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Last updated: 17/01/2022

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Drug Name Classification Clinical Indication Comments
3,4 DIAMINOPYRIDINE (NEW) Red Lambert Eaton Myasthenic Syndrome


ABATACEPT (UPDATED) Red Rheumatoid arthritis

In line with NICE TA 195 and NICE TA 280 and NICE TA715

ABROCITINIB (Cibinqo ®) (NEW) Grey Treatment of moderate-to-severe atopic dermatitis in adults and adolescents 12 years and older who are candidates for systemic therapy

Not yet reviewed

ACITRETIN (UPDATED) Red For psoriasis, Icthyosis, palmoplantar pustulosis and Dariers disease in males and postmenopausal women.

Reviewed by TAS 22nd June 2021

ADALIMUMAB (UPDATED) Red Moderate rheumatoid arthritis.

In line with NICE TA715

ANAKINRA (Kineret®) (NEW) Red Haemophagocytic Lymphohistiocytisis
ANDEXANET ALFA (Ondexxya®) (NEW) Red Reversing anticoagulation from apixaban or rivaroxaban in adults for life-threatening or uncontrolled GI bleed.

In line with NICE TA697


Not yet reviewed

BElIMUMAB (UPDATED) Red Active autoantibody-positive systemic lupus erythematosus. Rheumatology only
BEROTRALSTAT (Orladeyo®) (UPDATED) Red Prevention of recurrent attacks of hereditary angioedema (HEA)

In line with NICE TA378

BIMEKIZUMAB (Bimzelx®) (NEW) Red Moderate to severe plaque psoriasis

In line with NICE TA723

BOTULINUM TOXIN B (Neurobloc®) (UPDATED) Red Neurology use only

Used by Turning Point . If a patient is admitted to hospital contact turning point for advice about alternatives:

0116 3732117 – Direct dial to prescribing team

0116 3732108 – Direct Dial to Clinical Admin

0330 303 6000 – Main Switchboard

CASIRIVIMAB AND IMDEVIMAB (Ronapreve®) (NEW) Red For patients hospitalised due to COVID-19
CHLORAL HYDRATE/CLORAL BETAINE (NEW) Red Insomnia in children and adolescents

Traffic light change following MHRA restrictions.

Should not be stopped suddenly, so there will need to be some continuation in primary care in the short term.

CHLORMETHINE GEL (Ledaga®) (NEW) Red Mycosis fungoides-type T cell lymphomas

In line with NICE TA720

CHLOROPROCAINE HYDROCHLORIDE (Ampres®) (NEW) Do not prescribe Spinal anesthesia for orthopedic & urology day cases lasting 40 to 60 mins

Reviewed by TAS September 2021

COLISTIN (NEW) Red Nebulised for Cystic fibrosis
COLISTIN (Colomycin® and Promixin ®) Orange Nebulised for cystic fibrosis

Historic patients only. Must be prescribed by brand as the brands are not interchangeable.

CRIZANLIZUMAB (NEW) Red Preventing sickle cell crises in sickle cell disease

In line with NICE TA743

DALBAVANCIN (Xydalba®) (NEW) Red Osteoarticular infections (unlicensed)
DAPAGLIFLOZIN (NEW) Do not prescribe Type 1 diabetes

New patients

DAPAGLIFLOZIN (UPDATED) Yellow With insulin for treating Type 1 diabetes

Now unlicensed due to commercial reasons


DEXMEDETOMIDINE (Dexdor ®) (NEW) Red Pre procedure sedation in children
ESKETAMINE HYDROCHLORIDE NASAL SPRAY (Spravato®) (UPDATED) Red In combination with a SSRI or SNRI for adults with treatment-resistant Major Depressive Disorder

Administration in specialist clinic only

ESTRADIOL VAGINAL TABLETS (Vagirux®) (NEW) Green Vaginal atropy in post menopausal women
ETANERCEPT (NEW) Red Moderate rheumatoid arthritis.

In line with NICE TA715

FOSTEMSAVIR (Rukobia ®) (NEW) Red HIV Infections
GALANTAMINE Gazylan XL ® (UPDATED) Yellow Alzheimer's disease
GALANTAMINE LIQUID (UPDATED) Red Alzheimer's disease

Leicestershire Partnership Trust consultants only

GLYCEROL PHENYLBUTYRATE (Ravicti®) (UPDATED) Red Chronic management of patients with urea cycle disorders (UCDs)
GLYCOPYRONIUM/BECLOMETASONE/FORMETEROL DPI (Trimbow NEXThaler) (NEW) Green Maintenance treatment of adults with moderate to severe COPD

Reviewed by the Respiratory Prescribing Group September 2021

GUSELKUMAB (NEW) Red Treating active psoriatic arthritis after inadequate response to DMARDs

In line with NICE TA711

Herpes ZOSTER vaccine (UPDATED) Do not prescribe All indications outside of the green book. Zostavax is a live vaccine, therefore NOT suitable for immunocompromised patients. Do not prescribe on FP10 (black through this route).

Available centrally from 1st Sept 2013 for those aged 70 and 79 years
Public Health advice

HUMAN FIBRINOGEN & HUMAN THROMBIN (Veraseal®) (NEW) Red Supportive treatment in adults where standard surgical techniques are insufficient; for improvement of haemostasis & as suture support in vascular surgery
HYDROXYCHLOROQUINE (UPDATED) Yellow Rheumatological disease

Eye checks to be organised by secondary care.

IMIPENEM/CILASTATIN/ RELEBACTAM (Recarbrio®) (UPDATED) Red Aerobic Gram-negative infections
INFLIXIMAB (NEW) Red Moderate rheumatoid arthritis.

In line with NICE TA715

INHALED DRY POWDER BUDESONIDE (UPDATED) Do not prescribe Covid 19 treatment

No longer recommended for Covid treatment outside of a trial in line with CAS 103185


IXEKIZUMAB (Taltz®) (NEW) Red Axial spondyloarthritis

In line with NICE TA718

Implementation date 21st October

LURASIDONE (UPDATED) Orange Schizophrenia aged 13-17 years

Full SCA  Request form

MELATONIN M/R 1mg and 5mg tablets (Slenyto®) (UPDATED) Yellow Insomnia for children aged 2-18 years with Autism Spectrum Disorder and or Smith-Magenis syndrome
MOMETASONE/ OLOPATADINE NASAL SPRAY (Ryaltris ®) (NEW) Grey Moderate to severe nasal symptoms associated with allergic rhinitis

Not yet reviewed

OFATUMUMAB (Kesimpta ®) (NEW) Red For treating relapsing multiple sclerosis

In line with NICE TA699

Implementation date 19th August 2021

OPIATE/MORPHINE TINCTURE (Dropizol® oral drops) (NEW) Do not prescribe Severe diarrhoea

Reviewed by TAS 22nd June 2021

OPTIVE PLUS (UPDATED) Do not prescribe Dry eye
OXANDROLONE (UPDATED) Red Prophylaxis of acute attacks in hereditary angioedema. Third line after danazol and stanozolol when stanozolol is unavailable
PERGOLIDE (UPDATED) Do not prescribe Parkinson's disease

No longer recommended

PONESIMOD (Ponvory®) (NEW) Grey Relapsing forms of multiple sclerosis with active disease.

Not yet reviewed

PROGESTERONE SC INJECTION (Lubion®) (NEW) Do not prescribe Luteal Phase Support for assisted reproduction treatment (IVF/ICSI)

Reviewed by TAS September 2021

QUINIDINE (NEW) Red KCNT1 gene mutation related Early Infantile Epileptic Encephalopathy

Reviewed by TAS September 2021

RAVULIZUMAB (UPDATED) Red Treating atypical haemolytic uraemic syndrome (aHUS)

Only for use in specialist centres or in secondary care under an agreed tertiary centre as per NICE TA710.

RAVULIZUMAB (Ultomiris®) (UPDATED) Do not prescribe Paroxysmal nocturnal haemoglobinuria

In line with NICE TA698 this product should be used by specialist centres only. At the time of classification LLR is not a site of a specialist centre.

REMIMAZOLAM (Byfavo®) (NEW) Grey Procedural sedation in adults.

Not yet reviewed

SAPROPTERIN (NEW) Red Hyperphenylalaninaemia in phenylketonuria

In line with NICE TA729

SECUKINUMAB (Cosentyx®) (NEW) Red Non-radiographic axial spondyloarthritis

In line with NICE TA719

Implementation date 21st October 2021

SECUKINUMAB (Cosentyx®) (NEW) Red Treating moderate to severe plaque psoriasis in children and young people

In line with NICE TA734

Implementation date  7th January 2022

SIMPLE EYE OINTMENT (UPDATED) Do not prescribe Dry eye
SOLRIAMFETOL (Sunosi ®) (UPDATED) Red Excessive daytime sleepiness in narcolepsy
SOLRIAMFETOL (Sunosi ®) (UPDATED) Red Residual sleepiness in optimally CPAP treated obstructive sleep apnoea
TOFACITINIB (NEW) Red Juvenile idiopathic arthritis

In line with NICE TA735

Implementation date 20th January 2022

TRALOKINUMAB (Adtralza ®) (NEW) Grey Treatment of moderate-to-severe atopic dermatitis in adult

Not yet reviewed

TRANSDERMAL ESTRADIOL SPRAY (Lenzetto®) (NEW) Green Symptoms of menopause
TRI-IODOTHYROACETIC ACID (TRIAC) (Emcitate®) (NEW) Do not prescribe Allan-Herndon Dudley syndrome associated with MCT-8 deficiency

Reviewed by TAS 22nd June 2021

UPADACITINIB (Rinvoq®) (NEW) Red Moderate rheumatoid arthritis in adults

In line with NICE TA744

Implementation date 10th February 2022

VERICIGUAT (Verquvo®) (NEW) Grey Chronic heart failure in adult patients with reduced ejection fraction who are stabilised after a recent decompensation event requiring IV therapy.

Not yet reviewed


Clarification of historical status

Other Updates on this Website

Recent documents from LLR APC and TAS

About the Leicester, Leicestershire and Rutland Area Prescribing Committee

In common with other local health communities, the Leicester, Leicestershire and Rutland Area Prescribing Committee (LLR APC) acknowledges the benefits of having a Leicestershire Health Community-wide strategy for the prescribing of specialist medicines and the managed entry of new drugs and related technologies.

Leicestershire Health Community comprises the three Clinical Commissioning Groups, University Hospitals of Leicester (UHL) NHS Trust and Leicestershire Partnership NHS Trust (LPT), amongst which there is a total consensus on the need for this strategy, and the LLR APC has been in place since 2005. Learn more