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 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.08.01  Expand sub section  Parenteral anticoagulants
Argatroban (Exembol)
(injection)
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Formulary
Red

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

 
   
Defibrotide
(injection)
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Formulary
Red
High Cost Medicine

unlicensed unlicensed

 
   
02.08.01  Expand sub section  Heparin
Heparin calcium
(injection)
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Formulary
Red
 
   
Heparin sodium
(injection)
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Formulary
Red
 
   
02.08.01  Expand sub section  Low molecular weight heparins
Enoxaparin/enoxaparin biosimilar
(injection)
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Formulary

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

Prescribe by brand name.

Ensure patients are counselled on use of the relevant device.

Arovi, Enoxaparin Becat and Inhixa brands are black triangle

 

 
Link  DPC Enoxaparin Biosimilar Factsheet Nov 2017
Link  UKMi In use product safety assessment report for enoxaparin biosimilars
   
Tinzaparin
(multi-dose vial solution for injection)
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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  Expand sub section  Heparinoids
Danaparoid (Orgaran)
(injection)
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Formulary
Red

For thromboprophylaxis when history of heparin-induced thrombocytopenia

 
   
02.08.01  Expand sub section  Hirudins to top
Bivalirudin (Angiox)
(injection)
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Formulary
Red
 
Link  NICE TA230 : Bivalirudin for the treatment of STEMI, 2011
   
02.08.01  Expand sub section  Heparin flushes
Heparin sodium
(50 units in 5mL flush)
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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  Expand sub section  Epoprostenol
Epoprostenol (Flolan)
(injection)
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Formulary
Red
High Cost Medicine
 
   
02.08.01  Expand sub section  Fondaparinux
Fondaparinux (Arixtra)
(injection)
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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
 
   
 ....
 Non Formulary Items
Dalteparin  (Fragmin)
(injection)

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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
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.  

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