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Last updated: 13/05/2022

Other updates on this site
Drug Name Classification Clinical Indication Comments
3,4 DIAMINOPYRIDINE (NEW) Red Lambert Eaton Myasthenic Syndrome


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

Reviewed by TAS 22nd June 2021

ALEMTUZUMAB Red Relapsing, remitting multiple sclerosis

In line with NICE TA 312

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

In line with NICE TA752.

Implementation date 15th March 2022

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

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


In line with NICE TA757.

Implementation date 5th April.

CENOBAMATE (NEW) Red Focal onset seizures in epilepsy
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

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

DANTROLENE LIQUID (NEW) Red severe chronic spasticity

Please note this traffic light is for the liquid preparation.

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


DEOXYCHOLIC ACID (Belkyra ®) (NEW) 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 (NEW) Orange Excessive sleepiness caused by narcolepsy


DIROXIMEL FUMERATE (Vumerity®) (NEW) Grey Relapsing-remitting multiple sclerosis
DUPILUMAB (NEW) Red Severe asthma with type 2 inflammation

In line with NICE TA751.

Implementation date 8th March 2022

EMPAGLIFLOZIN (NEW) Yellow Chronic heart failure with reduced ejection fraction.

In line with NICE TA773

ERAVACYCLINE (Xerava®) (NEW) Grey Complicated intra-abdominal infections in adults
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 HEMIHYDRATE/NORETHISTERONE ACETATE/RELUGOLIX (Ryeqo ®) (NEW) Grey Treatment of moderate to severe symptoms of uterine fibroids in adult women of reproductive age.
FENFLURAMINE HYDROCHLORIDE (Fintepla ®) (NEW) Grey Treatment of seizures associated with Dravet syndrome as an add-on therapy to other anti-epileptic medicines.
FOSTEMSAVIR (Rukobia ®) (NEW) Red HIV Infections
FREMANEZUMAB (Ajovy®) (UPDATED) Red Prevention of migraine

In line with NICE TA764

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)
Herpes ZOSTER vaccine 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

HYDROCORTISONE (Alkindi®)(Granules in capsules for opening) (UPDATED) Yellow Adrenal insufficiency in paediatrics
ICOSAPENT ETHYL (Vazkepa ®) (NEW) Grey Reduce the risk of cardiovascular events.
INCLISIRAN (Leqvio®) (NEW) 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 (UPDATED) Do not prescribe Covid 19 treatment

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


LIRAGLUTIDE (Saxenda®) (NEW) Red Obesity in children aged over 12 years
LIRAGLUTIDE (Victoza®) (NEW) Yellow Type 2 diabetes mellitus in children 10 years and over
LURASIDONE (UPDATED) Orange Schizophrenia aged 13-17 years

Full SCA  Request form

MACROGOL 3350 (TransiSoft®) (NEW) Grey Chronic constipation, use usually limited to 2 weeks

Not to mixed up with other macrogol products such as Macrogol oral powder compound e.g. Laxido or Movicol

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
METHYLPHENIDATE (NEW) Orange Excessive sleepiness caused by narcolepsy


METRELEPTIN (Myalepta ®) (NEW) Grey Replacement therapy to treat the complications of leptin deficiency in lipodystrophy patients.
MEXILETINE (Namuscla®) Do not prescribe Symptomatic treatment of myotonia in adult patients with non-dystrophic myotonic disorders

In line with NICE TA748 this product should be used by specialist centres only. At the time of classification LLR is not a site of a specialist centre.

NEFOPAM (NEW) Green Pain

Non-formulary so use by exception only

NINTEDANIB (NEW) Red Fibrosing interstitial lung diseases

In line with NICE TA747.

Implementation date 17th February 2022.

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

In line with NICE TA769

Implementation date 2nd May 2022

PEGCETACOPLAN (NEW) Do not prescribe Paroxysmal nocturnal haemoglobinuria (PMH)

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

PITOLISANT (NEW) Do not prescribe Excessive daytime sleepiness caused by obstructive sleep apnoea

Not recommended by NICE TA776

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

In line with NICE TA767

Implementation date 2nd May 2022

RISDIPLAM (NEW) Do not prescribe Spinal Muscular Atrophy

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

RITUXIMAB (NEW) Do not prescribe IgM paraproteinaemic demyelinating peripheral neuropathy in adults

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

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

In line with NICE TA729

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

In line with NICE TA734


SOLRIAMFETOL (Sunosi ®) (UPDATED) Do not prescribe Sleepiness in patients treated with CPAP for obstructive sleep apnoea

Not recommended by NICE for this indication

TIPRANAVIR (UPDATED) Do not prescribe HIV infection


TOFACITINIB (NEW) Red Juvenile idiopathic arthritis

In line with NICE TA735

Implementation date 20th January 2022

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

Comments: In line with NICE TA768

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

In line with NICE TA744

Implementation date 10th February 2022

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

Clarification of historical status

Other Updates on this Website

Recent documents from LLR APC and TAS

SCA: ADHD Adults (907 KB) - Shared care agreement

Version 4.0 including narcolepsy uploaded March 2022

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 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