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Last updated: 19/05/2022

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


3,4-Diaminopyridine Red Lambert Eaton Myasthenic Syndrome
5-AMINOLAEVULINIC ACID GEL (Ameluz®) Do not prescribe Actinic keratosis
ABATACEPT Red Rheumatoid arthritis

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

ABATACEPT Red Juvenile idiopathic arthritis

In line with NICE TA 373

ABATACEPT Red Refractory idiopathic inflammatory myopathies (adults and children aged 2 years and over)
ACITRETIN Red For psoriasis, Icthyosis, palmoplantar pustulosis and Dariers disease in males and postmenopausal women.

Reviewed by TAS 22nd June 2021

ALISKIREN (UPDATED) Orange Existing patients with Hypertension

Full SCA

ALISKIREN (NEW) Do not prescribe New patients
AMANTADINE (NEW) Yellow Prolonged disorder of consciousness
ANAKINRA (Kineret®) Red Still’s disease and juvenile idiopathic arthritis

In line with NICE TA685


ANAKINRA (Kineret®) Red Haemophagocytic Lymphohistiocytisis
BALOXAVIR MARBOXIL (Xofluza®) Grey Treatment and post exposure prophylaxis of influenza
BELIMUMAB Red For treating active autoantibody positive systemic lupus erythematosus

In line with NICE TA752.

Implementation date 15th March 2022

BEMIPARIN (Zibor ®) Grey Prevention of thromboembolic disease. Prevention of clotting.
BEVACIZUMAB Red Treatment of angiodysplasia in the background of von Willebrand's disease second line to thalidomide use.
BLEPHACLEAN WIPES Do not prescribe Blepharitis
BUPRENORPHINE IMPLANT (Sixmo ® (implant)) Grey Substitution treatment for opioid dependence in clinically stable patients.

In line with NICE TA757.

Implementation date 5th April.

CENOBAMATE Red Focal onset seizures in epilepsy
CHLORAL HYDRATE/CLORAL BETAINE 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®) Red Mycosis fungoides-type T cell lymphomas

In line with NICE TA720

COLISTIN Red Nebulised for Cystic fibrosis
CRIZANLIZUMAB Red Preventing sickle cell crises in sickle cell disease

In line with NICE TA743

DAPAGLIFLOZIN Do not prescribe Type 1 diabetes

New patients

DAPAGLIFLOZIN Yellow With insulin for treating Type 1 diabetes, historic patients only

Now unlicensed due to commercial reasons


DAPAGLIFLOZIN (Forxiga®) (NEW) Green CKD in adults

In line with NICE TA775

See CKD pathway for more information


DAPSONE (NEW) Red Dermatology
DELAFLOXACIN MEGLUMINE (Quofenix®) (UPDATED) Red Acute bacterial skin and skin structure infections
DEOXYCHOLIC ACID (Belkyra ®) Grey Moderate to severe convexity or fullness associated with submental fat in adults when the presence of submental fat has an important psychological impact for the patient
DEXAMFETAMINE Orange Excessive sleepiness caused by narcolepsy


DIROXIMEL FUMERATE (Vumerity®) Grey Relapsing-remitting multiple sclerosis
DOXAZOSIN M/R TABLETS (UPDATED) Do not prescribe Hypertension
DUPILUMAB Red Severe asthma with type 2 inflammation

In line with NICE TA751.

Implementation date 8th March 2022

EMPAGLIFLOZIN Yellow Chronic heart failure with reduced ejection fraction.

In line with NICE TA773

ERAVACYCLINE (Xerava®) Grey Complicated intra-abdominal infections in adults
ESKETAMINE HYDROCHLORIDE NASAL SPRAY (Spravato®) Red In combination with a SSRI or SNRI for adults with treatment-resistant Major Depressive Disorder

Administration in specialist clinic only

ESTRADIOL HEMIHYDRATE/NORETHISTERONE ACETATE/RELUGOLIX (Ryeqo ®) Grey Treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age.
FAMOTIDINE (NEW) Green H2 antagonist
FENFLURAMINE HYDROCHLORIDE (Fintepla ®) Grey Treatment of seizures associated with Dravet syndrome as an add-on therapy to other anti-epileptic medicines.
FINERENONE (Kerendia®) (NEW) Grey Treatment of chronic kidney disease (stage 3 and 4 with albuminuria) associated with type 2 diabetes in adults.
FORMOTEROL/BUDESONIDE/GLYCOPYRRONIUM INHALER (Trixeo Aerospace®) (UPDATED) Do not prescribe Moderate to severe COPD

Reviewed by the Respiratory Prescribing Group May 2022

FOSTEMSAVIR (Rukobia ®) Red HIV Infections
FreeStyle Libre® Sensor (UPDATED) Green Diabetes glucose monitoring for those included on the LLRAPC position statement.

Eligibility as per LLRAPC freestyle libre documents.  Initial  six month trial. Continuation dependent on letter detailing improvement in the NHSE England parameters. There are now primary care and secondary care documents.


FREMANEZUMAB (Ajovy®) Red Prevention of migraine

In line with NICE TA764

GALANTAMINE Gazylan XL ® Yellow Alzheimer's disease
GALANTAMINE LIQUID Red Alzheimer's disease

Leicestershire Partnership Trust consultants only

GLYCEROL PHENYLBUTYRATE (Ravicti®) Red Chronic management of patients with urea cycle disorders (UCDs)
HYDROCORTISONE (Alkindi®)(Granules in capsules for opening) Yellow Adrenal insufficiency in paediatrics
ICOSAPENT ETHYL (Vazkepa ®) Grey Reduce the risk of cardiovascular events.
INCLISIRAN (Leqvio®) Green Treating primary hypercholesterolaemia or mixed dyslipidaemia. SECONDARY PREVENTION ONLY as per NICE TA733

For prescribers who feel competent to use this medication.

In line with NICE TA733.

The AAC Lipid management pathway gives further guidance on place in therapy and the AHSN have some inclisiran FAQS. Please see the Cardiovascular Guideline page

INHALED DRY POWDER BUDESONIDE Do not prescribe Covid 19 treatment

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


LIOTHYRONINE Red Treatment of depression where other therapies have failed
LIOTHYRONINE (NEW) Yellow Hypothyroidism

Monitoring will be undertaken by secondary care and patients remain open to secondary care.

LIRAGLUTIDE (Saxenda®) Red Obesity in children aged over 12 years
LIRAGLUTIDE (Victoza®) Yellow Type 2 diabetes mellitus in children 10 years and over
LURASIDONE Orange schizophrenia in adults aged over 18 years

For those who do not respond to or do not tolerate aripiprazole, or those who are not suitable for clozapine.


LURASIDONE Do not prescribe Psychosis not associated with schizophrenia
LURASIDONE Orange Schizophrenia aged 13-17 years

Full SCA  Request form

LYUMJEV (NEW) Green Fast acting insulin for adults with diabetes mellitus
MELATONIN M/R 1mg and 5mg tablets (Slenyto®) Yellow Insomnia for children aged 2-18 years with Autism Spectrum Disorder and or Smith-Magenis syndrome
MEPACRINE (NEW) Red Refractory giardiasis
MEPOLIZUMAB (Nucala®) Red To treat severe eosinophilic asthma.

In line with NICE TA 431

METHYLPHENIDATE Orange Excessive sleepiness caused by narcolepsy


METRELEPTIN (Myalepta ®) Grey Replacement therapy to treat the complications of leptin deficiency in lipodystrophy patients.
NEFOPAM Green Pain

Non-formulary so use by exception only

NINTEDANIB Red Fibrosing interstitial lung diseases

In line with NICE TA747.

Implementation date 17th February 2022.

OCTREOTIDE Red Hight output stoma
ODEVIXIBAT SESQUIHYDRATE (Bylvay®) Grey Treatment of progressive familial intrahepatic cholestasis in patients aged 6 months or older.
ORITAVANCIN (Tenkasi®) (NEW) Grey Acute bacterial skin and skin structure infections
PALFORZIA Red Treating peanut allergy in children and young people.

In line with NICE TA769

Implementation date 2nd May 2022

PEGCETACOPLAN Do not prescribe Paroxysmal nocturnal haemoglobinuria (PMH)

Recommended by NICE TA788 but all prescribing is via the national PMH centre

PERINDOPRIL ARGINE (UPDATED) Do not prescribe Hypertension
PITOLISANT Do not prescribe Excessive daytime sleepiness caused by obstructive sleep apnoea

Not recommended by NICE TA776

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

In line with NICE TA767

Implementation date 2nd May 2022

RISDIPLAM Do not prescribe Spinal Muscular Atrophy

Approved centres only. LLR is currently not an approved centre.

RITUXIMAB Do not prescribe IgM paraproteinaemic demyelinating peripheral neuropathy in adults

Approved centres only. LLR is currently not an approved centre.


In line with NICE TA335

RIVAROXABAN (Xarelto®) Yellow Treatment of VTE in paediatric patients
ROXADUSTAT (Evrenzo ®) Grey Symptomatic anaemia associated with chronic kidney disease (CKD) in adults
RUPATADINE Red Urticaria in paediatrics
SAPROPTERIN Red Hyperphenylalaninaemia in phenylketonuria

In line with NICE TA729

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

In line with NICE TA734


SIROLIMUS Topical Red Angiofibromas associated with tuberous sclerosis complex
SOLRIAMFETOL (Sunosi ®) Do not prescribe Sleepiness in patients treated with CPAP for obstructive sleep apnoea

Not recommended by NICE for this indication

STRONTIUM RANELATE (NEW) Red Severe postmenopausal osteoporosis to reduce the risk of vertebral & non-vertebral fractures in patients without established cardiovascular disease when other treatments are contraindicated
SUCRALFATE ENEMAS (NEW) Red Radiation proctitis
TIPRANAVIR Do not prescribe HIV infection


TOFACITINIB Red Juvenile idiopathic arthritis

In line with NICE TA735

Implementation date 20th January 2022

TOLVAPTAN (Samsca®) Red Hyponatraemia secondary to SIADH in patients requiring cancer chemotherapy
UPADACITINIB (Rinvoq®) Red Active psoriatic arthritis after inadequate response to DMARDs

Comments: In line with NICE TA768

UPADACITINIB (Rinvoq®) Red Moderate rheumatoid arthritis in adults

In line with NICE TA744

Implementation date 10th February 2022

VELMANASE ALFA (Lamzede ®) Grey Enzyme replacement therapy for the treatment of non-neurological manifestations in patients with mild to moderate alpha mannosidosis
VIGABATRIN Yellow Epilepsy

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