LVEF <25%).

 
 
   
02.02  Diuretics to top
02.02.01  Thiazides and related diuretics
Bendroflumethiazide
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Chlorothiazide
(liquid)
View adult BNF View childrens BNF
Formulary
Amber Initiation

unlicensed unlicensed

Restricted Item Child Health only

 
   
Indapamide
(tablet/MR tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Metolazone
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green

unlicensed unlicensed

 
   
02.02.02  Loop diuretics
Furosemide
(tablet/liquid/injection)
View adult BNF View SPC online View childrens BNF
First Choice
Green
 
Bumetanide
(tablet/liquid)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
02.02.03  Potassium-sparing diuretics and aldosterone antagonists
Amiloride Hydrochloride
(tablet/liquid)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Potassium canrenoate
(injection)
View adult BNF View childrens BNF
Formulary
Red

unlicensed unlicensed

 
   
02.02.03  Aldosterone antagonists
Eplerenone
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation

If hormonal side effects on spironolactone

To reduce the risk of CV mortality and morbidity in selected patients after recent MI or with CHF

 
   
Spironolactone
(tablet/liquid)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
02.02.04  Potassium-sparing diuretics with other diuretics to top
Co-amilofruse (furosemide and amiloride)
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Only as an aid to compliance

 
   
02.02.05  Osmotic diuretics
Mannitol
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
02.02.06  Mercurial diuretics
02.02.07  Carbonic anhydrase inhibitors
02.02.08  Diuretics with potassium
02.03  Anti-arrhythmic drugs to top
02.03.01  Management of arrhythmias
02.03.02  Drugs for arrhythmias
Ajmaline
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

unlicensed unlicensed

Restricted Item Cardiology use only. For provocative challenge in Brugada Syndrome

 
   
Magnesium sulfate 50%
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Phenytoin sodium
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Restricted Item Cardiology use only

 
   
02.03.02  Supraventricular arrhythmias
Adenosine (Adenocor«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Dronedarone (Multaq«)
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
Link  NICE TA197: Dronedarone for the treatment of non-permanent atrial fibrillation
   
Verapamil
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Verapamil
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation
 
   
02.03.02  Supraventricular and ventricular arrhythmias
Amiodarone
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
   
Amiodarone
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Disopyramide
(capsule)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation
 
   
Disopyramide
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Flecainide
(tablet/liquid)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation

Restricted Item Specialist use only

unlicensed Unlicensed liquid special 25mg in 5mL restricted to paediatrics unable to swallow until solid dosage forms are suitable.

 
   
Flecainide
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Restricted Item Specialist use only.

 
   
Procainamide
(injection)
View adult BNF View childrens BNF
Formulary
Red

unlicensed unlicensed.

Restricted Item Cardiology use only.

 
   
Propafenone
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation

Restricted Item Cardiology only.

 
   
Sotalol
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation
 
   
02.03.02  Ventricular arrhythmias to top
Lidocaine
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Lidocaine 0.4% in glucose 5%
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Mexiletine hydrochloride
(capsule)
View adult BNF View childrens BNF
Formulary
Amber Initiation

Restricted Item Cardiology use only  unlicensed unlicensed.

 

note Note: also approved as red for myotonia (see section 10.2.2)

 
   
02.04  Beta-adrenoceptor blocking drugs
Atenolol
(tablet/liquid)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Atenolol
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Bisoprolol
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Heart failure - first line

 
   
Carvedilol
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Heart failure - second line

 
   
Esmolol
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Restricted Item Critical care only

 
   
Labetalol
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Labetalol
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Metoprolol
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation

Tablets for initiation, review after 24 hours

 
   
Metoprolol
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Propranolol
(tablet/liquid/MR capsule)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Propranolol
(injection)
View adult BNF View childrens BNF
Formulary
Red

unlicensed unlicensed

 
   
02.05  Drugs affecting the renin-angiotensin system and some other antihypertensive drugs
02.05.01  Vasodilator antihypertensive drugs
Hydralazine
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
   
Hydralazine
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Iloprost 100micrograms/ml
(infusion)
View adult BNF View childrens BNF
Formulary
Red
High Cost Medicine

Refer to UHS Iloprost Intravenous Infusion Guidelines

 
   
Minoxidil
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
   
Sildenafil (Revatio«)
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Restricted Item  Specialist use only. Pulmonary hypertension.

 
   
Sodium nitroprusside
(injection)
View adult BNF
Formulary
Red

unlicensed unlicensed

Restricted Item  Critical Care and Child Health nephrology only

 
   
Ambrisentan
(tablets)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine

For patients managed under a shared care agreement with the Royal Brompton Hospital only

 
   
Bosentan (Tracleer«)
(tablet)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine

For patients managed under a shared care agreement with the Royal Brompton Hospital only

 
   
Macitentan (Opsumit «)
(tablet)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine

For patients managed under a shared care agreement with the Royal Brompton Hospital only.

 
   
02.05.02  Centrally acting antihypertensive drugs
Clonidine
(tablets)
View adult BNF View SPC online View childrens BNF
Formulary

Amber Recommended Amber Recommended for licensed indications (refer to SmPC for details).

Red Restricted Item unlicensed for short-term, off label use in sedation/opioid withdrawal in high care paediatrics in accordance with UHS protocol

 
   
Clonidine (Catapres«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Clonidine 50micrograms in 5ml
(oral solution)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Restricted Item unlicensed for short-term, off label use in sedation/opioid withdrawal in high care paediatrics in accordance with UHS protocol; oral solution only for use when tablet formulation not suitable

 

 
   
Methyldopa
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation

Antenatal use

 
   
Moxonidine
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation

Restricted Item  Specialist use only

 
   
02.05.03  Adrenergic neurone blocking drugs to top
Guanethidine Monosulphate (Ismelin«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
02.05.04  Alpha-adrenoceptor blocking drugs
Doxazosin
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Not XL (prolonged-release) tablet

 
   
02.05.04  Phaeochromocytoma
Phenoxybenzamine Hydrochloride
(capsule)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Phentolamine
(injection)
View adult BNF View childrens BNF
Formulary
Red

unlicensed unlicensed

Restricted Item  Critical Care only

 
   
02.05.05  Drugs affecting the renin-angiotensin system
02.05.05.01  Angiotensin-converting enzyme inhibitors (ACE inhibitors)
Ramipril
(capsule)
View adult BNF View SPC online View childrens BNF
First Choice
Green
 
Captopril
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Restricted Item  Child Health and for patients particularly at risk of hypotension

 
   
Captopril
(liquid)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation

Restricted Item  Child Health and for patients particularly at risk of hypotension

 
   
Enalapril
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Lisinopril
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Blue
 
   
02.05.05.02  Angiotensin-II receptor antagonists to top
Candesartan
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Losartan
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Sacubitril valsartan (Entresto«)
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation
 
Link  NICE TA388: Sacubitril valsartan for treating symptomatic chronic heart failure with reduced ejection fraction
   
02.05.05.03  Renin inhibitors
02.06  Nitrates, calcium-channel blockers, and potassium-channel activators
02.06  Angina
02.06.01  Nitrates
Glyceryl Trinitrate
(Sublingual tablet/Sublingual spray)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Glyceryl Trinitrate
(patch)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
   
Glyceryl Trinitrate 5mg/ml
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Isosorbide Mononitrate
(tablet/MR capsule)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Isosorbide Mononitrate (Isotard XL«)
(MR tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Blue
 
   
02.06.02  Calcium-channel blockers to top
Amlodipine
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green

For hypertension; or angina if on betablocker

 
   
Diltiazem 60mg
(modified-release tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Suitable for generic prescribing.

 
   
Diltiazem Hydrochloride (Viazem XL«)
(prolonged-release capsule)
View adult BNF View SPC online View childrens BNF
Formulary
Green

For angina if not on beta-blocker.

Once daily preparation.

Prescribe by brand name

 
   
Diltiazem Hydrochloride (Zemtard XL«)
(prolonged-release capsule)
View adult BNF View SPC online View childrens BNF
Formulary
Blue

For angina if not on beta-blocker

Once daily preparation

Prescribe by brand name

 
   
Nifedipine
(Modified-release tablets/capsules)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Prescribe by brand name, e.g. Adalat Retard®, Adipine MR®, Coracten SR®

 
   
Nifedipine
(prolonged-release tablets/capsules)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Prescribe by brand name, e.g. Adalat LA®, Adipine XL®, Coracten XL®

 
   
Nifedipine
(capsules)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Immediate release formulation for treatment of Raynaud's phenomenon.

Modified-release formulations preferred for other indications, including treatment of hypertension, angina prophylaxis and tocolysis.

Red Triangle Not recommended for (off label) sublingual administration.

 
   
Nimodipine (Nimotop«)
(injection)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red

For subarachnoid haemorrhage

 
   
Nimodipine (Nimotop«)
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation

For subarachnoid haemorrhage

 
   
Verapamil
(tablet/MR tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Verapamil
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
02.06.03  Other anitanginal drugs
Ivabradine
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Third-line option for stable angina in accordance with NICE guidelines

 
   
Ivabradine
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

For heart failure

 
Link  NICE TA267: Ivabradine for treating chronic heart failure
   
Nicorandil
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green

For stable angina in accordance with NICE Guidelines

 
   
Ranolazine (Ranexa«)
(prolonged-release tab)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

Restricted Item Specialist recommendation only. Third-line option for stable angina where other anti-anginals are contraindicated/not tolerated due to hypotensive and/or bradycardic effects and revascularisation options not available.

 
   
02.06.04  Peripheral vasodilators and related drugs
Naftidrofuryl
(capsule)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
Link  NICE CG147: Peripheral arterial disease: diagnosis and management
Link  NICE TA223: Intermittent claudication drugs
   
Papaverine
(injection)
View adult BNF View childrens BNF
Formulary
Red

unlicensed unlicensed

 
   
02.06.04  Other preparations used in peripheral vascular disease
Sildenafil
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation

Off label use

An option in patients with Raynaud’s phenomenon

 
   
02.07  Sympathomimetics
02.07.01  Inotropic sympathomimetics to top
Dobutamine
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Dopamine
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Isoprenaline
(injection)
View adult BNF View childrens BNF
Formulary
Red

unlicensed unlicensed

 
   
02.07.02  Vasoconstrictor sympathomimetics
Ephedrine
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Metaraminol
(injection)
View adult BNF View childrens BNF
Formulary
Red

unlicensed unlicensed

 
   
Noradrenaline
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Phenylephrine
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

First line for acute hypotension

 
   
02.07.03  Cardiopulmonary resuscitation
Adrenaline 1 in 10,000
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
02.08  Anticoagulants and protamine
02.08.01  Parenteral anticoagulants
Argatroban (Exembol«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Option for patients in critical care areas with heparin-induced thrombocytopenia

 
   
Defibrotide
(injection)
View adult BNF View childrens BNF
Formulary
Red
High Cost Medicine

unlicensed unlicensed

 
   
02.08.01  Heparin to top
Heparin calcium
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Heparin sodium
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
02.08.01  Low molecular weight heparins
Enoxaparin/enoxaparin biosimilar
(injection)
View adult BNF View SPC online View childrens BNF
Formulary

Amber Amber for extended thromboprophylaxis
Amber Amber in pregnancy
Green Green for other recognised indications

Red Triangle Prescribe by brand name and ensure patients are counselled on use of the relevant device. From mid-September 2020 UHS will be using Inhixa brand only.

Arovi, Enoxaparin Becat and Inhixa brands are black triangle

 

 
Link  Sept 2020: Information on Trust-wide switch to Inhixa brand enoxaparin (intranet access only)
Link  UKMi In use product safety assessment report for enoxaparin biosimilars
Link  DPC Enoxaparin Biosimilar Factsheet Nov 2017
   
Tinzaparin
(multi-dose vial solution for injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Restricted Item unlicensed Specialist use off label in paediatrics ONLY for prophylaxis or treatment of thromboembolic disorders in long term/Homecare patients with no necessity to remain in hospital (refer to Southampton Children's Hospital guidelines).

Not for use in adults (enoxaparin is LMWH of choice at UHS for adults).

Red Triangle Multidose vials contain 10mg/ml of the preservative benzyl alcohol: may cause toxic and anaphylactoid reactions in infants and children up to 3 years old. Where possible use alternative CIVAS enoxaparin syringes in neonates.

 
Link  The Use of Low Molecular Weight Heparin in Children
   
02.08.01  Heparinoids
Danaparoid (Orgaran«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

For thromboprophylaxis when history of heparin-induced thrombocytopenia

 
   
02.08.01  Hirudins
Bivalirudin (Angiox«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
Link  NICE TA230 : Bivalirudin for the treatment of STEMI, 2011
   
02.08.01  Heparin flushes
Heparin sodium
(50 units in 5mL flush)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

Restricted Item Restricted use in primary care. GPs to prescribe only for children for administration by specialist paediatric community nurses.

 
Link  NPSA Rapid Response Risks with Intravenous Heparin Flush Solutions April 2008
Link  RMOC Position Statement on heparinised saline for central venous catheter lock in adults Feb 2019
   
02.08.01  Epoprostenol to top
Epoprostenol (Flolan«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
   
02.08.01  Fondaparinux
Fondaparinux (Arixtra«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

  • for thromboprophylaxis when history of heparin-induced thrombocytopenia only when danaparoid is unobtainable
  • as an adjunct to thrombolysis with tenecteplase in STEMI
  • for NSTEMI
  • for superficial thrombophlebitis
 
   
02.08.02  Oral anticoagulants
EdoxabanBlack Triangle (Lixiana«)
(tablet)
View adult BNF View SPC online View childrens BNF
First Choice
Green

note Due to cost effectiveness this is the first choice DOAC locally for prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation (NVAF). See DPC Anticoagulant Decision Aid.

Note: other DOACs may be used if considered more clinically appropriate.

 
Apixaban (Eliquis«)(AF/VTE)
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
Link  NICE TA275: Apixaban for preventing stroke and systemic embolism in people with nonvalvular AF
Link  NICE TA341: Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism
   
Apixaban (Eliquis«)(Orthopaedic prophylaxis)
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
Link  NICE TA245: Apixaban for the prevention of VTE after total hip or knee replacement in adults
   
Dabigatran (Pradaxa«) (AF/VTE)
(capsule)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
Link  NICE TA249: Dabigatran for the prevention of stroke and systemic embolism in AF
Link  NICE TA327: Dabigatran etexilate for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism
   
Dabigatran (Pradaxa«) (Orthopaedic prophylaxis)
(capsule)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
Link  NICE TA157: Dabigatran for the prevention of VTE after hip or knee replacement surgery in adults
   
Phenindione
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
   
Rivaroxaban (Xarelto«) (ACS)
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Initiation
 
Link  NICE TA335: Rivaroxaban for preventing adverse outcomes after acute management of ACS
   
Rivaroxaban (Xarelto«) (AF/VTE)
(tab)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
Link  NICE TA256: Rivaroxaban for the prevention of stroke and systemic embolism in people with AF
Link  NICE TA261: Rivaroxaban for the treatment of DVT and prevention of recurrent DVT and PE
Link  NICE TA287: Rivaroxaban for treating PE and preventing recurrent VTE
Link  NICE TA607: Rivaroxaban for preventing atherothrombotic events in people with coronary or peripheral artery disease
Link  Pharmacist checklist for counselling patients starting rivaroxaban for NVAF
   
Rivaroxaban (Xarelto«) (Orthopaedic prophylaxis)
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Red

  • red for trauma (off-label use)
  • red for off-label use for patients with fractured neck of femur or who have a plaster cast and who fulfil the assessment criteria
 
Link  NICE TA170: Rivaroxaban for the prevention of VTE after total hip or total knee replacement in adults
   
Warfarin
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
02.08.02  Stroke prevention in AF
02.08.02  VTE treatment
02.08.03  Anticoagulant reversal agents to top
Idarucizumab (Praxbind«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

  • Restricted Item On  Consultant Haematologist advice only (refer to UHS guideline).
  • When rapid reversal of dabigatran is required for emergency surgery/urgent procedures or in life-threatening or uncontrolled bleeding.
 
   
Phytomenadione (Konakion MM «)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

Konakion MM Paediatric injection can be given orally

 
   
Protamine sulfate
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
02.09  Antiplatelet drugs
Abciximab
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
Link  NICE TA47: Guidance on the use of glycoprotein IIb/IIIa inhibitors in the treatment of ACS
   
Aspirin
(dispersible tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Aspirin
(suppositories/injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

unlicensed injection is unlicensed 

 
   
Clopidogrel
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
Link  NICE TA210: Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events
   
Dipyridamole
(MR capsule)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
Link  NICE TA210: Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events
   
Dipyridamole
(liquid)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

Only if opening capsules is inappropriate

Liquid is sugar free

 
Link  NICE TA210: Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events
   
Eptifibatide (Integrilin«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Prasugrel (Efient«)
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
Link  NICE TA317: Prasugrel with PCI for treating ACS
   
Ticagrelor
(orodispersible tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Red

For patients temporarily unable to swallow

 
   
Ticagrelor (Brilique«)
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
Link  NICE TA236: Ticagrelor for the treatment of acute coronary syndromes
Link  NICE TA420: Ticagrelor for preventing atherothrombotic events after myocardial infarction
   
Ticlopidine
(tablet)
View adult BNF View childrens BNF
Formulary
Red

unlicensed unlicensed

Restricted Item Specialist use only.

 
   
Tirofiban (Aggrastat«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
02.10  Stable angina, acute coronary syndromes, and fibrinolysis
02.10.01  Management of stable angina and acute coronary syndromes
02.10.02  Fibrinolytic drugs
Alteplase (Actilyse«; Actilyse Cathflo«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Also for pulmonary emboli

Actilyse Cathflo® 2mg only for clearing blocked central venous catheters

 
Link  NICE TA264: Ischaemic stroke (acute) - alteplase
Link  NICE TA52: Guidance on the use of drugs for early thrombolysis in the treatment of acute myocardial infarction
   
Reteplase (Rapilysin«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
Link  NICE TA52: Guidance on the use of drugs for early thrombolysis in the treatment of acute myocardial infarction
   
Streptokinase
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
Link  NICE TA52: Guidance on the use of drugs for early thrombolysis in the treatment of acute myocardial infarction
   
Tenecteplase (Metalyse«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
Link  NICE TA52: Guidance on the use of drugs for early thrombolysis in the treatment of acute myocardial infarction
   
Urokinase
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

For clearing blocked lines/catheters and treatment of empyema (off-label) only

 
   
02.11  Antifibrinolytic drugs and haemostatics to top
Aprotinin (Trasylol«)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Restricted Item Restricted to use by Cardio-thoracic anaesthetist only

 
   
Etamsylate
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Restricted Item Countess Mountbatten House use only

unlicensed unlicensed

 
   
Evicel« kit
View adult BNF View SPC online View childrens BNF
Formulary
Red

Restricted ItemáSpecialist use only

 
   
Rurioctocog alfa pegolBlack Triangle (Adynovi«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red Specialist Centre
NHS England

Restricted Item Haematology specialist use only under NHS England specialised commissioning arrangements.

 
   
Tisseel« kit
View adult BNF View SPC online View childrens BNF
Formulary
Red

Restricted Item Specialist use only

 
   
Tranexamic Acid
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green

For menorrhagia

 
   
Tranexamic Acid
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Tranexamic acid 5% mouthwash
View adult BNF View SPC online View childrens BNF
Formulary
Red

unlicensed Unlicensed special for use in post oral surgery bleeding

 
   
Turoctocog alfa pegolBlack Triangle (Esperoct«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red Specialist Centre
NHS England

Restricted Item Haematology specialist use only under NHS England specialised commissioning arrangements.

 
   
02.11  Blood-related products
02.12  Lipid-regulating drugs
Alirocumab (Praluent«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
Link  NICE TA393: Alirocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia
   
Evolocumab (Repatha« )
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine
 
Link  NICE TA394: Evolocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia
   
Lomitapide (Lojuxta«▼)
View adult BNF View SPC online View childrens BNF
Formulary
Red
High Cost Medicine

Restricted Item In line with commissioning criteria

 
Link  Clinical Commissioning Policy: Lomitapide for treating homozygous familial hypercholesterolaemia (adults)
   
02.12  Bile acid sequestrants
Colestyramine powder
(sachet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended
 
   
02.12  Ezetimibe
Ezetimibe (Ezetrol«)
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Mainly reserved as an adjunct to statins for patients with primary hypercholesterolaemia.

 
Link  NICE TA385: Ezetimibe for treating primary heterozygous-familial and non-familial hypercholesterolaemia
   
02.12  Fibrates to top
Fenofibrate
(capsule)
View adult BNF View SPC online View childrens BNF
First Choice
Green

First choice fibrate.

Consider only when a statin or other treatments are contraindicated or not tolerated.

 
Bezafibrate
(MR tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Amber Recommended

Consider only when a statin or other treatments are contra-indicated or not tolerated

unlicensed Also approved for off-label use for the treatment of primary biliary cholangitis

 
   
02.12  Statins
Atorvastatin
(tablet)
View adult BNF View SPC online View childrens BNF
First Choice
Green
 
Pravastatin
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Rosuvastatin
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green

Restricted Item Reserved for use in patients requiring high intensity statin unable to tolerate/unsuitable for atorvastatin or high dose simvastatin

 
   
Simvastatin
(tablet)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
02.12  Omega-3 fatty acid compounds
02.13  Local sclerosants
Ethanolamine Oleate
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
Sodium Tetradecyl Sulphate (Fibro-Vein«)
(injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
 
   
02.14  Miscellaneous
Regadenoson
(Injection)
Formulary
Red

unlicensed unlicensed

For use during radionuclide myocardial perfusion scanning

 
   
Tafamidis (Vyndaqel)
(capsules)
View adult BNF View SPC online View childrens BNF
Formulary
Red Specialist Centre
High Cost Medicine
NHS England
BlueTeq

Restricted Item Specialist use only. NHS England specialised commissioning for treatment of transthyretin amyloid cardiomyopathy in adults in Trusts providing specialised amyloidosis services.

Available via MHRA EAMS application for eligible patients.

Red Triangle Not routinely stocked at UHS. If required, liaise with lead divisional pharmacist.

 
Link  MHRA Early Access to Medicines Scheme (EAMS): tafamidis for transthyretin amyloid cardiomyopathy (May 2019)
   
 ....
 Non Formulary Items
Acebutolol  (Sectral«)
(capsules/tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Acenocoumarol  (Sinthrome«)
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Aliskiren  (Rasilez«)
(tablets)

View adult BNF
Non Formulary
Link  MHRA Safety Update: Aliskiren (Rasilez): risk of cardiovascular and renal adverse reactions
Link  MHRA Safety Update:Aliskiren (Rasilez): risk of angioedema and renal dysfunction
 
Amlodipine besilate & valsartan  (Exforge«)
(tabs)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Amlodipine, hydrochlorothiazide & olmesartan  (Sevikar HCT «)
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Aspirin
(enteric-coated/gastro-resistant tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cangrelor Black Triangle  (Kengrexal«)
(injection/infusion)

View adult BNF View SPC online View childrens BNF
Non Formulary
Link  NICE TA351: Reducing Artherothrombotic Events
 
Celiprolol hydrochloride
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Chlortalidone
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cilostazol Black Triangle 
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
Link  NICE TA223:Cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease
 
Ciprofibrate
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Clonidine
(transdermal patch)

Non Formulary

unlicensed Unlicensed - available as imported product. In occasional use on a non-formulary (exceptional use only) basis at UHS for children with dystonias/dyskinesias as an alternative to high frequency IV/oral administration  - specialist use only in secondary care. Not for prescribing in primary care. Awaiting full formulary review.

 
Co-amilozide
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary

Amiloride and hydrochlorothiazide

 
Colestipol  (Colestid«)
(sachet)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Co-tenidone
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary

Atenolol and chlortalidone

 
Co-triamterzide  (Dyazide«)
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary

Hydrochlorothiazide and triamterene

 
Cyclopenthiazide & amiloride  (Navispare «)
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Dalteparin  (Fragmin«)
(injection)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Doxazosin XL
(prolonged-release tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
Link  NHS England: prolonged-release doxazosin should not routinely be prescribed in primary care
 
Enalapril and hydrochlorothiazide
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Enoximone  (Perfan«)
(injection)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Eprosartan
(tabs)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Felodipine
(prolonged-release tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Fluvastatin
(capsules/prolonged-release tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Fosinopril
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Furosemide & spironolactone  (Lasilactone «)
(capsules)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Furosemide & triamterene  (Frusene «)
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Gemifibrozil
(tablets/capsules)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Iloprost
(nebuliser solution)

View adult BNF View SPC online View childrens BNF
Non Formulary

Note: infusion is formulary

 
Imidapril  (Tanatril«)
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Indoramin
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Inositol nicotinate
(capsules)

View adult BNF View SPC online View childrens BNF
Non Formulary
Link  NICE TA223:Cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease
 
Irbesartan
(tabs)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Isosorbide dinitrate
(tablets/prolonged-release tablets/injection)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lacidipine
(tabs)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lercanidipine
(tabs)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lisinopril and hydrochlorothiazide
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Moxisylyte  (Opilon«)
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Nadolol  (Corgard«)
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Nebivolol
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Not supported by DPC 

 
Nicardipine
(caps/injection)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Olmesartan
(tabs)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Omega 3 fatty acid compounds

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

Self Care Self Care Medicine

NHS England recommendation: Should not be routinely prescribed by CCGs

Link  EMA confirms omega-3 fatty acids not effective in preventing further heart problems after heart attack
 
Oxerutins  (Paroven«)
(capsules)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Oxprenolol
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Pentoxifylline  (Trental«)
(modified-release tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
Link  NICE TA223:Cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease
 
Perindopril
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary

NHS England: Perindopril arginine should not be routinely prescribed in primary care

All perindopril formulations are non-formulary

 
Pindolol
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Prazosin  (Hypovase«)
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Quinapril
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Quinapril and hydrochlorothiazide
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ramipril & felodipine  (Triapin«)
(prolonged-release tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Riociguat  (Adempas«)
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
 
Simvastatin & ezetimibe  (Inegy«)
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Telmisartan
(tabs)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Terazosin
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Timolol maleate
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Torasemide
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Trandolapril
(capsules)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Triamterene
(capsules)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Triamterene & chlortalidone  (Kalspare «)
(tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Valsartan
(tabs/caps/oral solution)

View adult BNF View SPC online View childrens BNF
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
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine

Traffic Light Status Information

Status Description

Green

Suitable for prescribing by all in both primary and secondary care.  

Amber Recommended

Specialist recommended but suitable for continuation in primary care.  

Amber Initiation

Specialist initiated but suitable for continuation in primary care.  

Amber SCG

Specialist initiated and for continuation in primary care under a locally approved shared care guideline.  

Red

Suitable for prescribing in specialist settings (secondary care) only.   

Red Specialist Centre

Secondary care medicines to be used under specialised commissioning arrangements only.  

Blue

For primary care, either via FP10 or supplied through specialist services. These products may be stocked by hospital pharmacies only for supply to primary care units/wards or for continuing supplies for patients admitted on therapy.  

Black

Not recommended for use.  

netFormulary