LLR APC Minutes 2022(4 MB) - LMSG/LLR APC minutes
Date added: 26th Jan 2023
| Drug Name | Classification | Clinical Indication | Comments |
|---|---|---|---|
| ADAPALENE / BENZOYL PEROXIDE TOPICAL (Epiduo®) | Green | Acne |
For more information please see local algorithm. |
| ADAPALENE topical | Green | Acne |
For more information see local algorithm. |
| AMANTADINE | Yellow | For fatigue in Multiple sclerosis |
Amantadine for fatigue in Multiple sclerosis: prescribing notes |
| AMIKACIN (Arikayce Liposomal®) | Red | For the treatment of non-tuberculous mycobacterial pulmonary disease caused by Mycobacterium Avium Complex (MAC) adults and post pubescent children) | |
| ANTIPSYCHOTICS-Atypical | Yellow |
See the LLR Antipsychotic prescribing guide Clozapine remains red – secondary care only. |
|
| APIXABAN | Green | Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation |
Use in line with |
| ATROPINE EYE DROPS | Green | Palliative care in line with guidance |
Conditional on recommendation from palliative care team. |
| AZATHIOPRINE | Orange | Rheumatological disease | |
| AZELAIC ACID 20% TOPICAL | Green | Acne |
See local algorithm for more information. |
| BECLOMETASONE DIPROPIONATE / FORMOTEROL (Fostair®) | Green |
Asthma COPD |
Prescribe in line with respiratory guidelines |
| BIMATOPROST / TIMOLOL eye drops (Ganfort®) | Green | Glaucoma | |
| BRINZOLAMIDE / BRIMONIDINE (Simbrinza®) eye drops | Green | Glaucoma | |
| BRINZOLAMIDE / TIMOLOL (Azarga®) | Green | Glaucoma | |
| CICLOSPORIN Oral | Orange | Dermatological disease | |
| CIPROFLOXACIN 2mg/ml ear drops (Cetraxal®) | Green | Acute otitis externa |
Please see appropriate antimicrobial guidance for treatment advice in otitis externa. Antimicrobial Guidance for Primary Care |
| CLINDAMYCIN AND BENZYL PEROXIDE TOPICAL (Duac ®) | Green | Acne |
See local algorithm for more information |
| CLINDAMYCIN AND TRETINOIN TOPICAL (Treclin®) | Green | Acne |
See local algorithm for more information. |
| DABIGATRAN | Green | Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation |
Use in line with |
| DENOSUMAB (Prolia®) | Orange | Osteoporosis |
|
| DIFELIKALIN (Kapruvia®) (NEW) | Grey | Moderate-to-severe pruritus associated with chronic kidney disease in adult patients on haemodialysis. | |
| DULOXETINE | Green | Diabetic neuropathy |
To be used in conjunction with Neuropathic Pain Guidelines |
| EDOXABAN | Green | Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation |
Use in line with |
| EPTINEZUMAB (Vyepti®) (NEW) | Grey | For the prophylaxis of migraine in adults who have at least 4 migraine days per month. | |
| ERTAPENEM IV | Green | Extended Spectrum Beta Lactamase (ESBL) Urinary Tract Infection (UTI) |
UTI in line with Primary Care Multi-resistant lower UTI guidance |
| ESTRADIOL HEMIHYDRATE/NORETHISTERONE ACETATE/RELUGOLIX (Ryeqo ®) | Red | For treating moderate to severe symptoms of uterine fibroids. |
In line with NICE TA832
|
| FENTANYL Sublingual (Abstral®) | Green | Breakthrough cancer pain in patients already on opioids. Palliative care in line with guidance |
Conditional on recommendation from palliative care team. |
| FIDAXOMICIN | Yellow |
Clostridium difficile infection |
GP can initiate if in line with Community Clostridium difficile Care Pathway |
| FLUTICASONE / AZELASTINE NASAL SPRAY (Dymista®) | Green | Rhinitis |
To be used in line with the Allergic Rhinitis Pathway |
| FOSTAMATINIB (Tavlesse®) | Red | For treating refractory chronic immune thrombocytopenia |
In line with NICE TA835
|
| GANCICLOVIR 0.15% EYE GEL | Do not prescribe | Acute herpetic keratitis |
Only GREEN whilst Aciclovir eye ointment 3% is not available. Definite diagnosis only. |
| GLYCOPYRRONIUM LIQUID (Colonis®) | Do not prescribe | Sialorrhea in paediatrics |
Patients started on Glycopyrronium liquid after 16th December 2022 should have been started on the Sialanar® brand. |
| GLYCOPYRRONIUM LIQUID (Sialanar®) | Yellow | Sialorrhoea in paediatrics |
Switching to the Sialanar® brand from another glycopyrronium liquid to be done by secondary care using the paper work which can be found on this page |
| GOSERELIN | Green | Prostatic carcinoma |
GP can give first injection to patients in whom anti-androgen treatment has been started by secondary care clinician. |
| GRANISETRON oral and injection | Green | Palliative care in line with guidance |
Conditional on recommendation from palliative care team. |
| GUANFACINE | Orange | ADHD - Adult |
Adult Full SCA and Request Form |
| GUANFACINE | Orange | ADHD - Peadiatric |
Paediatric Full SCA and Request Form |
| HYDROCORTISONE INJECTION | Yellow | Emergency HC injection kit |
Kit for patients with Addison’s disease or high risk due to long term steroid use. Dose to be recommended by specialist. |
| IMIQUIMOD cream 5% (Aldara®) | Green | Actinic keratoses | |
| INDOCYANINE (Verdye®) | Red | Detection of sentinel lymph nodes in Endometrial cancer |
Reviewed by TAS November 2022 |
| INSULIN ASPART (Trurapi®) | Green | Insulin |
New initiations only |
| KETAMINE | Green | Palliative care in line with guidance |
Conditional on recommendation from palliative care team.
|
| KETOROLAC | Green | Palliative care in line with guidance |
Conditional on recommendation from palliative care team. |
| LANREOTIDE | Green | Palliative Care |
Link to Palliative Care Guidelines |
| LATANOPROST preservative free eye drops | Green | Glaucoma | |
| LEFLUNOMIDE | Orange | Rheumatological disease | |
| LEUPRORELIN | Green | Prostate cancer (subcutaneous injection for patients at risk of haematoma) |
GP can give first injection to patients in whom anti-androgen treatment has been started by secondary care clinician. |
| LEVETIRACETAM | Green | Palliative care in line with guidance |
Conditional on recommendation from palliative care team. |
| LITHIUM SALTS | Orange | Mania, Bipolar Disorder, Recurrent Depression or Aggressive or Self-mutilating behaviour. | |
| Luforbec 200/6 mdi® (formeterol/beclometasone) (NEW) | Do not prescribe | Treatment of asthma where use of a combination product (inhaled corticosteroid and long-acting beta2-agonist) is appropriate |
At the request of the Respiratory Prescribing Group for formulary reasons. |
| METHADONE | Green | Palliative care in line with palliative care guidance. |
Conditional on recommendation from palliative care team. |
| METHOTREXATE Oral | Orange | Rheumatological disease | |
| METHYLNATREXONE | Green | Palliative care in line with guidance. |
Conditional on recommendation from palliative care team. |
| METHYLPHENIDATE | Green | Palliative care in line with guidance |
Conditional on recommendation from palliative care team. |
| MIDAZOLAM buccal | Green | Palliative care in line with guidance. |
Conditional on recommendation from palliative care team. |
| MIRABEGRON | Green | Symptoms of urinary frequency, urgency and urge incontinence |
In line with Overactive Bladder Pathway |
| NALOXONE | Green | Palliative care in line with guidance. |
Conditional on recommendation from palliative care team. |
| OCTREOTIDE | Green | Palliative care in line with guidance |
Conditional on recommendation from palliative care team. |
| OLANZAPINE | Green | Palliative care in line with guidance |
Conditional on recommendation from palliative care team. |
| OLANZAPINE Oral | Yellow | Schizophrenia. Combination therapy for mania. Preventing recurrence in bipolar disorder. Monotherapy for mania. Control of agitation and disturbed behaviour in schizophrenia or mania. Personality disorder. |
See the LLR Antipsychotic Prescribing Guide |
| OMEGA-3 ACID ETHYL ESTERS (Omacor®) (UPDATED) | Green | Hypertriglyceridaemia |
In line with LLR lipid pathway |
| ONDANSETRON | Green | Nausea |
Further information when used for palliative care can be found in the Palliative Care Prescribing Guide |
| OXYBUTYNIN patch | Green | Symptomatic treatment of urge incontinence in unstable bladder |
For use only in patients who cannot take oral medication See Overactive bladder pathway |
| PENICILLAMINE | Orange | Rheumatoid arthritis | |
| QUETIAPINE | Green | Palliative care in line with guidance. |
Conditional on recommendation from palliative care team. |
| QUINIDINE | Red | Brugada syndrome |
Reviewed by TAS November 2022 |
| RIMEGEPANT (Vydura®) (NEW) | Grey | Migraine | |
| RITUXIMAB | Red | Idiopathic membranous nephropathy | |
| RIVAROXABAN | Green | Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation | |
| ROMOSOZUMAB (Evenity®) | Red | Severe osteoporosis |
In line with NICE TA791
|
| SACUBITRIL / VALSARTAN (Entresto®) | Yellow | Heart failure |
For background and information and monitoring requirements, (in line with ACEI/ARB monitoring for heart failure), please see interim information whilst the heart failure guide is being updated.
|
| SOLIFENACIN / TAMSULOSIN (Vesomni®) | Green | Benign prostatic hyperplasia | |
| SULFASALAZINE | Orange | Rheumatological disease | |
| TEICOPLANIN | Green | Cellulitis (in primary care) |
To be used in conjunction with the Cellulitis-Teicoplanin Pathway |
| TIOTROPIUM (Braltus Zonda®) | Green | COPD |
Use in line with Leicestershire LAMA Prescribing Guide
|
| TIRZEPATIDE (Mounjaro®) (NEW) | Grey | Treatment of adults with insufficiently controlled type 2 diabetes mellitus | |
| TRIPTORELIN | Yellow | Precocious puberty | |
| TRIPTORELIN | Green | Prostatic carcinoma |
GP can give first injection to patients in whom anti-androgen treatment has been started by secondary care clinician. |
Other Updates on this Website
Recent documents from LLR APC and TAS
Dry Eye Guidance(799 KB) - Guidelines
Version 1 Uploaded January 2023
Date added: 24th Jan 2023
LLRAPC Newsletter – January 23(233 KB) - LMSG/LLR APC newsletters
Date added: 23rd Jan 2023
LPT Anticholinergic Side effects and Prescribing Guidance(689 KB) - Guidelines
Version 1 Uploaded January 2023
Date added: 12th Jan 2023
Clozapine Primary Care Information Sheet(523 KB) - Guidelines
Version 1 Uploaded January 2023
Date added: 12th Jan 2023
Inhaler recognition guide(733 KB) - Guidelines
Version 1 Uploaded January 2023
Date added: 11th Jan 2023
Diabetes Glucose Monitoring Interim Position Statement(402 KB) - Guidelines
Uploaded January 2023
Date added: 11th Jan 2023
LLR APC Minutes December 2022 - LMSG/LLR APC minutes
Date added: 11th Jan 2023
RMOC Style Generic Shared Care Request Form(74 KB) - Shared care agreement
For use from 3rd January 2023
Date added: 14th Nov 2022
LLR Lipid Pathway(1 MB) - Guidelines
Version 2 Uploaded January 2023
Date added: 12th Oct 2022
My COPD Plan(461 KB) - Guidelines
Version 3 Uploaded January 2023
Date added: 7th Sep 2020
My COPD information(504 KB) - Guidelines
Patient COPD information. Version 2.1 Uploaded January 2023
Date added: 7th Sep 2020
Wound Care Formulary(897 KB) - Guidelines
Updated August 22 Primary Care and LPT only
Date added: 20th Jun 2019
Wound Care Formulary Comparison Chart(513 KB) - Guidelines
Wound Care Formulary Comparison Chart updated August 22 Primary Care and LPT only
Date added: 20th Jun 2019
Vitamin D Deficiency(775 KB) - Guidelines
Version 9.5 uploaded January 2023
Date added: 22nd May 2019
LLR APC Members(410 KB) - Uncategorised
February 2022
Date added: 28th May 2015
Osteoporosis(1 MB) - Guidelines
Version 3.1 Uploaded January 2023
Date added: 28th May 2015
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 Leicester, Leicestershire and Rutland Integrated Care Board, 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