Leicestershire Traffic Light System
View classifications| Drug Name | Classification | Clinical Indication | Comments |
|---|---|---|---|
| Phenobarbital | Yellow | Epilepsy |
MHRA alert (Dec 2014) adverse effects on bone and MHRA alert (Nov 2017) updated advice on switching between different manufacturers’ products |
| TIRZEPATIDE (Mounjaro®) (UPDATED) | Red | Management of overweight and obesity |
March 2025: Further details about local implementation will be provided in due course. Until that time, tirzepatide should not be prescribed in primary care for this indication.
|
| 1mg Estradiol and 100mg Micronised progesterone(Bijuve) | Green | Continuous combined hormone replacement therapy (HRT) for estrogen deficiency symptoms in postmenopausal women | |
| 3,4 DIAMINOPYRIDINE | Red | Lambert Eaton Myasthenic Syndrome |
Unlicensed |
| 3,4-Diaminopyridine | Red | Lambert Eaton Myasthenic Syndrome | |
| 5-AMINOLAEVULINIC ACID (AS HYDROCHLORIDE) (Ameluz®) (NEW) | Red | Pre-treatment to photodynamic therapy for Actinic Keratosis, Bowen’s disease & superficial basal cell carcinoma. | |
| ABACAVIR / LAMIVUDINE (Kivexa®) | Red | ||
| ABACAVIR/DOLUTEGRAVIR/LAMIVUDINE (Triumeq®) | Red | HIV | |
| Abaloparatide (NEW) | Red | Treating osteoporosis after menopause | |
| ABATACEPT | Red | Refractory idiopathic inflammatory myopathies (adults and children aged 2 years and over) | |
| 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 |
| ABIRATERONE | Red | ||
| ABROCITINIB (Cibinqo ®) | Red | Treatment of moderate-to-severe atopic dermatitis in adults and adolescents 12 years and older who are candidates for systemic therapy | |
| ABROCITINIB (Cibunqo®) | Red | Moderate to severe atopic dermatitis |
In line with NICE TA814 |
| ACAMPROSATE | Yellow | Alcohol dependence | |
| ACENOCOUMAROL | Green | Anticoagulation |
For patients currently being treated with phenindione. |
| ACENOCOUMAROL | Red | Anticoagulation |
New patients only. |
| ACETAZOLAMIDE | Yellow | Idiopathic Intracranial hypertension | |
| ACETYLCYSTEINE 10% preservative free eye drops | Yellow | Ocular lubricants |
|
| ACETYLCYSTEINE EFFERVESCENT TABLETS | Green | COPD Reduction of sputum viscosity |
LMSG Mucolytic prescribing guide Effervescent tablets only, prescribe generically. Capsules not to be prescribed. |
| ACETYLCYSTEINE NEBULISED | Red | Last line mucolytic treatment to loosen tenacious secretions. Under supervision of a senior respiratory physiotherapist only. | |
| ACITRETIN | Red | For psoriasis, Icthyosis, palmoplantar pustulosis and Dariers disease in males and postmenopausal women. |
Reviewed by TAS 22nd June 2021 |
| ACLIDINIUM / FORMOTEROL INHALER (Duaklir Genuair®) | Green | COPD |
LABA/LAMA combination product – to be used in line with updated COPD Guidelines |
| ACLIDINIUM INHALER 322 micrograms | Green | COPD |
For patients that cannot manage tiotropium handihaler |
| ACTIKERALL | Green | Actinic keratoses | |
| Actipatch® | Do not prescribe | Joint and muscle pain | |
| ADALIMUMAB | Red | Moderate to severe ulcerative colitis |
In line with NICE TA 329 |
| ADALIMUMAB | Red | Behcet’s disease |
Alternative to infliximab once established on therapy. |
| ADALIMUMAB | Red | Juvenile idiopathic arthritis |
In line with NICE TA 373 |
| ADALIMUMAB | Red | Psoriasis |
In line with NICE TA 146 |
| ADALIMUMAB | Red | Hidradenitis suppurativa |
In line with NICE TA 392 |
| ADALIMUMAB | Red | Plaque psoriasis in children |
In line with NICE TA 455 |
| ADALIMUMAB | Red | Non-infectious uveitis |
In line with NICE TA 460 |
| ADALIMUMAB | Red | Psoriatic arthritis; ankylosing spondylitis; refractory Crohn's disease | |
| ADALIMUMAB | Red | Moderate rheumatoid arthritis. |
In line with NICE TA715 |
| ADAPALENE / BENZOYL PEROXIDE TOPICAL (Epiduo®) | Green | Acne |
For more information please see local algorithm. |
| ADAPALENE topical | Green | Acne |
For more information see local algorithm. |
| Adios® | Do not prescribe | Herbal slimming aid | |
| Advagraf Prolonged Release (Tacrolimus) | Red | immunosuppression | |
| ADVASIL CONFORM® | Yellow | Hypertrophic Scars |
Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform® |
| AFATINIB | Red | ||
| AFLIBERCEPT (Eylea®) | Red | Wet age related macular degeneration. Diabetic macular oedema. Macular oedema due to central retinal vein occlusion and branch retinal vein occlusion. Choroidal neovascularisation. |
In line with NICE TA294, NICE TA346, NICE TA305, NICE TA409, NICE TA486 |
| Age-Related Macular Degeneration - Dietary Supplements | Do not prescribe | Age-related macular degeneration (AMD) | |
| AGOMELATINE | Orange | Depression | |
| ALBIGLUTIDE (Eperzan®) | Grey | Type 2 diabetes |
Not yet reviewed |
| ALBUTREPENONACOG ALPHA (Idelvion®) | Red | Prophylaxis and treatment of bleeding in Haemophilia B | |
| ALEMTUZUMAB | Red |
Relapsing, remitting multiple sclerosis |
In line with NICE TA 312 |
| ALENDRONIC ACID | Green | Osteoporosis |
In line with NICE TA 464 |
| ALENDRONIC ACID + VITAMIN D | Do not prescribe | Postmenopausal osteoporosis | |
| ALENDRONIC ACID EFFERVESCENT TABLETS (Binosto®) | Green | Osteoporosis |
For patients that cannot swallow tablets. Not suitable for administration via a feeding tube. |
| ALFENTANIL | Green | Pain management in severe renal impairment for palliative care |
In line with Palliative Care Guidance only. |
| ALIMEMAZINE (UPDATED) | Do not prescribe | Various |
All other new patients not covered in alternative traffic lights Current patients should be discussed with the prescribing specialist and not have treatment stopped abruptly without appropriate review. |
| ALIMEMAZINE | Green | Various |
Historic patients who have tried or not been suitable for other sedating antihistamines or melatonin. GP to continue prescribing. |
| ALIMEMAZINE | Red | Various |
Historic patients who have not tried or been considered for alternatives. Patients to be reviewed by secondary care. Secondary care to prescribe if continuing treatment required. |
| Alimemazine (NEW) | Red |
LPT only. Insomnia for new patients (under 18 yr olds) if melatonin and/or another sedating antihistamine has failed or is inappropriate. May be continued into adulthood if patient requires it after transition. |
|
| ALIROCUMAB (Praluent®) | Red | Primary hypercholesterolaemia |
In line with NICE TA 393 |
| ALIROCUMAB (Praluent®) | Grey | Adults with established atherosclerotic cardiovascular disease to reduce cardiovascular risk by lowering LDL-C levels |
Not yet reviewed |
| ALISKIREN (NEW) | Do not prescribe | New patients | |
| ALISKIREN | Orange | Existing patients with Hypertension | |
| ALITRETINOIN | Red | Severe chronic hand eczema |
In line with NICE TA 177 |
| ALOGLIPTIN | Green | Type 2 diabetes | |
| ALPHA-1 ANTITRYPSIN (Respreeza®) | Grey | Emphysema in adults |
Not yet reviewed |
| ALPHA-TOCOPHEROL (VITAMIN E) | Red | When given with pentoxifylline or the treatment of persistently thin endometrium during IVF therapy | |
| ALPROSTADIL cream (Vitaros®) | Do not prescribe | Erectile dysfunction | |
| ALPROSTADIL uretheral sticks and injections | Green | Erectile dysfunction |
Not prescribable under the NHS for treatment of erectile dysfunction except in men who meet the criteria listed in part XVIIIB of the Drug Tariff. The prescription must be endorsed ‘SLS’. Maximum 4 doses per month to be prescribed. |
| Alteplase (Actilyse) | Red | Thrombolysis | |
| Alutard Bee venom ® | Grey | Preventative treatment for bee sting allergy |
Not yet reviewed |
| Alutard Wasp venom ® | Grey | Preventative treatment for wasp sting allergy |
Not yet reviewed |
| AMANTADINE | Yellow | For fatigue in Multiple sclerosis |
Amantadine for fatigue in Multiple sclerosis: prescribing notes |
| AMANTADINE | Yellow | Prolonged disorder of consciousness | |
| AMANTADINE | Yellow | Parkinson's disease |
Click on drug name for further detail |
| AMIFAMPRIDINE (Firdapse®) | Do not prescribe | Lambert-Eaton myasthenic syndrome | |
| AMIKACIN (Arikayce Liposomal®) | Red | For the treatment of non-tuberculous mycobacterial pulmonary disease caused by Mycobacterium Avium Complex (MAC) adults and post pubescent children) | |
| AMILORIDE | Orange | Heart failure and hypertension in infants and children | |
| AMIODARONE (UPDATED) | Orange |
All new patients initiating therapy require a SCA. |
|
| AMISULPRIDE | Yellow | Schizophrenia | |
| AMPHOTERICIN 0.15% preservative free eye drops | Red | ||
| ANAGRELIDE | Red | ||
| ANAKINRA (Kineret®) | Red | Periodic fevers and autoinflammatory diseases |
Requested for UHL as part of NHS England commissioning policy |
| ANAKINRA (Kineret®) | Red | Still’s disease and juvenile idiopathic arthritis |
In line with NICE TA685
|
| ANAKINRA (Kineret®) | Red | Haemophagocytic Lymphohistiocytisis | |
| ANASTROZOLE | Yellow | Off label chemoprevention to reduce incidence of breast cancer. |
Use in line with NICE CG 164 |
| ANASTROZOLE | Yellow | Adjuvant therapy in early breast cancer | |
| ANDEXANET ALFA (Ondexxya®) | Red | Reversing anticoagulation from apixaban or rivaroxaban in adults for life-threatening or uncontrolled GI bleed. |
In line with NICE TA697 |
| ANGIOTENSIN II (Giapreza® ) | Grey | Hypotension in adults with septic or other distributive shock | |
| ANIDULAFUNGIN | Do not prescribe | Invasive candidiasis | |
| ANTICANCER DRUGS | Red | Neoplastic disease |
Classified as BLACK or RED unless an exception for shared care (see this list). |
| ANTIPSYCHOTICS-Atypical | Yellow |
See the LLR Antipsychotic prescribing guide Clozapine remains red – secondary care only. |
|
| ANTIRETROVIRALS | Red | HIV | |
| ANTITHROMBIN recombinant | Red | Congenital antithrombin deficiency | |
| APIXABAN | Green | Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation |
Use in line with |
| APIXABAN | Yellow | Treatment and secondary prevention of DVT and PE |
In line with NICE TA 341 |
| APOMORPHINE | Orange | Parkinson's disease | |
| APRACLONIDINE | Red | Glaucoma | |
| APREMILAST (Otezla®) | Red | Psoriatic arthritis |
In line with NICE TA 433 |
| APREMILAST (Otezla®) | Red | Psoriasis |
In line with NICE TA 419 |
| ARGATROBAN (Exembol®) | Red | For anticoagulation in adult patients with heparin induced thrombocytopenia. | |
| ARGININE | Red | Urea Cycle Disorders | |
| ARIPIPRAZOLE LONG-ACTING INJECTION (Abilify Maintena®) (UPDATED) | Yellow | Maintenance treatment of schizophrenia in patients currently stabilised on oral aripiprazole |
See the LLR Antipsychotic Prescribing Guide 2 strengths available: 400mg (each month) and 960mg (every 2 months) |
| ARIPIPRAZOLE oral | Yellow | Schizophrenia. Treatment and recurrence of mania. Control of agitation and disturbed behaviour in schizophrenia | |
| ARMOUR THYROID | Do not prescribe | Thyroid replacement | |
| ASCORBIC ACID PASCOE 150 MG/ML CONCENTRATE FOR SOLUTION FOR INJECTION / INFUSION | Grey | Treatment of clinical vitamin C deficiency |
Not yet reviewed |
| ASENAPINE | Do not prescribe | Manic episodes of bipolar disorder. | |
| Aspirin | Yellow | Chemoprevention for colorectal cancer for patients with Lynch Syndrome identified via Clinical Genetics |
*on advice of clinical genetics Patient weight <75kg: 150mg daily Patient weight >75kg: 300mg daily |
| ATALUREN | Red | Duchenne muscular dystrophy |
In line with NICE HST3 |
| ATAZANAVIR | Red | ||
| ATAZANAVIR / COBICISTAT (Evotaz®) | Red | HIV infection | |
| Atogepant (NEW) | Yellow | preventing migraine |
For preventing migraines |
| ATOMOXETINE (UPDATED) | Orange | Attention deficit hyperactivity disorder (ADHD) |
Adults Children and adolescents
|
| ATOVAQUONE | Red | ||
| ATROPINE 1% EYE DROPS | Yellow | Hypersalivation and sialorrhoea management in children |
Initiated and stabilised in secondary care before transfer to primary care. FOURTH line LPT recommendation. Note for ‘sub-lingual’ use. |
| ATROPINE EYE DROPS | Green | Palliative care in line with guidance |
Conditional on recommendation from palliative care team. |
| AVACOPAN (Tavneos®) | Red | For treating severe active granulomatosis with polyangiitis or microscopic polyangiitis. |
In line with NICE TA825
|
| AVALGLUCOSIDASE ALFA (Nexviadyme®) | Do not prescribe | Pompe disease |
In line with NICE TA821. This product should be used by specialist centres only. At the time of classification LLR is not a site of a specialist centre |
| AVANAFIL | Grey | Erectile dysfunction |
Not yet reviewed |
| AVATROMBOPAG (Doptelet®) (UPDATED) | Red | For treating primary chronic immune thrombocytopenia | |
| AVIPTADIL/PHENTOLAMINE intracavernosal injection (Invicorp®) | Green | Erectile dysfunction | |
| AXITINIB | Red | ||
| AZATHIOPRINE (UPDATED) | Orange | Dermatological disease | |
| AZATHIOPRINE (UPDATED) | Orange | Paediatric Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease) |
|
| AZATHIOPRINE | Orange | Rheumatological disease | |
| AZATHIOPRINE | Orange | Inflammatory Bowel Disease (Ulcerative Colitis, Crohn's Disease) & Autoimmune Hepatitis | |
| AZATHIOPRINE | Orange | Autoimmune neurological disorders |
Please see shared care agreement for individual indications |
| Azathioprine 75mg & 100mg | Do not prescribe | Autoimmune Conditions |
Increased risk of medication errors with 75mg and 100mg tablets. Use 25mg and 50mg tablets only. |
| AZELAIC ACID 20% TOPICAL | Green | Acne |
See local algorithm for more information. |
| AZILSARTAN | Do not prescribe | Hypertension | |
| AZTREONAM | Red | Infection in cystic fibrosis | |
| Aztreonam and Avibactam (Emblaveo) | Red | For infections caused by NDM producing Enterobacteriaceae |
restricted with microcode |
| BALOXAVIR MARBOXIL (Xofluza®) | Grey | Treatment and post exposure prophylaxis of influenza | |
| BALSALAZIDE | Yellow | Ulcerative colitis | |
| BARICITINIB | Red | Moderate to severe atopic dermatitis |
In line with NICE TA681
|
| BARICITINIB (Olumiant®) | Red | Moderate-to-severe rheumatoid arthritis |
In line with NICE TA466 |
| BASILIXIMAB (Simulect®) | Red | Immunosuppressive therapy for Kidney Transplant in Adults and Children/Young People |
In line with NICE TA 481, NICE TA 482 |
| BATH EMOLLIENTS | Do not prescribe | Skin |
Leave on emollients should be used instead. |
| BECAPLERMIN | Do not prescribe | ||
| BECLOMETASONE AND FORMETEROL (Bibecfo®) (NEW) | Grey | Asthma | |
| BECLOMETASONE DIPROPIONATE / FORMOTEROL (Fostair®) | Green |
Asthma COPD |
Prescribe in line with respiratory guidelines |
| Beclometasone extra-fine/ Formoterol Inhaler (LUFORBEC pMDI) (NEW) | Green | Asthma and COPD |
Asthma: 100/6 mcg/dose and 200/6 mcg/dose COPD: 100/6 mcg/dose only |
| BECLOMETASONE Inhaler - CFC free | Green | Asthma |
QVAR brand recommended for adults. Clenil Modulite brand recommended only for children. |
| BECLOMETASONE/FORMETEROL/GLYCOPYRRONIUM (Trimbow ®) | Do not prescribe | Asthma |
As per the Respiratory Prescribing Group September 22 Different strengths are licensed for different indications – please check the BNF |
| BEDAQUILINE | Red | Multi-drug resistant tuberculosis | |
| BELATACEPT (Nulojix®) | Red | Immunosuppressive therapy for Kidney Transplant in Adults and Children/Young People |
In line with NICE TA 481, NICE TA 482 |
| BELIMUMAB | Red | For treating active autoantibody positive systemic lupus erythematosus |
In line with NICE TA752. Implementation date 15th March 2022 |
| BELUMOSUDIL (Rezurock®) (NEW) | Red | For treating chronic graft-versus host disease after 2 or more systemic treatments in people 12 years and over. | |
| BEMIPARIN (Zibor ®) | Grey | Prevention of thromboembolic disease. Prevention of clotting. | |
| BEMPEDOIC ACID (Nilemdo®) | Green | Primary hypercholesterolaemia or mixed dyslipidaemia and secondary prevention in adults |
In line with LLR lipid pathway
|
| BEMPEDOIC ACID / EZETIMIBE (Nustendi®) | Green | Primary hypercholesterolaemia or mixed dyslipidaemia and secondary prevention in adults |
In line with the LLR lipid guidance
|
| BENRALIZUMAB | Red | Severe Eosinophilic Asthma |
In line with NICE TA565 Implementation date 6th June 2019 |
| BENZBROMARONE | Do not prescribe | Gout |
Not supported TAS Feb 14 |
| BEROTRALSTAT (Orladeyo®) | Red | Prevention of recurrent attacks of hereditary angioedema (HEA) |
In line with NICE TA378 |
| BETA-INTERFERON-1a (Avonex®) | Red | Multiple sclerosis in adults |
In line with NICE TA 527 |
| BETA-INTERFERON-1a (Rebif®) | Red | Multiple sclerosis in adults |
In line with NICE TA 527 |
| BETA-INTERFERON-1b (Betaferon®) | Red | Multiple sclerosis in adults |
In line with NICE TA 527 |
| BETA-INTERFERON-1b (Extavia®) | Red | Multiple sclerosis in adults |
In line with NICE TA 52 |
| BETAMETHASONE (AS DIPROPIONATE) 0.05% WITH SALICYLIC ACID 3% (Diprosalic®) | Green | Inflammatory skin disorders |
Available as ointment and scalp application. |
| BETAMETHASONE plaster (Betesil®) | Do not prescribe | Inflammatory skin disorders not responding to less potent corticosteroids |
Not approved by local committee |
| BETULA VERRUCOSA ALLERGEN EXTRACT (Itulazax®) | Orange | Moderate to severe allergic rhinitis/conjunctivitis caused by Birch pollen |
|
| BEVACIZUMAB | Red | Treatment of angiodysplasia in the background of von Willebrand's disease second line to thalidomide use. | |
| BEVACIZUMAB | Red | Retinopathy of prematurity either first line or as a second line rescue treatment. | |
| BEVACIZUMAB GAMMA (Lytenava) (NEW) | Red | Wet age-related macular degeneration in adults in line with NICE TA1022 | |
| BEXAROTENE | Red | ||
| BEZLOTOXUMAB (Zinplava®) | Grey | Prevention of recurrence of Clostridium difficile infection |
Not yet reviewed |
| BICALUTAMIDE | Yellow | Prostate cancer | |
| BICTEGRAVIR, EMTRICITABINE, AND TENOFOVIR ALAFENAMIDE (Biktarvy®) | Red | HIV |
As per NHSE Clinical commissioning Policy |
| BIFONAZOLE (Canesten Bifonazole Once Daily®) | Grey | Athlete’s foot |
Not yet reviewed |
| BIJUVE (Estradiol and Progesterone combined) (NEW) | Green | Indicated for continuous combined hormone replacement therapy (HRT) for estrogen deficiency symptoms in postmenopausal women with intact uterus and with at least 12 months since last menses. | |
| BILASTINE | Grey | Allergic rhinoconjunctivitis and urticaria | |
| BIMATOPROST / TIMOLOL eye drops (UPDATED) | Green | Glaucoma |
If a combination product is considered appropriate. If a preservative free formulation is required, please prescribe the 3ml preservative free multi-dose containers as a first choice. Preservative free multi-dose containers are unsuitable for patients with a history of contact hypersensitivity to silver. Please use ‘unpreserved unit doses’ in their place. |
| BIMATOPROST / TIMOLOL preservative free eye drops (Ganfort UD®) | Green | Glaucoma | |
| BIMATOPROST preservative free eye drops (UPDATED) | Green | Glaucoma |
If a preservative free formulation is required, please prescribe the 3ml preservative free multi-dose containers as a first choice. Preservative free multi-dose containers are unsuitable for patients with a history of contact hypersensitivity to silver. Please use ‘unpreserved unit doses’ in their place. |
| BIMEKIZUMAB (Bimzelx®) | Red | Moderate to severe plaque psoriasis |
In line with NICE TA723 |
| BIMEKIZUMAB (Bimzelx®) (NEW) | Red | For treating axial spondyloarthritis in adults |
In line with NICE TA918 |
| BIMEKIZUMAB (Bimzelx®)) (NEW) | Red | For treating active psoriatic arthritis in adults. |
In line with NICE TA916 |
| Bio-Oil® | Do not prescribe | Skincare product | |
| BIOBRAN MGN-3 | Do not prescribe | Adjuvant to cancer treatment |
Cancer Research UK statement |
| Bismuth, Metronidazole & Tetracycline ( Pylera) (NEW) | Green | Eradication of H. Pylori for patients with penicillin allergy already exposed to clarithromycin |
Use in line with local antimicrobial guidelines. |
| BLEPHACLEAN WIPES | Do not prescribe | Blepharitis | |
| BOSENTAN | Red | Pulmonary hypertension |
Specialist centres only |
| BOSUTINIB | Red | ||
| BOTULINUM A TOXIN | Red | Chronic migraine |
see NICE TA 260 |
| BOTULINUM A TOXIN (Dysport®) | Red | Ophthalmology, for use in extra ocular muscles for patients already on therapy who had previously not responded to Botox® | |
| BOTULINUM A TOXIN (Xeomin®) | Red | As per licence | |
| BOTULINUM NEUROTOXIN TYPE A (Xeomin®) | Red | Chronic sialorrhoea |
In line with NICE TA 605 |
| BOTULINUM TOXIN B (Neurobloc®) | Red | Neurology use only | |
| BREXPIPRAZOLE (Rexulti ®) | Do not prescribe | Antipsychotics |
LPT prescribing group have reviewed and found no significant advantages over existing formulary products |
| BRIMONIDINE CUTANEOUS GEL | Green | Facial erythema of rosacea (fixed erythema not flushing) |
Review after one month and discontinue if no benefit |
| BRIMONIDINE eye drops (UPDATED) | Green | Glaucoma |
Prescribe generically. |
| BRINZOLAMIDE / BRIMONIDINE (Simbrinza®) eye drops | Green | Glaucoma | |
| BRINZOLAMIDE / TIMOLOL eye drops (UPDATED) | Green | Glaucoma |
Prescribe generically. |
| BRINZOLAMIDE eye drops (UPDATED) | Green | Glaucoma |
Prescribe generically. |
| BRIVARACETAM | Yellow | Epilepsy (third line agent) | |
| BRODALUMAB (Kyntheum®) | Red | Moderate to severe plaque psoriasis |
In line with NICE TA 511
|
| BROLUCIZUMAB (Beovu®) | Red | Wet ARMD |
In line with NICE TA672 |
| BROLUCIZUMAB (Beovu®) | Red | Diabetic Macular oedema |
In line with NICE TA820 |
| BROMOCRIPTINE | Yellow | Hyperprolactinaemic disorders |
Annual monitoring undertaken in secondary care Primary care should be aware of fibrotic reactions |
| BUDESONIDE (1mg orodipersible tablet) (Jorveza®) | Red | For treatment of eosinophilic esophagitis in adults and children | |
| BUDESONIDE (Budenofalk®) | Yellow | Autoimmune hepatitis, Crohn's disease, ulcerative colitis | |
| BUDESONIDE / FORMOTEROL INHALER (DuoResp Spiromax®) | Green | Asthma & COPD |
Prescribe by brand as Budesonide/Formoterol devices not interchangeable. For new patients and existing patients over 18 years after a review by a healthcare professional and counselling of patient to ensure correct use of device |
| BUDESONIDE 64mcg NASAL SPRAY (Benacort®) | Do not prescribe | ||
| BUDESONIDE and FORMOTEROL (Fobumix®) Easyhaler | Green | Asthma | |
| BUDESONIDE M/R TABLETS (Cortiment®) | Yellow | Ulcerative colitis |
See formulary for place in therapy |
| BUDESONIDE/ FORMOTEROL FUMARATE DIHYDRATE INHALER (GoResp Digihaler®) (UPDATED) | Red | Asthma & COPD |
Restricted to severe asthma clinic only on a named patient basis |
| BULEVIRTIDE (Hepcludex ®) (UPDATED) | Red | Chronic Hepatitis D |
In line with NICE TA896. |
| BUPRENORPHINE | Green | Severe pain |
including transdermal patch |
| BUPRENORPHINE IMPLANT (Sixmo ® (implant)) | Grey | Substitution treatment for opioid dependence in clinically stable patients. | |
| BUPRENORPHINE PROLONGED RELEASE INJECTION (Buvidal®) | Red | Substance misuse |
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 |
| BUROSUMAB (Crysvita®) | Grey | X-linked hypophosphataemia in children and young people |
Not yet reviewed |
| BUSERELIN (Suprecur®) (UPDATED) | Red | IVF |
Regulation restricts the prescribing and supply of puberty-suppressing hormones to children and young people under 18 |
| BUSPIRONE | Red | Gastroparesis/functional dyspepsia | |
| BUSPIRONE | Yellow | Anxiety |
Specialist psychiatrist initiation only. |
| BUSULFAN | Red | ||
| CABERGOLINE | Do not prescribe | Parkinson's disease |
For new patients, existing patients to remain on therapy. |
| CABERGOLINE | Yellow | Hyperprolactinaemic disorders |
Annual monitoring undertaken in secondary care Primary care should be aware of fibrotic reactions |
| CABERGOLINE | Red | Suppression of lactation | |
| CABOTEGRAVIR WITH RILPIVIRINE | Red | For treating HIV-1 |
In line with NICE TA757. Implementation date 5th April. |
| CALCIPOTRIOL 50MCG/G / BETAMETHASONE 0.05% (UPDATED) | Green | Psoriasis |
Prescribe generically. Available as ointment, gel, cream and foam. To be used in line with the Management of Psoriasis in Primary Care
|
| CALCITONIN injection | Red |
New patients only |
|
| CANAGLIFLOZIN | Green | Type 2 diabetes |
Conditional on prescriber being competent to select appropriate patients. |
| CANAGLIFLOZIN / METFORMIN (Vokanamet®) | Grey | Type 2 diabetes |
Not yet reviewed |
| CANAKINUMAB | Red | Treating periodic fever syndromes | |
| CANAKINUMAB | Do not prescribe | Gout | |
| CANGRELOR (Kengrexal®) | Red | When undergoing PCI and cannot take oral P2Y12 inhibitors | |
| CANNABIDIOL(Epidyolex®) | Red | Seizures associated with Dravet syndrome or Lennox-Gastaut syndrome in combination with clobazam |
In line with NICE TA614 and NICE TA615 |
| CANNABIDIOL(Epidyolex®) | Red | Seizures caused by tuberous sclerosis complex in people aged 2 years and over |
In line with NICE TA873 |
| CANNABIS Derivative (Sativex®) | Do not prescribe | Multiple sclerosis |
The BMA cancard statement can be found here |
| CANNABIS OIL | Grey | ALL |
The BMA cancard statement can be found here |
| CAPECITABINE | Red | ||
| CAPHOSOL® | Red | Oral mucositis in head & neck cancer patients | |
| CAPLACIZUMAB (Cablivi®) | Red | Acquired TTP |
In line with NICE TA667
|
| CAPSAICIN 8% PATCH (Qutenza®) | Do not prescribe | Diabetic neuropathy | |
| CAPSAICIN 8% patch (Qutenza®) | Red | Peripheral neuropathic pain |
Only if unresponsive to other treatments in local guidance. |
| CAPTOPRIL | Orange | Heart failure and hypertension in infants and children | |
| Carbamazepine | Yellow | Epilepsy |
MHRA alert (Dec 2014) adverse effects on bone and MHRA alert (Nov 2017) updated advice on switching between different manufacturers’ products |
| Carbetocin | Red | Management and prevention of postpartum haemorrhage | |
| CARIPRAZINE | Do not prescribe | Bipolar disorder | |
| CARIPRAZINE(Reagila®) | Red | Schizophrenia |
|
| CASIRIVIMAB AND IMDEVIMAB (Ronapreve®) | Red | For patients hospitalised due to COVID-19 | |
| CASPOFUNGIN | Red | ||
| CATRIDECACOG (Novothirteen ®) | Grey | Long term prophylaxis of bleeding in patients with congenital factor XIII A-subunit deficiency and bleeding episodes during regular prophylaxis. | |
| CEFAZOLIN (NEW) | Red | for Methicillin susceptible Staphylococcus aureus (MSSA) bacteraemia for who flucloxacillin is not suitable | |
| CEFEPIME (Renapime®) (UPDATED) | Red | for blood stream infections caused by organisms that commonly produce AmpC but that do not express ESBL. Severe infections with Pseudomonas areruginosa with OprD mediated Meropenem resistance. | |
| Cefepime dihydrochloride monohydrate/Enmetazobactam) powder for concentrate for solution for infusion (2 g/0.5 g) Exblifep | Grey | Complicated UTIs including pyelonephritis, hospital-acquired pneumonia, and treatment of bacteraemia in association (or potentially linked) with these infections | |
| CEFIDEROCOL (Fetcroja®) | Red | Infections caused by extensively antibiotic resistant Gram negative bacteria | |
| CEFIXIME | Green | Gonorrhoea | |
| CEFIXIME (Suprax®) (NEW) | Red | For the management of irinotecan induced diarrhoea in paediatric patients, not responsive to standard treatments. | |
| CEFOTAXIME | Red | ||
| CEFOXITIN (Renoxitin®) | Red | Antibiotic | |
| CEFTAROLINE | Red | Confirmed MRSA community acquired pneumonia and complicated skin and soft tissue infections |
On advice of a consultant microbiologist only |
| CEFTAZIDIME | Red | ||
| CEFTAZIDIME / AVIBACTAM (Zavicefta®) | Red | As per antimicrobial advice |
Prescribe by brand to prevent confusion. |
| CEFTOBIPROLE (Zevtera®) | Do not prescribe | For Hospital and community-acquired pneumonia in adults. | |
| CEFTOLOZANE-TAZOBACTAM (Zerbaxa®) | Red | As per antimicrobial advice | |
| CEFUROXIME 5% eye drops | Red | ||
| CELECOXIB | Yellow | Inflammatory pain associated with cancer or other palliative conditions | |
| CELECOXIB | Do not prescribe | Indications not traffic lighted yellow | |
| CELECOXIB | Yellow | For pain and inflammation for asthmatic patients with NSAID allergy |
To be initiated in a specialist clinic with resuscitation facilities |
| CELECOXIB (Onsenal®) | Do not prescribe | Familial adenomatous polyposis | |
| CENEGERMIN (Oxervate®) | Do not prescribe | Neurotrophic keratitis |
Not recommended in NICE TA 532 |
| CENOBAMATE | Red | Focal onset seizures in epilepsy | |
| CERTOLIZUMAB PEGOL | Red | Ankylosing spondylitis and non-radiographic axial spondyloarthritis |
In line with NICE TA 383 |
| CERTOLIZUMAB PEGOL | Red | Psoriatic arthritis |
In line with NICE TA 445 |
| CERTOLIZUMAB PEGOL | Red | Rheumatoid arthritis |
In line with NICE TA 375 and NICE TA 415 |
| CERTOLIZUMAB PEGOL (Cimzia®) | Red | Moderate to severe plaque psoriasis |
In line with NICE TA574
|
| CETRORELIX (Cetrotide®) | Red | IVF | |
| CHENODEOXYCHOLIC ACID | Red | Inborn error of bile synthesis | |
| 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. |
| CHLORAMBUCIL | Red | ||
| CHLORHEXIDINE 2% EYE DROPS | Do not prescribe | Fungal keratitis |
Not approved by local committee |
| CHLORHEXIDINE GLUCONATE 1% cream (Eczmol®) | Green | Adjunctive therapy for decreasing bacterial load only in cases of recurrent infected atopic eczema in children. | |
| CHLORHEXIDINE GLUCONATE 1% cream (Eczmol®) | Do not prescribe | Eczema and Dermatitis |
Not approved by local committee |
| CHLORHEXIDINE HYDROCHLORIDE 0.1% AND NEOMYCIN SULFATE 0.5% (Naseptin®) (NEW) | Green | MRSA decolonization (to match current guidelines) |
MRSA decolonisation for patients unable to tolerate mupirocin (Bactroban) and where mupirocin resistance is identified. |
| CHLORMETHINE GEL (Ledaga®) | Red | Mycosis fungoides-type T cell lymphomas |
In line with NICE TA720 |
| CHLOROPROCAINE HYDROCHLORIDE (Ampres®) | Do not prescribe | Spinal anesthesia for orthopedic & urology day cases lasting 40 to 60 mins |
Reviewed by TAS September 2021 |
| CHONDROSPHERE (Spherox®) | Red | Autologous chondrocyte implantation for treating symptomatic articular cartilage defects of the knee in adults |
In line with NICE TA 508
|
| CHORIONIC GONADOTROPHIN (Pregnyl®) | Red | IVF | |
| CICA-CARE® | Yellow | Hypertrophic Scars |
Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform® |
| CICLOSPORIN EYEDROPS (Verkazia®) | Yellow | Treatment of severe vernal keratoconjunctivitis (VKC) in children from 4 years of age and adolescents | |
| CICLOSPORIN OPTHALMIC EMULSION (Ikervis®) | Yellow | Dry eye disease |
In line with NICE TA 369 |
| CICLOSPORIN Oral (UPDATED) | Orange | Dermatological disease | |
| CIDOFOVIR | Red | CMV retinitis | |
| CINACALCET | Yellow | Secondary hyperparathyroidism |
In line with NICE TA 117. Initiation, dose changes and monitoring for cinacalcet carried out by secondary care renal team. Cinacalcet to be prescribed by primary care after achievement of a stable dose regime by secondary care. |
| CINACALCET | Red | Primary hyperparathyroidism | |
| CINNARIZINE / DIMENHYDRINATE (Arlevert®) | Yellow | Dizziness in Meniere's disease |
Click on drug name for further details |
| CIPROFLOXACIN 0.2% preservative free eye drops | Red | ||
| 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 |
| CIPROFLOXACIN eye ointment | Green | Eye infections |
Second-line to chloramphenicol |
| CIPROFLOXACIN HYDROCHLORIDE 3mg / FLUOCINOLONE ACETONIDE 0.25mg (Cetraxal Plus®) | Do not prescribe | Acute otitis externa (AOE). Acute otitis media in patients with tympanostomy (AOMT) |
Not yet reviewed. |
| CITALOPRAM | Yellow | Mental health indications as per the children’s BNF for children and young people | |
| CLADRIBINE | Red | Relapsing-remitting multiple sclerosis |
In line with NICE TA616 |
| 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. |
| CLOMIPHENE | Red | ||
| CLONIDINE PATCH (Catapres®) | Red | Dystonia | |
| CLONIDINE TRANSDERMAL PATCH (Catapres®) | Red | Hypertension | |
| CLOZAPINE | Red |
Leicestershire Partnership Trust consultants only |
|
| CO-BENELDOPA | Yellow | Parkinson's disease | |
| CO-CARELDOPA | Yellow | Parkinson's disease | |
| CO-PROXAMOL | Do not prescribe | Analgesia |
Due to safety concerns |
| Cobicistat (Tybost®) | Red | HIV infection | |
| COBICISTAT / ELVITEGRAVIR / EMTRICITABINE / TENOFOVIR (Stribild) | Red | HIV | |
| COLESEVELAM | Grey |
Primary and familial hypercholesterolaemia |
Not yet reviewed |
| COLESEVELAM | Yellow | Bile acid malabsorption |
Off label use second line to colestyramine if that is not tolerated. |
| COLESTILAN | Do not prescribe | Hyperphosphataemia with renal failure |
Following local review |
| COLISTIMETHATE SODIUM (Colobreathe®) INHALATION POWDER | Red | Cystic Fibrosis | |
| COLISTIN | Red | IV for cystic fibrosis | |
| COLISTIN | Red | Nebulised for Cystic fibrosis | |
| COLISTIN (Colomycin ® and Promixin®) (UPDATED) | Yellow | Bronchiectasis |
Please see guide for more information. Must be prescribed by brand as the brands are not interchangeable. |
| COLISTIN (Colomycin® and Promixin ®) (UPDATED) | Orange | Nebulised for cystic fibrosis |
Historic patients only. Must be prescribed by brand as the brands are not interchangeable. |
| COLLAGENASE | Red | ||
| COLLAGENASE CLOSTRIDIUM HISTOLYCUM | Red | Dupuytrens |
In Line with NICE TA 459 |
| COLONIS melatonin 1mg/1ml liquid | Do not prescribe | Insomnia |
This brand due to excipient content is not approved for use in LLR. |
| COPPER HISTIDINE | Red | Menkes disease | |
| CORNEAL EPITHELIAL CELLS (Ex vivo expanded autologous human) containing stem cells (Holoclar®) | Red | Moderate-severe limbal stem cell deficiency after eye burns |
In line with NICE TA 467 |
| CRIZANLIZUMAB | Red | Preventing sickle cell crises in sickle cell disease |
In line with NICE TA743 |
| CRIZOTINIB | Red | ||
| CYANOCOBALAMIN | Do not prescribe | Dietary supplementation of Vitamin B12 | |
| CYANOCOBALAMIN (Orobalin ®1mg tablet) | Green | Higher strength cyanocobalamin oral product |
Only to be used where there is malabsorption of Vitamin B12 in needle phobic patients, patients with mobility issues unable/ unsuitable to attend for injections or patients where injection is not tolerated preventing the use of hydroxycobalamin injections. |
| CYCLOPHOSPHAMIDE | Red | ||
| Cytisine 1.5mg Tablets (NEW) | Red | For smoking cessation |
*25 day course only In case of treatment failure, the treatment should be discontinued and may be resumed after 2 to 3 months |
| DABIGATRAN | Yellow | Venous thromboembolism (treatment and long term secondary prevention) |
In line with NICE TA 327
|
| DABIGATRAN | Green | Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation |
Use in line with |
| DABIGATRAN | Red | Prevention of Venous Thromboembolism (VTE) following knee / hip replacement surgery |
In line with NICE TA 157 |
| DABRAFENIB | Red | ||
| DACLATASVIR | Red | Patients with hepatitis C who have Cirrhosis |
Reviewed by TAS |
| DACLATASVIR | Red | Hepatitis C |
In line with NICE TA 364 |
| DACLIZUMAB | Red | Relapsing forms of multiple sclerosis |
In line with NICE TA 441 |
| DALBAVANCIN | Red | Bacterial skin infections |
As per antimicrobial working party recommendations |
| DALBAVANCIN (Xydalba®) | Red | Osteoarticular infections (unlicensed) | |
| DALTEPARIN | Yellow | Antenatal Indications | |
| DALTEPARIN | Green | Low INR |
In line with Warfarin Guidelines for Primary Care |
| DALTEPARIN | Green | Thromboprophylaxis and Treatment of DVT & PE | |
| DANTROLENE Capsules | Orange | Chronic Spasticity in Adults | |
| DANTROLENE LIQUID | Red | severe chronic spasticity in paediatrics | |
| DAPAGLIFLOZIN | Yellow | With insulin for treating Type 1 diabetes, historic patients only |
Now unlicensed due to commercial reasons
|
| DAPAGLIFLOZIN | Do not prescribe | Type 1 diabetes |
New patients |
| DAPAGLIFLOZIN | Yellow | Type 2 diabetes |
Simple amber if GP does not feel competent to initiate. Use in line with NICE TA 288 |
| DAPAGLIFLOZIN | Green | Type 2 diabetes |
Conditional on prescriber being competent to select appropriate patients |
| DAPAGLIFLOZIN (Forxiga®) (UPDATED) | Yellow | Chronic Heart failure with reduced ejection fraction and preserved ejection fraction |
In line with NICE TA679 and NICE TA902 |
| DAPAGLIFLOZIN (Forxiga®) | Green | CKD in adults |
In line with NICE TA775 See CKD pathway for more information
|
| DAPAGLIFLOZIN / METFORMIN (Xigduo®) | Grey | Type 2 diabetes |
Not yet reviewed |
| DAPOXETINE | Do not prescribe | Premature ejaculation | |
| DAPSONE (UPDATED) | Orange | Dermatology |
See shared care agreement for details. |
| DAPSONE | Red | Erythema elevatum diutinum, Bullous systemic lupus erythematosus, Subcorneal pustular dermatosis, Eosinophilic pustular folliculitis, Lupus nephritis, Coeliac Skin disease, Acne, Leprosy | |
| DAPTOMYCIN | Red | Complicated Gram +ve skin/soft tissue infections | |
| DARBEPOETIN | Red | Anaemia of chronic kidney disease | |
| DARIDOREXANT (Quviviq®) (UPDATED) | Green | Treating long-term insomnia |
Management of long term insomnia in primary care Chronic Insomnia Pathway In line with NICE TA922 |
| DARIFENACIN | Do not prescribe | Urinary incontinence/urgency | |
| DARUNAVIR | Red | HIV infection | |
| DARUNAVIR / COBICISTAT (Rezolsta®) | Red | HIV infection | |
| DARVADSTROCEL (Alofisel®) | Do not prescribe | Complex perianal fistulas in adults with Crohn’s disease |
Not recommended by NICE TA 556 |
| DASABUVIR | Red | Patients with hepatitis C who have Cirrhosis |
Reviewed by TAS |
| DASATINIB | Red | ||
| DEFERASIROX (UPDATED) | Red | Treatment of iron overload for transfused and non-transfused patients with chronic inherited anaemias (all ages) |
See formulary |
| DEFERIPRONE (UPDATED) | Red | Treatment of iron overload for transfused and non-transfused patients with chronic inherited anaemias (all ages) |
See formulary |
| DEFLAZACORT (Calcort®) | Yellow | Duchenne muscular dystrophy | |
| DEGARELIX | Yellow | Treatment of prostate cancer | |
| DEKAS | Yellow | Vitamin Supplement for paediatric and adult patients with cystic fibrosis | |
| DEKAS VITAMINS (various formulations) | Grey | Depending on formulation, bariatric surgery or liver disease |
Not yet reviewed |
| DELAFLOXACIN MEGLUMINE (Quofenix®) | Red | Acute bacterial skin and skin structure infections | |
| DENOSUMAB (Prolia®) (UPDATED) | Orange | Osteoporosis |
|
| Denosumab (Xgeva) (UPDATED) | Red | Prevention of skeletal related events for myeloma patients with CKD (GFR <10ml/min) | |
| DENOSUMAB (Xgeva®) | Orange | Prevention of skeletal related events in adults with bone metastases from solid tumours other than prostate | |
| DENOSUMAB 120mg (Xgeva®) (UPDATED) | Red | Prevention of skeletal related events for myeloma patients with CKD (GFR <10ml/min) | |
| 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 | |
| DEQUALINIUM CHLORIDE VAGINAL TABLETS (Fluomizin®) | Do not prescribe | Bacterial vaginosis | |
| Dermatix® | Do not prescribe | Dressing for treatment of scars | |
| DERMATOPHAGOIDES PTERONYSSINUS ALLERGEN EXTRACT (Acarizax®) (UPDATED) | Orange | Immunotherapy treatment for house dust mite and allergic rhinitis in paediatrics. | |
| DESFERRIOXAMINE (UPDATED) | Red | Treatment of iron overload for transfused and non-transfused patients with chronic inherited anaemias (all ages ) |
See formulary |
| DESIRUDIN | Red | ||
| DESMOPRESSIN ORAL LYOPHILISATE (Noqdirna ®) | Green | Symptomatic treatment of nocturia due to idiopathic nocturnal polyuria in adults |
To be started in primary care only. Please click drug name for more information. |
| DEUCRAVACITINIB (Sotyktu®) (NEW) | Red | For treating moderate to severe plaque psoriasis |
In line with NICE TA907 |
| DEXAMETHASONE / LEVOFLOXACIN EYE DROPS (Ducressa®) | Grey | Prevention and treatment of inflammation and prevention of infection associated with cataract surgery in adults. | |
| DEXAMETHASONE intravitreal implant | Red | Macular oedema due to retinal vein occlusion |
In line with NICE TA 229 |
| DEXAMETHASONE intravitreal implant (Ozurdex®) (NEW) | Red | Diabetic macular oedema |
In line with NICE TA824 |
| DEXAMETHASONE intravitreal implant (Ozurdex®) (NEW) | Red | Non-infectious uvetitis |
In line with NICE TA460 |
| DEXAMFETAMINE (UPDATED) | Orange | Excessive sleepiness caused by narcolepsy | |
| DEXAMFETAMINE (UPDATED) | Orange | Attention deficit hyperactivity disorder (ADHD) |
Adults Children and adolescents |
| Dexcom ONE® Glucose Monitoring System (NEW) | Yellow | Diabetes glucose monitoring for those included on the LLRAPC position statement |
Eligibility as per LLRAPC documents. Initial six months trial. Please see relevant documents for initiation and continuation. |
| DexcomONE + | Yellow | Diabetes glucose monitoring for those included on the LLRAPC position statement |
Update September 2024: DexcomONE + is now available; all new patients must be started on the updated device. DexcomONE is due to be discontinued early 2025, exact date to be confirmed. |
| DEXIBUPROFEN | Do not prescribe | Pain and inflammation | |
| DEXMEDETOMIDINE (Dexdor ®) | Red | Pre procedure sedation in children | |
| DEXMEDETOMIDINE (Dexdor®) (NEW) | Red | Sedation in paediatric cardiac theatre | |
| DEXMEDETOMIDINE (Dexdor®) | Red | Sedation of intubated paediatric patients in an intensive care setting. | |
| DIAMORPHINE NASAL SPRAY (Ayendi®) | Grey | Acute severe pain in children and adolescents |
Not yet reviewed |
| DICLOFENAC GEL 3% (Solaraze®) | Green | Actinic keratosis | |
| DICLOFENAC INJECTION (Dyloject®) | Do not prescribe | Analgesisa | |
| DIDANOSINE | Red | ||
| DIENOGEST (UPDATED) | Green | Treatment of endometriosis. | |
| DIFELIKEFALIN (Kapruvia®) (UPDATED) | Red | For moderate to severe pruritus in adults with chronic kidney disease (CKD) having in-centre haemodialysis |
In line with NICE TA890 |
| DIMETHYL FUMARATE | Red | Moderate to severe plaque psoriasis |
In line with NICE TA 475 |
| DIMETHYL FUMARATE | Red | Multiple sclerosis |
In line with NICE TA 320
|
| DINOPROSTONE | Red | Induction of labour | |
| DIROXIMEL FUMERATE (Vumerity®) | Red | Relapsing-remitting multiple sclerosis |
In line with NICE TA794 |
| DISODIUM PAMIDRONATE | Red | ||
| DISULFIRAM | Yellow | Adjunct in alcohol dependence | |
| DOLASETRON | Do not prescribe | Chemotherapy-induced nausea & vomiting | |
| DOLUTEGRAVIR | Red | HIV | |
| DOLUTEGRAVIR /LAMIVUDINE (Dovato®) | Red | HIV-1 in adults and adolescents over 12 years | |
| DOLUTEGRAVIR/RILPIVIRINE (Juluca®) | Red | HIV-1 in adults | |
| DONEPEZIL | Yellow | Alzheimer's disease |
In line with NICE NG 97
|
| DORAVIRINE (Pifeltro®) | Red | HIV | |
| DORIPENEM | Do not prescribe | Complicated intra-abdominal and urinary tract infection | |
| DORIPENEM | Red | Hospital acquired/ventilator associated pneumonia | |
| DORNASE ALFA (UPDATED) | Red | Cystic fibrosis |
Red; all new patients. Yellow status for existing patients where patients are already in primary care |
| DORNASE ALFA | Red | Pleural Infections | |
| DORZOLAMIDE / TIMOLOL eye drops (UPDATED) | Green | Glaucoma |
Prescribe generically. If a preservative free formulation is required, please prescribe the 5ml preservative free multi-dose containers as a first choice. Preservative free multi-dose containers are unsuitable for patients with a history of contact hypersensitivity to silver. Please use ‘unpreserved unit doses’ in their place. |
| DORZOLAMIDE eye drops (UPDATED) | Green | Glaucoma |
Prescribe generically. If a preservative free formulation is required, please prescribe the 5ml preservative free multi-dose containers as a first choice. Preservative free multi-dose containers are unsuitable for patients with a history of contact hypersensitivity to silver. Please use ‘unpreserved unit doses’ in their place. |
| DOXAZOSIN M/R TABLETS | Do not prescribe | Hypertension | |
| DOXEPIN oral | Red | Urticaria paediatrics |
Unlicensed |
| DOXYCYCLINE Controlled release (Efracea®) | Do not prescribe | Rosacea |
Not approved by local committee |
| DOXYLAMINE SUCCINATE AND PYRIDOXINE (Xonvea®) | Do not prescribe | Nausea and vomiting in pregnancy | |
| DRONEDARONE | Red | Atrial fibrillation |
New patients only |
| DROPERIDOL | Red | Post operative nausea & vomiting |
3rd line |
| DULAGLUTIDE | Yellow | Type 2 Diabetes |
If prescriber has not received specific training. |
| DULAGLUTIDE | Green | Type 2 diabetes |
Conditional on prescriber being trained to select and train patients – use in conjunction with updated NICE Clinical Guideline. Once a week preparation. |
| DULOXETINE | Green | Fibromyalgia & Neuropathic Pain | |
| DULOXETINE | Green | Diabetic neuropathy |
To be used in conjunction with Neuropathic Pain Guidelines |
| DULOXETINE | Green | Stress incontinence | |
| DULOXETINE | Green | Anxiety and depression | |
| DUPILUMAB | Red | Severe asthma with type 2 inflammation |
In line with NICE TA751. Implementation date 8th March 2022 |
| DUPILUMAB | Red | Moderate to severe atopic dermatitis |
In line with NICE TA 534 |
| DUPILUMAB (Dupixent®) | Red | Type 2 inflammation in asthma inadequately controlled by high dose ICS |
As part of FOC scheme |
| DUTASTERIDE / TAMSULOSIN (Combodart®) | Green | Benign Prostatic Hyperplasia | |
| ECULIZUMAB | Red | Prevention and management of delayed haemolytic transfusion reactions and hyperhaemolysis in patients with haemoglobinopathies | |
| ECULIZUMAB (Soliris ®) | Grey | Treatment of neuromyelitis optica spectrum disorder in adults who are anti-aquaporin-4 antibody-positive with a relapsing course of the disease |
Not yet reviewed |
| EDOXABAN | Yellow | DVT and PE |
Use in line with NICE TA354
|
| EDOXABAN | Green | Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation |
Use in line with |
| EFAVIRENZ | Red | ||
| EFAVIRENZ / EMTRICITABINE / TENOFOVIR (Atripla®) | Red | ||
| EFLORNITHINE | Do not prescribe | Female facial hirsuitism |
Not approved by local committee |
| Elafibranor (Iqirvo) | Red | Previously treated primary biliary cholangitis | |
| ELBASVIR/GRAZOPREVIR (Zepatier) | Red | Hepatitis C |
In line with NICE TA 413 |
| ELEXACAFTOR/IVACAFTOR/TEZACAFTOR (Kaftrio®) | Red | Cystic fibrosis | |
| ELTROMBOPAG | Red | Chronic immune thrombocytopenic purpura (ITP) |
In line with NICE TA293 |
| ELUXADOLINE (Truberzi®) | Red | Irritable bowel syndrome with diarrhoea |
In line with NICE TA 471 |
| ELVITEGRAVIR/COBICISTAT/EMTRICITABINE/TENOFOVIR ALAFENAMIDE (Genvoya®) | Red | HIV infection | |
| EMICIZUMAB (Hemlibra®) | Red | Severe congenitial haemophilia A without factor VIII inhibitors | |
| EMPAGLIFLOZIN (UPDATED) | Green | Type 2 diabetes & Chronic Kidney Disease |
Type 2 diabetes in line with NICE TA336. CKD treatment in line with NICE TA942. See local CKD pathway. |
| EMPAGLIFLOZIN (Jardiance®) (UPDATED) | Yellow | Chronic heart failure with preserved or mildly reduced fraction and reduced ejection fraction |
In line with NICE TA929 and NICE TA773 |
| EMPAGLIFLOZIN / LINAGLIPTIN (Glyxambi®) | Grey | Type 2 diabetes mellitus in adults |
New formulation |
| EMPAGLIFLOZIN/METFORMIN (Synjardy®) | Grey | Type 2 diabetes |
Not yet reviewed |
| EMTRICITABINE | Red | ||
| EMTRICITABINE / RILPIVIRINE / TENOFOVIR (Eviplera®) | Red | ||
| EMTRICITABINE / RILPIVIRINE / TENOFOVIR ALAFENAMIDE (Odefsey®) | Red | HIV infection | |
| EMTRICITABINE/TENOFOVIR ALAFENAMIDE (Descovy®) | Red | HIV infection | |
| EMTRICITABINE/TENOFOVIR DISOPROXIL (Ictastan®) | Red | HIV | |
| ENALAPRIL | Orange | Heart failure and hypertension in infants and children | |
| ENALAPRIL MALEATE (Orodispersible tablet - Aqumeldi) (NEW) | Orange | Treatment of heart failure in children from birth to less than 18 years. |
Not licensed in Adults |
| ENFUVIRTIDE | Red | ||
| ENOXAPARIN | Red | Acute coronary syndrome | |
| ENOXAPARIN (UPDATED) | Green | Thromboprophylaxis and treatment of DVT |
Prescribe by brand name INHIXA® as different brands have different injection techniques. Courses started during the dalteparin shortage can be continued to be supplied in primary care |
| ENOXAPARIN (Inhixa®) | Yellow | Antenatal Indications | |
| ENOXAPARIN BECAT prefilled syringes | Do not prescribe | Parenteral anticoagulant | |
| ENTACAPONE | Yellow | Parkinson's disease |
Click on drug name for further details |
| ENTECAVIR | Red | Chronic hepatitis B | |
| EPISIL® | Red | Oral mucositis in paediatric patients following chemotherapy | |
| EPLERENONE | Green | Post myocardial infarction with proven LVH | |
| EPOETIN DELTA | Do not prescribe | Anaemia of renal failure | |
| EPOETIN intravenous | Red |
HDU |
|
| EPOETIN subcutaneous | Red | Anaemia of Chronic Kidney Disease | |
| EPTACOG BETA (Cevenfacta®) | Grey | For the treatment of bleeding episodes & prevention of bleeding in those undergoing surgery/invasive procedures | |
| EPTINEZUMAB (Vyepti®) (UPDATED) | Red | For the prophylaxis of migraine in adults who have at least 4 migraine days per month. |
In line with NICE TA871 |
| ERAVACYCLINE (Xerava®) | Grey | Complicated intra-abdominal infections in adults | |
| ERDOSTEINE | Do not prescribe | Mucolytic - acute exacerbation of chronic bronchitis |
Not approved by local committee |
| ERENUMAB 70mg injection (Aimovig®) | Red | Migraine prophylaxis |
In line with NICE TA682
|
| ERLOTINIB | Red | ||
| ERTAPENEM | Red | Resistant Gram negative infections (ESBL) | |
| ERTAPENEM IV | Green | Extended Spectrum Beta Lactamase (ESBL) Urinary Tract Infection (UTI) |
UTI in line with Primary Care Multi-resistant lower UTI guidance |
| ERTUGLIFLOZIN (Steglatro®) | Green | Type 2 diabetes mellitus (for 18 years and over) as monotherapy |
In line with NICE TA 572 |
| ERTUGLIFLOZIN (Steglatro®) | Yellow | Type 2 diabetes mellitus (for 18 years and over) as monotherapy or with metformin or with metformin and a dipeptidyl peptidase-4 inhibitor |
In line with NICE TA 572 and NICE TA 583 |
| ESCITALOPRAM | Do not prescribe | All indications except treatment resistant depression and generalised anxiety disorder |
Not approved by local committee |
| ESCITALOPRAM | Green | Treatment resistant depression and generalised anxiety disorder | |
| 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 |
| ESLICARBAZEPINE | Yellow | Treatment resistant epilepsy | |
| ESOMEPRAZOLE IV | Do not prescribe |
Not supported TAS 2010 |
|
| Estradiol & Medroxyprogesterone (Tridestra) (NEW) | Green | Hormone replacement therapy | |
| Estradiol & Norethisterone (Trisequens) (NEW) | Green | Hormone replacement therapy | |
| ESTRADIOL / NOMEGESTROL (Zoely®) | Do not prescribe | Combined oral contraceptive | |
| ESTRADIOL HEMIHYDRATE/NORETHISTERONE ACETATE/RELUGOLIX (Ryeqo ®) (UPDATED) | Yellow | For treating moderate to severe symptoms of uterine fibroids in adults of reproductive age. |
Treatment for 6-12 months at the direction of specialist team. In line with NICE TA832 |
| ESTRADIOL VAGINAL TABLETS (Vagirux®) | Green | Vaginal atropy in post menopausal women | |
| ESTRAMUSTINE | Red | ||
| ETANERCEPT | Red | DMARD for RA, including weekly SC injection | |
| ETANERCEPT | Red | Plaque psoriasis |
In line with NICE TA103 |
| ETANERCEPT | Red | Juvenile idiopathic arthritis |
In line with NICE TA 373 |
| ETANERCEPT | Red | Plaque psoriasis in children |
In line with NICE TA 455 |
| ETANERCEPT | Red | Moderate rheumatoid arthritis. |
In line with NICE TA715 |
| ETELCALCETIDE injection (Parsabiv) | Red | Secondary hyperparathyroidism in adult patients with chronic kidney disease on haemodialysis therapy |
Inline with NICE TA 448 |
| ETHAMBUTOL | Red | Tuberculosis treatment |
Red for treatment of TB |
| ETOPOSIDE | Red | ||
| Etrasimod (Velsipity®) (NEW) | Red | Severely active ulcerative colitis |
In line with NICE TA956 |
| ETRAVIRINE | Red | ||
| EVENING PRIMROSE OIL (GAMOLENIC ACID) (Epogam® or Efamast®) | Do not prescribe | Cyclical breast pain/mastalgia. Atopic eczema |
No evidence to support use for these indications. |
| EVEROLIMUS | Red | Angiomyolipomas associated with tuberous sclerosis | |
| EVEROLIMUS (Certican®) | Red | Immunosuppressive therapy for Kidney Transplant in Adults and Children/Young People |
In line with NICE TA 481, NICE TA 482 |
| EVEROLIMUS (Votubia®) | Red | Refractory focal onset seizures associated with tuberous sclerosis complex |
As per NHSE Clinical Commissioning Policy |
| EVOLOCUMAB subcutaneous injection (Repatha®) | Red | Primary hypercholesterolaemia or mixed dyslipidaemia |
In line with NICE TA 394 |
| EVRA® patch | Green | Contraception | |
| EXEMESTANE | Yellow | Adjuvant therapy in early breast cancer | |
| EXENATIDE | Yellow | Type 2 Diabetes |
If prescriber has not received specific training. |
| EXENATIDE | Green | Type 2 diabetes |
Once a week preparation (Bydureon®) is formulary. Conditional on prescriber being trained to select and train patients. Use in conjunction with Updated Nice Clinical Guideline. ————————- Twice daily preparation (Byetta®) is non formulary. However, existing patients may remain on treatment |
| EZETIMIBE | Green | ||
| EZETIMIBE + SIMVASTATIN (Inegy®) | Do not prescribe | Hypercholesterolaemia | |
| FAECAL MICROBIOME TRANSPLANT (NEW) | Red | Treatment resistant C.difficile | |
| FAMOTIDINE | Green | H2 antagonist | |
| FAMPRIDINE | Do not prescribe | Multiple Sclerosis | |
| FARICIMAB (Vabysmo®) | Red | Diabetic macular oedema |
In line with NICE TA799 |
| FARICIMAB (Vabysmo®) | Red | Wet age-related macular degeneration |
In line with NICE TA800 |
| FAVIPIRAVIR (Avigan®) (NEW) | Red | For treatment of Chronic Norovirus related to immunodeficiency | |
| FEBUXOSTAT | Green | Gout (2nd line after allopurinol) |
In line with NICE TA 164 |
| FENFLURAMINE HYDROCHLORIDE (Fintepla ®) | Red | Treatment of seizures associated with Dravet syndrome |
In line with NICE TA808 |
| FENTANYL intranasal spray | Do not prescribe | Breakthrough cancer pain | |
| 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. |
| FENTANYL TRANSDERMAL SYSTEM (IONSYS®) | Do not prescribe | Post-operative pain | |
| FENTICONAZOLE | Do not prescribe | Vulvovaginal candidiasis | |
| FERRIC MALTOL(Feraccru®) | Yellow | Iron deficiency anaemia in IBD after at least two failed oral treatment options | |
| FERROUS FUMARATE | Green | Iron Deficiency Anaemia |
Recommended ONCE DAILY dosage in adults as per NICE CKS and British Society of Gastroenterology |
| FERROUS SULPHATE | Green | Iron Deficiency Anaemia |
Recommended ONCE DAILY dosage in adults as per NICE CKS and British Society of Gastroenterology |
| FERUMOXYTOL INJECTION (Rienso®) | Do not prescribe | Iron deficiency anaemia in chronic kidney disease | |
| FESOTERODINE | Do not prescribe | Urinary frequency | |
| FIDAXOMICIN | Yellow |
Clostridium difficile infection |
GP can initiate if in line with Community Clostridium difficile Care Pathway |
| FILGOTINIB (Jyseleca®) | Red | Moderate to severe arthritis |
In line with NICE TA676
|
| FILGOTINIB (Jyseleca®) | Red | Moderate to severe active ulcerative colitis |
In line with NICE TA792 Implementation date 1st September 2022 |
| FILGRASTIM | Red | ||
| FINERENONE (UPDATED) | Yellow | Treatment of Chronic Kidney Disease (Stage 3 and 4 with albuminuria) associated with Type 2 Diabetes in Adults |
In line with NICE TA877 Use in line with the CKD pathway |
| FINGOLIMOD | Red | Multiple Sclerosis |
NICE supported. |
| FLUDARABINE | Red | ||
| FLUNARIZINE | Red | Alternating hemiplegia/refractory migraine in children |
Unlicensed |
| FLUNARIZINE | Red | Migraine prophylaxis in adults | |
| FLUOCINOLONE ACETONIDE (Iluvien®) intravitreal implant | Red | Diabetic macular oedema |
In line with NICE TA953 |
| FLUOCINOLONE ACETONIDE (Synalar®) | Green | Inflammatory skin disorders |
Synalar 0.00625% or 0.025% strength Available as gel, cream and ointment. |
| FLUOCINOLONE ACETONIDE INTRAVITRAL IMPLANT (Iluvien®) | Red | Recurrent non-infectious uveitis |
In line with NICE TA590
|
| FLUOXETINE | Yellow | Mental health indications as per the children’s BNF for children and young people | |
| FLUPENTIXOL (oral) | Yellow | Schizophrenia and other psychoses | |
| FLUPENTIXOL DECANOATE | Yellow | Schizophrenia | |
| FLUPHENAZINE DECANOATE | Yellow | Schizophrenia |
See the LLR Antipsychotic Prescribing Guide |
| FLUTICASONE / AZELASTINE NASAL SPRAY (Dymista®) | Green | Rhinitis |
To be used in line with the Allergic Rhinitis Pathway |
| FLUTICASONE / FORMOTEROL INHALER (Flutiform®) | Do not prescribe | Asthma |
Reviewed by LLR Respiratory Prescribing Group. |
| FLUTICASONE FUROATE (Avamys®) | Green | Allergic rhinitis | |
| FLUTICASONE FUROATE / VILANTEROL INHALER (Relvar Ellipta®) (UPDATED) | Yellow | Paediatric / adolescent asthma |
Paediatric / adolescent asthma only. On initiation of Specialist Difficult Asthma clinic. |
| FLUTICASONE/ SALMETEROL XINAFOATE INHALER (AirFluSal Forspiro®) | Do not prescribe | COPD and Asthma |
Reviewed by LLR Respiratory Prescribing Group. |
| FLUTICASONE/UMECLIDINIUM/VILANTEROL DRY POWDER INHALER (Trelegy Ellipta®) | Do not prescribe | COPD |
Reviewed by the respiratory group |
| FOLINIC ACID | Red | ||
| FOLLITROPHIN alfa | Red | IVF | |
| FONDAPARINUX | Red | Heparin Induced Thrombocytopenia (HIT) | |
| FORMOTEROL/BUDESONIDE/GLYCOPYRRONIUM INHALER (Trixeo Aerosphere®) | Do not prescribe | Moderate to severe COPD |
Reviewed by the Respiratory Prescribing Group May 2022 |
| FOSAMPRENAVIR | Red | ||
| FOSFOMYCIN IV | Red | Only in line with advice from UHL microbiology |
Please note that there is a separate traffic light entry for oral Fosfomycin. |
| FOSFOMYCIN Oral | Green | Extended Spectrum Beta Lactamase (ESBL) Urinary Tract Infection (UTI) |
UTI in line with Primary care Multi-resistant Lower UTI Guidance. |
| FOSTAMATINIB (Tavlesse®) | Red | For treating refractory chronic immune thrombocytopenia |
In line with NICE TA835
|
| FOSTEMSAVIR (Rukobia ®) (UPDATED) | Red | HIV Infections | |
| Freestyle Libre 2 Plus | Yellow | Continuous glucose monitoring (CGM) for those included on the LLRAPC position statement. |
Update September 2024: Freestyle Libre 2 Plus is now available; all new patients must be started on the updated device. Freestyle Libre 2 is due to be discontinued early 2025, exact date to be confirmed. |
| FreeStyle Libre 2® Sensor (UPDATED) | Yellow | Diabetes glucose monitoring for those included on the LLRAPC position statement. |
Eligibility as per LLRAPC documents. Initial six month trial. Please see relevant documents for initiation and continuation.
|
| FREMANEZUMAB (Ajovy®) | Red | Prevention of migraine |
In line with NICE TA764 |
| FULVESTRANT | Yellow | Oestrogen receptor positive metastatic or locally advanced breast cancer in post menopausal women in whom disease progresses or relapses while on or after other anti oestrogen therapy |
Secondary care will administer first three doses. |
| FUMADERM | Do not prescribe | Dermatology | |
| FUROSEMIDE | Orange | Heart failure and hypertension in infants and children | |
| GABAPENTIN | Green | Neuropathic pain |
To be used in conjunction with |
| GALANTAMINE Gazylan XL ® | Yellow | Alzheimer's disease | |
| GALANTAMINE LIQUID | Red | Alzheimer's disease |
Leicestershire Partnership Trust consultants only |
| GALCANEZUMAB (Emgality ®) | Red | Migraine prophylaxis |
In line with NICE TA659 |
| GAMMAGLOBULIN | Red | ||
| GANCICLOVIR | Red | ||
| GANCICLOVIR 0.15% EYE GEL | Do not prescribe | Acute herpetic keratitis |
Only GREEN whilst Aciclovir eye ointment 3% is not available. Definite diagnosis only. |
| GANIRELIX ACETATE (Fyremadel®) | Red | Prevention of premature luteinising hormone (LH) surges in women undergoing ovarian stimulation for IVF | |
| GEFITINIB | Red | ||
| GENTAMICIN | Red | IV and inhalation | |
| GENTAMICIN 1.5% preservative free eye drops | Red | ||
| GIVINOSTAT (Duvyzat) (NEW) | Red | For the treatment of Duchenne Muscular Dystrophy. |
Via the Early Access Programme only |
| GIVOSIRAN (Givlaari®) | Grey | Acute hepatic porphyria |
Not yet reviewed |
| GLATIRAMER ACETATE (Copaxone®) | Red | Multiple sclerosis in adults |
In line with NICE TA 527 |
| GLECAPREVIR-PIBRENTASVIR (Maviret®) | Red | Hepatitis C |
In line with NICE TA 499 |
| GLUCODRATE® | Yellow | High Output Stoma (HOS) | |
| GLUCOSAMINE | Do not prescribe | Osteoarthritis | |
| Gluten Free Products (UPDATED) | Do not prescribe |
As of February 2025, the prescribing of all gluten free products is ending. |
|
| GLYCEROL PHENYLBUTYRATE (Ravicti®) | Red | Chronic management of patients with urea cycle disorders (UCDs) | |
| GLYCERYL TRINITRATE Ointment 0.4% | Green | Anal fissure | |
| GLYCOPROTEIN IIb/IIIa inhibitors | Red | ||
| GLYCOPYRRONIUM / BECLOMETASONE / FORMOTEROL metered dose Inhaler (Trimbow®) | Green | Maintenance of COPD. |
Different strengths are licensed for different indications – please check the BNF |
| GLYCOPYRRONIUM BROMIDE LIQUID 400 micrograms/ml (320 micrograms/ml Glycopyrronium) Sialanar® brand | Yellow | Hypersalivation and sialorrhoea management in children |
Initiated and stabilised in secondary care before transfer to primary care. SECOND line LPT recommendation. |
| GLYCOPYRRONIUM BROMIDE oral solution 1mg/5ml | Grey | Peptic ulcer (add-on therapy) |
Not yet reviewed |
| GLYCOPYRRONIUM INHALER (Seebri Breezhaler®) | Do not prescribe | COPD |
Following review by LLR Respiratory Prescribing Group and Therapeutic Advisory Service |
| GLYCOPYRRONIUM LIQUID (Colonis®) | Yellow | Sialorrhoea in paediatrics |
For current patients who have yet been switched by secondary care to sialanar® |
| 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/BECLOMETASONE/FORMETEROL DPI (Trimbow NEXThaler) | Green | Maintenance treatment of adults with moderate to severe COPD |
Reviewed by the Respiratory Prescribing Group September 2021
|
| GLYCOPYRRONIUM/FORMOTEROL INHALER (Bevespi aerosphere®) | Grey | COPD |
Not yet reviewed |
| GOLD salts | Red | Rheumatoid arthritis |
Red for new patients Full SCA to remain for existing patients |
| GOLIMUMAB | Red | Psoriatic arthritis (PA) and Rheumatoid arthritis(RA)in line with NICE guidance |
PA see NICE TA 220 |
| GOLIMUMAB | Red | Ankylosing spondylitis |
In line with NICE TA 233 |
| GOLIMUMAB | Red | Moderate to severe active ulcerative colitis |
In line with NICE TA 329 |
| GOLIMUMAB | Red | Non-radiographic axial spondyloarthritis |
In line with NICE TA 497 |
| GONADORELIN ANALOGUES (UPDATED) | Yellow | Gender reassignment |
Must be prescribed in line with recommendations from specialist. The nearest specialist is Nottingham. Regulation restricts the prescribing and supply of puberty-suppressing hormones to children and young people under 18 |
| GONADORELIN ANALOGUES | Green | Prostate cancer |
GP can give first injection to patients in whom anti-androgen treatment has been started by secondary care clinician. |
| GOSERELIN | Green | Prostatic carcinoma |
GP can give first injection to patients in whom anti-androgen treatment has been started by secondary care clinician. Regulation restricts the prescribing and supply of puberty-suppressing hormones to children and young people under 18 |
| GOSERELIN | Yellow | Endometriosis, uterine fibroids | |
| GOSERELIN 3.6mg (Zoladex®) (UPDATED) | Yellow | Breast cancer |
Zoladex 3.6mg implant is the only licensed product for breast cancer
|
| GRANISETRON | Do not prescribe | Chemotherapy-induced nausea | |
| GRANISETRON oral and injection | Green | Palliative care in line with guidance |
Conditional on recommendation from palliative care team. |
| GRANISETRON patch | Grey | Chemotherapy-induced nausea |
Not yet reviewed |
| GRASS POLLEN ALLERGEN EXTRACT subcutaneous injection (Pollinex®) | Red | Grass pollen allergies | |
| GRASS POLLEN ALLERGEN EXTRACT sublingual (Grazax®) (UPDATED) | Orange | Grass pollen allergies | |
| GUANFACINE (UPDATED) | Orange | ADHD - Adult |
Adult Full SCA and Request Form |
| GUANFACINE (UPDATED) | Orange | ADHD - Peadiatric |
Paediatric Full SCA and Request Form |
| GUSELKUMAB | Red | Moderate to severe plaque psoriasis in adults |
In line with NICE TA 521.
|
| GUSELKUMAB (UPDATED) | Red | Treating active psoriatic arthritis after inadequate response to DMARDs |
In line with NICE TA815
|
| HALOPERIDOL (oral) | Yellow | Schizophrenia and psychoses |
See the LLR Antipsychotic Prescribing Guide |
| HALOPERIDOL DECANOATE | Yellow | Schizophrenia |
See the LLR Antipsychotic Prescribing Guide |
| HEMOPATCH | Red | Pancreatic surgery to prevent pancreatic anastomotic leaks | |
| HEPARIN | Red | Full IV anticoagulation | |
| HEPARIN SODIUM FLUSH | Green | Flushing solution for maintenance of patency of intravenous devices | |
| HEPATITIS C treatments | Red | ||
| HERBAL MEDICINES that are unregistered | Do not prescribe |
Not approved by local committee |
|
| HERBAL MEDICINES with a Marketing Authorisation | Do not prescribe |
Reviewed upon request by a consultant or GP prescribing lead |
|
| HERBAL MEDICINES with a Traditional Herbal Registration | Do not prescribe |
Not approved by local committee |
|
| 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). |
From 1st September 2023, Shingrix® will be offered to immunocompetent individuals routinely at 60 years of age, and to immunocompromised individuals aged 50 years old and over. Please see Green Book for further details. |
| HISTIDINE TRYTOPHAN KETOGLUTARATE MANITOL (Custodiol®) | Red | For myocardial protection in complex cardiac surgery. For organ preservation in transplant surgery | |
| HOMEOPATHIC MEDICINES | Do not prescribe | Various |
Not approved by local committee see Position Statement |
| HUMAN COAGULATION FACTOR X | Red | Herediatry factor X deficiency | |
| HUMAN CYTOMEGALOVIRUS IMMUNOGLOBULIN (CMVIG) (Cytotect CP Biotest®) | Grey | Clinical manifestations of cytomegalovirus infection in patients subjected to immunosuppressive therapy |
Not yet reviewed |
| HUMAN FIBRINOGEN & HUMAN THROMBIN (Veraseal®) | Red | Supportive treatment in adults where standard surgical techniques are insufficient; for improvement of haemostasis & as suture support in vascular surgery | |
| HYALURONIC ACID DERIVATIVE (Synvisc®) | Red | Pain relief in osteoarthritis of shoulder joint. | |
| HYALURONIC ACID DERIVATIVE (Synvisc®) | Do not prescribe | Black in all indications EXCEPT for pain relief in osteoarthritis of shoulder joint (RED) | |
| Hyaluronidase/Trehalose Eye Drops(Thealoz Duo®) (NEW) | Yellow | Ocular Lubricant |
For patients with dexterity issues unable to use 1st line recommendation in ocular lubricant guideline |
| HYBRID CLOSED LOOP (NEW) | Red | Diabetes Glucose Monitoring & Delivery System |
In line with NICE TA943 |
| HYDROCORTISONE (Alkindi®)(Granules in capsules for opening) | Yellow | Adrenal insufficiency in paediatrics | |
| HYDROCORTISONE 1% / OXYTETRACYCLINE 3% (Terra-Cortril®) | Do not prescribe | Overgranulation of wounds |
Not approved by local committee |
| Hydrocortisone Eye Drops(Softacort®) (NEW) | Yellow | Mild non-infectious allergic or inflammatory conjunctival diseases |
When preservative free preparation required |
| 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. |
| HYDROCORTISONE modified release (Plenadren®) | Do not prescribe |
Hypoadrenalism (once daily dose) |
|
| HYDROXYCARBAMIDE (UPDATED) | Orange | Myeloproliferative disorders, sickle cell anaemia | |
| HYDROXYCARBAMIDE SOLUTION (Xromi®) | Grey | Prevention of vaso-occlusive complications of Sickle Cell disease |
Not yet reviewed |
| HYDROXYCHLOROQUINE | Yellow | Dermatological conditions |
Eye checks to be organised by secondary care |
| HYDROXYCHLOROQUINE | Yellow | Rheumatological disease |
Eye checks to be organised by secondary care. |
| HYOSCINE HYDROBROMIDE 1.5mg PATCH (SCOPODERM®) | Yellow | Hypersalivation and sialorrhoea management in children |
Initiated and stabilised in secondary care before transfer to primary care. FIRST line LPT recommendation. |
| HYPERTONIC SODIUM CHLORIDE, NEBULISED | Yellow | To loosen tenacious secretions. Under supervision of a respiratory physiotherapist. |
Available as 3% and 7% solutions. |
| IBANDRONIC ACID - IV | Red | osteoporosis | |
| IBANDRONIC ACID - Oral | Yellow | Breast cancer bone metastases | |
| IBANDRONIC ACID 50mg tablets | Yellow | Prevention of mestastases in early breast cancer patients with low female sex hormones |
First three months of prescribing due to renal monitoring to be from the hospital. Stop date to be recorded as total treatment with bisphosphonate to be 36 months. Unlicensed use see NICE ES 15 for more information. |
| IBANDRONIC ACID Oral monthly | Green | Postmenopausal osteoporosis |
In line with NICE TA 464 |
| IBUPROFEN MR (NEW) | Red | Stat doses prior to day case surgery | |
| ICATIBANT acetate | Red | Hereditary angioedema | |
| ICOSAPENT ETHYL (Vazkepa ®) (UPDATED) | Green | Raised triglycerides in patients with CVD | |
| IDARUBICIN | Red | ||
| IDARUCIZUMAB (Praxbind) | Red | Reversal of severe bleeding due to dabigatran | |
| IDEBENONE (Raxone®) | Grey | Leber’s hereditary optic neuropathy |
Not yet reviewed |
| IDELALISIB | Red | ||
| IDURSULFASE | Do not prescribe | Hunter syndrome (mucopolysaccharidosis II) | |
| IMATINIB | Red | ||
| IMIPENEM | Red | ||
| IMIPENEM/CILASTATIN/ RELEBACTAM (Recarbrio®) | Red | Aerobic Gram-negative infections | |
| IMIQUIMOD CREAM 3.75% (Zyclara®) | Do not prescribe |
Actinic keratosis of face and scalp |
|
| IMIQUIMOD cream 5% (Aldara®) | Red | Basal cell carcinoma | |
| IMIQUIMOD cream 5% (Aldara®) | Green | Actinic keratoses | |
| IMLIFIDASE (Idefirix®) | Red | Desentisation treayment before kidney transplant in people with CKD |
In line with NICE TA809 |
| IMMEDIATE RELEASE FENTANYL PREPARATIONS | Do not prescribe | Pain not associated with breakthrough cancer pain or palliative care |
As agreed at FWP September 22 |
| IMMUNOGLOBULINS | Red | ||
| 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. For further related guidance please see the Cardiovascular Guidelines page. This page also includes an interim inclisiran pathway.
|
| INDACATEROL (Breezhaler®) | Do not prescribe | COPD |
Reviewed by LLR Respiratory Prescribing Group, deemed not appropriate for review by TAS |
| INDACATEROL / GLYCOPYRRONIUM INHALER (Ultibro Breezhaler®) | Do not prescribe | COPD |
Reviewed by LLR Respiratory Prescribing Group, deemed not appropriate for review by TAS |
| INDACATEROL/GLYCOPYRRONIUM/ MOMETASONE (Enerzair Breezhaler) | Grey | Maintenance treatment of asthma in adult patients not adequately controlled with a maintenance combination of a long-acting beta2-agonist and a high dose of an inhaled corticosteroid who experienced one or more asthma exacerbations in the previous year. |
Not yet reviewed |
| INDACATEROL/MOMETASONE dry powder inhaler (Atectura Breezhaler®) | Grey | Maintenance treatment of asthma in adults and adolescents 12 years of age and older |
Not yet reviewed |
| INDINAVIR | Do not prescribe | ||
| Indium 111 Oxinate (NEW) | Red | radiopharmaceutical for platelet and leukocyte studies | |
| INDOCYANINE (Verdye®) | Red | Detection of sentinel lymph nodes in Endometrial cancer |
Reviewed by TAS November 2022 |
| INFLIXIMAB | Red | Moderate rheumatoid arthritis. |
In line with NICE TA715 |
| INFLIXIMAB | Red | All indications |
As indicated on the LLR Medicines Formulary |
| INGENOL MEBUTATE GEL (Picato®) | Do not prescribe |
Actinic keratosis (non hypertrophic) |
|
| 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
|
| INOTERSEN (Tegsedi®) | Grey | Treatment of stage 1 or stage 2 polyneuropathy in adult patients with hereditary transthyretin amyloidosis (hATTR). | |
| INSULIN ASPART (Fiasp®) | Green | Type 1 and 2 diabetes mellitus in adults |
Conditional on prescriber being competent to select appropriate patients. |
| INSULIN DEGLUDEC (Tresiba®) | Green | Diabetes mellitus in adults |
Conditional on prescriber being trained to select appropriate patients |
| INSULIN DEGLUDEC (Tresiba®) | Yellow | Diabetes mellitus in adults |
Simple amber if prescriber has not received specific training. |
| INSULIN DEGLUDEC/LIRAGLUTIDE (combination product) (Xultophy®) | Yellow | Diabetes | |
| INSULIN EYE DROPS | Red | Persistent epithelial defects (PED) in patients who don’t respond to standard therapy |
Unlicensed special |
| INSULIN GLARGINE (Toujeo® 300units per ml) | Green | Diabetes mellitus in adults. First line concentrated insulin of choice in insulin resistant patients requiring large amounts of insulin. Please take extra care in prescribing |
Conditional on prescriber being competent to select appropriate patients. |
| INSULIN GLARGINE / LIXISENATIDE (Suliqua®) | Grey | Type 2 Diabetes mellitus in combination with metformin |
New formulation |
| INSULIN GLULISINE (Apidra®) | Green | Type 1 and 2 diabetes |
Conditional on prescriber being competent to select appropriate patients |
| INSULIN LISPRO (Humalog®) U200 | Green | Diabetes Mellitus |
Conditional on prescriber being competent to select appropriate patients |
| INSULIN LISPRO (Humalog®) U200 | Yellow | Diabetes Mellitus |
Amber if GP does not feel competent to initiate. |
| INTERFERON ALFA | Red | ||
| INTERFERON BETA | Red | ||
| INTERFERON GAMMA (Immukin®) | Red | For mycobacterial infections and pulmonary and miliary | |
| IQoro® | Grey | Neuromuscular training device | |
| IRON(III) ISOMALTOSIDE 1000 (Diafer®) | Red | Iron deficiency (renal use only) | |
| ISAVUCONAZOLE | Red | Invasive aspergillosis and mucormycosis | |
| Isoniazid | Red | Tuberculosis treatment |
Red for treatment of TB |
| ISOTRETINOIN - Oral | Red | Severe acne | |
| IVABRADINE | Green | Chronic stable angina |
For patients who cannot tolerate beta blockers |
| IVABRADINE | Yellow | Chronic heart failure | |
| IVACAFTOR (Kalydeco®) | Red | Cystic fibrosis |
As per NHSE policy statement |
| IVERMECTIN CREAM | Green | Moderate to severe papulo-pustula rosacea | |
| IVERMECTIN TABLETS (NEW) | Green | Human sarcoptic scabies | |
| IVERMECTIN TABLETS (NEW) | Yellow | Gastrointestinal strongyloidiasis (anguillulosis) and suspected or diagnosed microfilaraemia | |
| IXEKIZUMAB | Red | Psoriasis |
In line with NICE TA 442 |
| IXEKIZUMAB | Red | Psoriatic arthritis after inadequate response to DMARDs |
In line with NICE TA 537
|
| IXEKIZUMAB (Taltz®) | Red | Axial spondyloarthritis |
In line with NICE TA718
|
| KELO-COTE® | Yellow | Hypertrophic Scars |
Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform® |
| KETAMINE | Green | Palliative care in line with guidance |
Conditional on recommendation from palliative care team.
|
| KETOCONAZOLE TABLETS | Do not prescribe | Fungal infections |
Risk of hepatotoxicity outweighs benefit |
| KETOPROFEN / OMEPRAZOLE (Axorid®) | Do not prescribe | Pain and inflammation for patients at risk of NSAID associated ulcers | |
| KETOROLAC | Green | Palliative care in line with guidance |
Conditional on recommendation from palliative care team. |
| KETOTIFEN | Yellow | Mast Cell Activation Syndrome (MCAS) | |
| KETOTIFEN UNIT DOSE EYE DROPS (Ketofall®) | Green | Seasonal allergic conjunctivitis |
After OTC products have been tried. |
| Klean-Prep® | Green | Bowel cleansing before lower GI endoscopy (second line) |
In line with prism pathway (currently under development, traffic light change in readiness) |
| LACOSAMIDE | Yellow | Resistant epilepsy | |
| LAMIVUDINE | Red | ||
| LAMIVUDINE / ZIDOVUDINE | Red | ||
| LAMOTRIGINE | Yellow | Bipolar disorder | |
| LANADELUMAB (Takhyzro®) | Red | Preventing recurrent attacks of hereditary angioedema |
In line with NICE TA606 |
| LANREOTIDE | Red | Neuroendocrine tumours | |
| LANREOTIDE | Red | Acromegaly |
New patients only |
| LANREOTIDE | Green | Palliative Care |
Link to Palliative Care Guidelines |
| LANTHANUM CARBONATE | Yellow | Hyperphosphataemia with renal failure | |
| LAPATINIB | Red | ||
| LATANOPROST eye drops | Green | Glaucoma |
Prescribe generically. Preservative -free formulation available if required. |
| Latanoprost–netarsudil eye drops (NEW) | Green | Primary open-angle glaucoma or ocular hypertension | |
| LAUROMACROGOL 400 (Aethoxysklerol®) | Grey | Sclerotherapy of varicose veins of the lower extremities |
Not yet reviewed |
| Lebrikizumab (NEW) | Red | For treating moderate to severe atopic dermatitis in people 12 years and over | |
| LECICARBON A® suppositories | Grey | Laxative or bowel preparation |
Not yet reviewed |
| LEDIPASVIR/SOFOSBUVIR (Harvoni®) | Red | Hepatitis C |
In line with NICE TA 363 |
| LEFLUNOMIDE (UPDATED) | Orange | Rheumatological disease | |
| LENACAPAVIR (Sunlenca®) | Grey | HIV-1 | |
| LENOGRASTIM | Red | ||
| LETERMOVIR (Prevymis®) | Red | Prevention of cytomegalovirus disease after a stem cell transplant |
In line with NICE TA591
|
| LETROZOLE | Yellow | Adjuvant therapy in early breast cancer | |
| LEUPRORELIN | Yellow | Endometriosis, uterine fibroids | |
| LEUPRORELIN (UPDATED) | 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. Regulation restricts the prescribing and supply of puberty-suppressing hormones to children and young people under 18 |
| LEUPRORELIN (PROSTAP 3 DCS ®) | Yellow | Breast cancer |
3 monthly preparation |
| LEVETIRACETAM | Yellow | Control of seizures in palliative care medicine |
To be used on recommendation from specialist palliative care team only. |
| LEVETIRACETAM - IV | Red | Epilepsy |
Restricted to patients who are already maintained on the oral preparation |
| LEVETIRACETAM - Oral | Yellow | Epilepsy | |
| LEVODOPA/CARBIDOPA infusion (Duodopa) | Red | Parkinson's disease |
Specialist centres only |
| LEVOFLOXACIN Eyedrops - unpreserved | Red | Bacterial keratitis | |
| LEVOFLOXACIN NEBULISER SOLUTION (Quinsair®) | Red | Chronic Pseudomonas lung infection in cystic fibrosis (adults) | |
| Levonorgestrel IUS (Benilexa) | Green | Long-acting contraception / heavy menstrual bleeding | |
| LEVONORGESTREL-RELEASING INTRAUTERINE SYSTEM (Levosert®) | Green | Contraception or heavy menstrual bleeding | |
| LIDOCAINE patch | Green | Postherpetic neuralgia | |
| LIDOCAINE patch (NEW) | Red | Acute use following rib fracture or following thoracic surgery. Short term management only |
Full supply from secondary care, not to be continued in primary care. |
| LIDOCAINE patch (NEW) | Red | Sickle cell crisis with focal origin of pain. Managed by haematology only. |
Full supply from secondary care, not to be continued in primary care. |
| LIDOCAINE Patch | Do not prescribe | All indications except post herpetic neuralgia | |
| LIDOCAINE/PRILOCAINE cutaneous spray (Fortacin) | Grey | Primary premature ejaculation |
Not yet reviewed |
| LINACLOTIDE | Green | Moderate to severe irritable bowel syndrome with constipation | |
| LINAGLIPTIN | Green | Type 2 Diabetes | |
| Linzagolix (Yselty ) | Yellow | Moderate to severe symptoms of uterine fibroids | |
| LIOTHYRONINE (NEW) | Yellow | Hypothyroidism |
Monitoring will be undertaken by secondary care and patients remain open to secondary care. |
| LIOTHYRONINE | Red | Treatment of depression where other therapies have failed |
This should be under the advice of an NHS consultant psychiatrist. In line with NICE NG222 |
| LIPEGFILGRASTIM | Grey |
Chemotherapy-induced neutropenia |
Not yet reviewed locally |
| LIRAGLUTIDE (Diavic®) (UPDATED) | Yellow | Type 2 diabetes |
Diavic® is the preferred liraglutide formulation across LLR. Dec 2024 update: GLP-1 agonist Victoza to be discontinued | MIMS online |
| LIRAGLUTIDE (Saxenda®, Nevolat® and Biolide®) | Red | Obesity in children aged over 12 years | |
| LIRAGLUTIDE (Saxenda®, Nevolat® and Biolide®) | Red | Obesity as part of a tier 3 specialist weight management service |
In line with NICE TA664 |
| LIRAGLUTIDE (Victoza®) | Yellow | Type 2 diabetes mellitus in children 10 years and over |
Dec 2024 update: GLP-1 agonist Victoza to be discontinued | MIMS online |
| LIRAGLUTIDE (Victoza®) | Yellow | Type 2 diabetes |
Dec 2024 update: GLP-1 agonist Victoza to be discontinued | MIMS online
|
| LISDEXAMFETAMINE DIMESYLATE (UPDATED) | Orange | ADHD when response to methylphenidate is inadequate |
Adults Children and adolescents |
| LISINOPRIL | Orange | Heart failure and hypertension in infants and children | |
| LITHIUM SALTS | Orange | Mania, Bipolar Disorder, Recurrent Depression or Aggressive or Self-mutilating behaviour. | |
| LIXISENATIDE | Green | Type 2 diabetes |
Conditional on prescriber being trained to select and train patients |
| LIXISENATIDE | Yellow | Type 2 diabetes |
If prescriber has not received specific training. |
| LOMITAPIDE (Lojuxta®) | Red | Homozygous familial hypercholesterolaemia |
Requested for UHL as part of NHS England commissioning policy. |
| LOMUSTINE | Red | ||
| LOPINAVIR / RITONAVIR (Kaletra®) | Red | ||
| LOSARTAN | Orange | Heart failure and hypertension in infants and children | |
| LOTEPREDNOL eye drops (Lotemax®) | Red | Post-operative inflammation following ocular surgery | |
| LOXAPINE inhalation powder (Adasuve®) | Grey | Rapid control of mild-moderate agitation in schizophrenia or bipolar disorder |
Not yet reviewed |
| LUBIPROSTONE | Do not prescribe | Constipation |
Withdrawn from market |
| LUMACAFTOR /IVACAFTOR (Orkambi®) | Red | Cystic fibrosis |
As per NHSE policy statement |
| LURASIDONE | Do not prescribe | Psychosis not associated with schizophrenia | |
| LURASIDONE | Yellow | schizophrenia | |
| LUSUTROMBOPAG (Mulpleo®) | Grey | Severe thrombocytopenia |
Not yet reviewed |
| LUTROPIN ALFA, FOLLITROPIN ALFA (Pergoveris®) | Grey | Stimulation of follicular development |
Not yet reviewed |
| LYUMJEV | Green | Fast acting insulin for adults with diabetes mellitus | |
| MacuLEH Light® | Do not prescribe | Age-related macular degeneration |
Not approved by local committee |
| MAGNESIUM ASPARTATE DIHYDRATE (Magnaspartate®) | Yellow | Magnesium deficiency |
Licensed preparation now available. This will be used in preference to any unlicensed preparations. |
| MANNITOL dry powder inhaler | Red | Cystic fibrosis | |
| MARAVIROC | Red | ||
| MARIBAVIR (NEW) | Red | Refractory cytomegalovirus infection after transplant |
In line with NICE TA860 |
| MAVACAMTEN (Camzyos®) (NEW) | Red | For treating symptomatic obstructive hypertrophic cardiomyopathy. |
As per NICE TA913 |
| MBrIDA | Red | Diagnosis of hepatobiliary tract patency and differentiation of jaundice | |
| MECASERMIN (Increlex®) (NEW) | Red | For the treatment of growth failure in line with the NHSE Clinical Commissioning Policy. | |
| MEDROXYPROGESTERONE ACETATE DEPOT INJECTION (Sayana Press®) | Green | Long-term contraception | |
| MELATONIN | Do not prescribe | Primary insomnia in adults. Circadian asynchrony in elderly institutionalised patients. Jet Lag | |
| MELATONIN | Yellow | Free running circadian rhythm and delay sleep phase syndrome in adults and children. | |
| MELATONIN (UPDATED) | Yellow | Learning disability (Adult). Huntington's disease. Parkinson's disease. |
Off-label use, Under Specialist Initiation. |
| MELATONIN | Red |
Acute circadian asynchrony in hospitalised patients on ITU, HDU and other care areas |
|
| MELATONIN (NEW) | Yellow | REM Sleep Behaviour Disorder |
Off-label use, under specialist initiation |
| MELATONIN (doses of 10mg daily or less). | Yellow | Sleep disorders children (see comments) continued in adults if proven efficacy in childhood |
Yellow only applies to the products stated in the LLR APC guidance. Other formulations are secondary care only.
|
| MELATONIN (doses over 10mg daily) | Red | Sleep disorders children (see comments), continued in adults if proven efficacy in childhood |
Sleep onset insomnia and delayed sleep phase syndrome in children |
| MELATONIN M/R 1mg and 5mg tablets (Slenyto ®) | Do not prescribe | Treatment of insomnia not covered by the yellow status | |
| 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 | |
| MELPHALAN | Red | ||
| MEMANTINE | Yellow | Alzheimer's disease |
in line with NICE NG 97
|
| MEMANTINE | Red | Nystagmus | |
| MENOTROPHIN (Menopur®) | Red | IVF | |
| MEPACRINE | Red | Refractory giardiasis | |
| MEPIFORM® | Yellow | Hypertrophic Scars |
Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform® |
| MEPOLIZUMAB (Nucala®) | Red | To treat severe eosinophilic asthma. |
In line with NICE TA 431 |
| MERCAPTAMINE (Cystadrops®) | Grey | Corneal cystine crystal deposits in patients aged ≥ two years with cystinosis |
New formulation |
| MERCAPTOPURINE (UPDATED) | Orange | Paediatric Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease) | |
| MERCAPTOPURINE | Red | Leukaemia | |
| MERCAPTOPURINE (UPDATED) | Orange | Inflammatory Bowel Disease (Ulcerative Colitis, Crohn's Disease) & Autoimmune Hepatitis | |
| MEROPENEM | Red | ||
| MEROPENEM and Vaborbactam (Vaborem®) | Red | Infections known/suspected to be caused by KPC producing bacteria | |
| MESALAZINE (Mezavant® XL) | Do not prescribe | Ulcerative colitis |
Not supported by local committee |
| MESALAZINE ORAL (prescribe by brand) (UPDATED) | Yellow | Ulcerative colitis, Crohn's disease and paediatric colitis |
Monitoring for paediatrics done by secondary care |
| MESALAZINE RECTAL | Yellow | Ulcerative colitis and Crohn's disease | |
| METHADONE | Yellow | Palliative care in line with palliative care guidance. |
Conditional on recommendation from palliative care team. |
| METHADONE (oral) but note NOT 10mg/1ml | Yellow | Chronic pain with ongoing advice from specialist services on dose reduction | |
| METHADONE 10mg/1ml oral liquids | Do not prescribe | All indications |
This is to prevent dosing errors. The 1mg/1ml oral liquid strength remains available. |
| METHENAMINE HIPPURATE (NEW) | Green | UTI prevention in women. |
Prescribing as per LLR Guidelines on Management of Lower Recurrent Urinary Tract Infections in Adults. |
| METHOTREXATE Injection | Red | ||
| METHOTREXATE Oral (UPDATED) | Orange | Rheumatological disease |
Always prescribe oral Methotrexate in multiples of 2.5mg tablet strength. The 10mg tablets must NOT be prescribed or supplied. |
| METHOTREXATE Oral (UPDATED) | Orange | Dermatological disease |
Always prescribe oral Methotrexate in multiples of 2.5mg tablet strength. The 10mg tablets must NOT be prescribed or supplied |
| METHOTREXATE Oral (UPDATED) | Red | Severe refractory asthma |
Always prescribe oral Methotrexate in multiples of 2.5mg tablet strength. The 10mg tablets must NOT be prescribed or supplied |
| METHOTREXATE Oral (UPDATED) | Orange | Crohn's Disease |
Always prescribe oral Methotrexate in multiples of 2.5mg tablet strength. The 10mg tablets must NOT be prescribed or supplied |
| 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. |
| METHYLPHENIDATE (UPDATED) | Orange | Attention deficit hyperactivity disorder (ADHD)- prescribe CR formulation by brand name only |
For information about products please see relevant Shared Care. |
| METHYLPHENIDATE (UPDATED) | Orange | Excessive sleepiness caused by narcolepsy | |
| METRELEPTIN (Myalepta ®) | Grey | Replacement therapy to treat the complications of leptin deficiency in lipodystrophy patients. | |
| MEXILETINE | Red | Ventricular arrhythmia |
New patients. Existing prescribing in primary care to continue. |
| 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. |
| MIANSERIN | Yellow | Depression |
Mianserin is yellow once the specialist has prescribed and monitored FBC for the first three months. After this time there are no on-going monitoring requirements but treatment should be stopped and a full blood count obtained if fever, sore throat, stomatitis, or other signs of infection develop. Seek advice from specialist in this scenario. |
| MICONAZOLE NITRATE 2% WITH HYDROCORTISONE 1% (Daktacort®) | Green | Topical treatment of inflamed dermatoses with infection | |
| MIDAZOLAM (Buccolam®) | Yellow | Status epilepticus | |
| MIDAZOLAM buccal | Green | Palliative care in line with guidance. |
Conditional on recommendation from palliative care team. |
| MIDODRINE | Yellow | Severe orthostatic hypotension |
Licensed product now available |
| MIFEPRISTONE | Red | ||
| MIGLUSTAT | Do not prescribe | Niemann-Pick type C disease | |
| MIRABEGRON | Green | Symptoms of urinary frequency, urgency and urge incontinence |
In line with Overactive Bladder Pathway |
| MIRIKIZUMAB (Omvoh®) (NEW) | Red | For treating moderately to severely active ulcerative colitis |
As per NICE TA925 |
| MITOTANE | Red | ||
| MODAFINIL (UPDATED) | Yellow | Daytime sleepiness associated with Narcolepsy and existing patients being treated for Daytime Sleepiness associated with Obstructive Sleep Apnoea Syndrome & Idiopathic Hypersomnia. | |
| MOLLUDAB® | Grey |
Molluscum contagiosum |
Not yet reviewed. |
| MOLOGRAMOSTIN | Red | ||
| MOLUTREX® | Grey | Molluscum contagiosum |
Not yet reviewed |
| MOMETASONE NASAL SPRAY | Green | Allergic Rhinitis | |
| MOMETASONE/ OLOPATADINE NASAL SPRAY (Ryaltris ®) | Grey | Moderate to severe nasal symptoms associated with allergic rhinitis |
Not yet reviewed |
| MORPHINE SULPHATE 100micrograms/ml ORAL SOLUTION (NEW) | Red | Pain. For paediatric use ONLY. |
Unlicensed preparation. Not to be prescribed in primary care. |
| MOVICOL liquid® | Do not prescribe | Constipation | |
| MOVICOL® ready to take solution in sachet | Grey | Constipation |
Not yet reviewed |
| Moviprep® | Green | Bowel cleansing before lower GI endoscopy (first line) |
In line with prism pathway (currently under development, traffic light change in readiness) |
| MOXIFLOXACIN | Red | Multi-drug resistant tuberculosis | |
| MOXIFLOXACIN | Do not prescribe | Respiratory tract infections (general) | |
| MUCODIS® | Red | Oral mucositis in head & neck cancer patients | |
| MYCOPHENOLATE | Red | Immunosuppression following renal transplantation | |
| MYCOPHENOLATE | Orange | Immunosuppression following renal transplantation |
Exception agreed to red status: Full shared care to allow GPs to continue supplying to historical patients still on shared care where appropriate for patient and the GP agrees. |
| MYCOPHENOLATE MOFETIL | Red | Specialist heamatology use in graft versus host disease in bone marrow transplant | |
| MYCOPHENOLATE MOFETIL (UPDATED) | Orange | Autoimmune conditions |
Please see shared care agreement for individual indications |
| N-ACETYLCYSTEINE | Do not prescribe | Idiopathic pulmonary fibrosis | |
| NABILONE | Do not prescribe | Chemotherapy induced nausea and vomiting | |
| NALDEMEDINE TOSYLATE (Rizmoic®) | Green | opioid-induced constipation |
As per NICE TA651.
|
| NALMEFENE | Green | Alcohol dependence |
In line with NICE TA 325 |
| NALOXEGOL | Green | Opiod induced constipation |
In line with NICE TA345
|
| NALOXONE | Green | Palliative care in line with guidance. |
Conditional on recommendation from palliative care team. |
| NALOXONE nasal spray (Nyxoid®) (UPDATED) | Red | Opioid overdose |
Turning point or on TTO from secondary care only |
| NALTREXONE | Yellow | Opioid dependence |
To be initiated by specialists for maintenance treatment to help prevent relapse in opioid dependence. |
| NALTREXONE | Red | Pruritus in liver disease |
Unlicensed indication |
| NALTREXONE (low dose) | Red | Mast Cell Activation Syndrome (MCAS) | |
| NALTREXONE / BUPROPION M/R (Mysimba®) | Do not prescribe | Managing obesity |
NICE TA 494 not supported for managing obesity in adults |
| NAPROXEN / ESOMEPRAZOLE (Vimovo®) | Do not prescribe | Osteoarthritis, RA & ankylosing spondylitis | |
| NARSOPLIMAB | Red | IgA Nephropathy | |
| NATALIZUMAB | Red | Rapidly evolving relapsing-remitting multiple sclerosis | |
| Natamycin 5% eye drops | Red | Fungal keratitis (moulds only) | |
| NEBIVOLOL | Green | Hypertension |
Black for all other indications |
| NEBIVOLOL | Do not prescribe | All indications excluding hypertension (Green) | |
| Nebulised therapies for use at home | Yellow | Asthma and COPD |
Exception palliative care Please see nebuliser guidance and MHRA alert |
| NEFOPAM (UPDATED) | Yellow | Pain |
Initiation restricted on advice of secondary care pain team only. Historic patients may continue therapy as appropriate. |
| NEFOPAM | Red | For post-operative analgesia for patients undergoing THR / TKR and acute gynaecology |
ONLY for patients who are intolerant of NSAIDs, tramadol and/or opioids. 5 – 7 days treatment only. |
| NELFINAVIR | Do not prescribe | ||
| Nephrotrans (UPDATED) | Yellow | metabolic acidosis in chronic kidney disease |
Treatment of metabolic acidosis and for maintenance treatment against recurrence of metabolic acidosis in adults with chronic renal impairment only (limited use as a 2nd line option for patients who cannot tolerate the standard capsules e.g. due to bloating).’ To be initiated by renal team only. |
| NETAZEPIDE | Do not prescribe | Fundic gland polyps |
Not supported TAS 2012 |
| NETILMICIN AND DEXAMETHASONE EYE DROPS (Netildex®) | Grey | Treatment of inflammatory ocular conditions of the anterior segment of the eye, including post-operative cases, where bacterial infection or a risk of bacterial infection with netilmicin-susceptible microorganisms exists | |
| NETILMICIN EYE DROPS (Nettacin®) | Grey | Topical treatment of external infections of the eye and its adnexa caused by netilmicin sensitive bacteria | |
| NETUPITANT & PALONOSETRON (Akynzeo) (NEW) | Red | For chemotherapy induced nausea & vomiting. |
Feb 2025: Short-term change in practice only whilst there is a supply issue with aprepitant |
| NETUPITANT/PALONOSETRON capsules (Akynzeo®) | Grey | Prevention of nausea and vomiting associated with chemotherapy |
Not yet reviewed |
| NEVIRAPINE | Red | ||
| NICARDIPINE injection (NEW) | Red | Blood pressure reduction in acute intra-cerebral haemorrhage within 6 hours of onset |
Second line agent |
| NILOTINIB | Red | ||
| NINTEDANIB | Red | Fibrosing interstitial lung diseases |
In line with NICE TA747. Implementation date 17th February 2022. |
| NINTEDANIB (Ofev®) | Red | Idiopathic Pulmonary Fibrosis |
In line with NICE TA 379 and NICE TA864 |
| NONACOG BETA PEGOL (Refixia®) | Red | Haemophilia | |
| NUSINERSEN SODIUM (Spinraza®) (NEW) | Grey | Treatment of 5q Spinal Muscular Atrophy | |
| NUVARING® | Green | Contraception | |
| OBETICHOLIC ACID | Red | Primary Biliary cholangitis |
In line with NICE TA 443 |
| OCRELIZUMAB | Red | Relapsing-remitting multiple sclerosis |
In line with NICE TA 533
|
| OCRELIZUMAB | Red | Primary progressive multiple sclerosis |
In line with NICE TA585 |
| OCRIPLASMIN INJECTION (Jetrea®) | Red | Vitreomacular traction | |
| OCTREOTIDE | Red | Acromegaly |
New patients only |
| OCTREOTIDE | Red | GEP tumours and post-pancreatic surgery | |
| OCTREOTIDE | Yellow | Palliative care in line with guidance |
Conditional on recommendation from palliative care team. |
| OCTREOTIDE | Red | Hight output stoma | |
| ODEVIXIBAT SESQUIHYDRATE (Bylvay®) | Grey | Treatment of progressive familial intrahepatic cholestasis in patients aged 6 months or older. | |
| OFATUMUMAB (Kesimpta ®) | Red | For treating relapsing multiple sclerosis |
In line with NICE TA699
|
| 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 |
| OLANZAPINE PAMOATE MONOHYDRATE (Zypadhera®) | Red | Schizophrenia |
Requires case by case consideration by Prescribing Group |
| OLMESARTAN/AMLODIPINE/HYDROCHLOROTHIAZIDE (Sevikar HCT) | Do not prescribe | Non-adherence due to polypharmacy | |
| OLODATEROL INHALER | Grey | COPD |
Not yet reviewed |
| OLOPATADINE | Green | Hay fever | |
| OMALIZUMAB | Red | Asthma |
In line with NICE TA 278 |
| OMALIZUMAB | Red | Chronic spontaneous urticaria | |
| OMBITASVIR/PARAPREVIR/RITONAVIR (Viekirax®) | Red | Hepatitis C |
In line with NICE TA 365 (with or without dasabuvir) |
| OMEGA-3 ACID ETHYL ESTERS (Dualtis®) | Grey | Secondary prevention of MI, hypertriglyceridaemia |
Not yet reviewed |
| OMEGA-3 ACID ETHYL ESTERS (Omacor®) | Green | Hypertriglyceridaemia |
In line with LLR lipid pathway |
| OMEGA-3 ACID ETHYL ESTERS (Omacor®) | Do not prescribe | Secondary prevention of MI |
Contains Omega-3 acid ethyl esters |
| ONASEMNOGENE ABEPARVOVEC (Zolgensma®) | Grey | 5q spinal muscular atrophy (SMA) |
Not yet reviewed |
| ONDANSETRON | Green | Nausea | |
| ONDANSETRON (SC) | Yellow | For use in palliative care medicine. |
Initiation / recommendation via specialist palliative care team only. |
| OPIATE/MORPHINE TINCTURE (Dropizol® oral drops) | Do not prescribe | Severe diarrhoea |
Reviewed by TAS 22nd June 2021 |
| OPICAPONE capsules (Ongentys®) | Yellow | Parkinson's disease | |
| OPTIVE PLUS | Do not prescribe | Dry eye | |
| ORITAVANCIN (Tenkasi®) | Red | Acute bacterial skin and skin structure infections (ABSSSI) in adults |
Reviewed by TAS September 22 |
| ORLISTAT | Green | ||
| OSILODROSTAT PHOSPHATE (Isturisa®) | Do not prescribe | Treatment of endogenous Cushing’s syndrome | |
| OSPEMIFENE (Senshio®) | Grey | Vulvar and vaginal atrophy in post-menopausal women |
Not yet reviewed |
| OSVAREN® (previously known as REPHOREN®) | Yellow | Hyperphosphataemia | |
| OXANDROLONE | Red | Prophylaxis of acute attacks in hereditary angioedema. Third line after danazol and stanozolol when stanozolol is unavailable | |
| OXYBUPROCAINE HYDROCORTISONE | Red | Local anaesthetic | |
| 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 |
| OXYCODONE / NALOXONE | Yellow | Severe pain in patients with opioid-induced bowel dysfunction | |
| OXYCODONE HYDROCHLORIDE / NALOXONE (combination product) prolonged release tablet | Do not prescribe | Post colorectal surgery |
Reviewed by TAS – No evidence to support use for this indication. |
| OXYCODONE/NALOXONE COMBINATION PRODUCTS | Do not prescribe | Pain not associated with opioid-induced bowel dysfunction |
As agreed at FWP September 22 |
| OZANIMOD (Zeposia®) | Grey | Adults with active disease as part of relapsing-remitting Multiple Sclerosis. |
Not yet reviewed |
| OZANIMOD (Zeposia®) (NEW) | Red | For treating moderately to severely active ulcerative colitis |
In line with NICE TA828 Implementation date 5th January 2023 |
| PALFORZIA | Red | Treating peanut allergy in children and young people. |
In line with NICE TA769 Implementation date 2nd May 2022 |
| PALIPERIDONE PALMITATE Long-Acting Injection | Yellow | Maintenance in schizophrenia in patients previously responsive to risperidone. |
See the LLR Antipsychotic Prescribing Guide |
| PALIVIZUMAB | Red | ||
| PALONOSETRON | Do not prescribe | Nausea and vomiting with chemotherapy | |
| PARACETAMOL/TRAMADOL COMBINATION PRODUCTS | Do not prescribe | Pain |
As agreed at FWP September 22 |
| PARATHYROID HORMONE (Natpar®) | Red | Post-trial continuation of treatment of chronic hypoparathyroidism when standard therapy alone is inadequate. | |
| PARAVIT CF® | Yellow | Vitamin Supplement for paediatric and adult patients with cystic fibrosis | |
| PARECOXIB (NEW) | Red | Single intra-operative dose for the management of acute postoperative pain. |
Only to be given to patients for whom PR diclofenac is not appropriate. |
| PARECOXIB(Dynastat ®) | Yellow | Inflammatory pain associated with cancer or other palliative conditions | |
| PARICALCITOL | Do not prescribe | Secondary hyperparathyroidism in renal failure | |
| PASIREOTIDE subcutaneous injection (Signifor®) | Grey | Cushing’s disease |
Not yet reviewed |
| Patiromer (Veltassa) | Red | Hyperkalaemia | |
| PATIROMER (Veltassa®) | Red | Hyperkalaemia |
In line with NICE TA623 |
| PATISIRAN (Onpattro®) | Grey | Hereditary transthyretin-mediated amyloidosis in adult patients with stage 1 or stage 2 polyneuropathy |
Not yet reviewed |
| PAZOPANIB | Red | ||
| PEGCETACOPLAN | Do not prescribe | Paroxysmal nocturnal haemoglobinuria (PMH) |
Recommended by NICE TA788 but all prescribing is via the national PMH centre |
| PEGFILGRASTIM (NEW) | Red | Treatment of neutropenia in children and TYA patients | |
| PEGINTERFERON BETA-1a (Plegridy®) | Red | Relapsing-remitting multiple sclerosis |
In line with NICE TA624 |
| PEGLOTICASE | Do not prescribe | Gout |
Not supported by NICE |
| PENICILLAMINE | Orange | Rheumatoid arthritis | |
| PENICILLAMINE | Red | Wilson's disease | |
| PENTHROX®(Methoxyflurane) (UPDATED) | Red | Analgesia |
For use in Emergency department or for removal of brachytherapy only |
| PENTOSAN POLYSULFATE SODIUM (Elmiron®) | Red | Bladder pain syndrome characterised by either glomerulations or Hunner’s lesions |
In line with NICE TA610 |
| PENTOXIFYLLINE (Trental®) | Red | When given with alpha tocopherol (vitamin E) for the treatment of persistently thin endometrium during IVF therapy | |
| PERAMPANEL (Fycompa®) | Yellow | Refractory epilepsy | |
| PERGOLIDE | Do not prescribe | Parkinson's disease |
No longer recommended |
| PERINDOPRIL ARGINE | Do not prescribe | Hypertension | |
| PHENAZONE WITH LIDOCAINE EAR DROP (Otigo®) (NEW) | Green | Otitis Media (if an immediate antibiotic is not given, and there is no eardrum perforation or otorrhoea) |
To be used in line with Primary Care Antimicrobial Policy & Guidance. |
| Phenytoin | Yellow | Epilepsy | |
| PIMECROLIMUS cream | Green | Dermatitis | |
| PIRFENIDONE (Esbriet®) | Red | For Idiopathic pulmonary fibrosis |
In line with NICE TA 504 (Replaces NICE TA 282) |
| PITOLISANT | Do not prescribe | Excessive daytime sleepiness caused by obstructive sleep apnoea |
Not recommended by NICE TA776 |
| PITOLISANT (Wakix®) | Yellow | Narcolepsy | |
| PITRESSIN | Red | Myomectomy | |
| PIVMECILLINAM | Green | Extended Spectrum Beta Lactamase (ESBL) Urinary Tract Infection (UTI) |
UTI in line with Primary care Multi-resistant lower UTI Guidance |
| PLASMA-LYTE 148 | Red | fluid replacement | |
| PLASMA-LYTE 148 & 5% GLUCOSE solution for infusion | Red | Source of water, electrolyte and calories or as a alkalinising agent | |
| PLENVU | Red | Bowel cleansing | |
| POLIHEXANIDE 0.02% eye drops | Red | ||
| Pollinex Quattro® (UPDATED) | Red | Treatment of rhinitis and conjunctivitis in adults, adolescents and children over the age of six caused by an IgE mediated allergy against grass/rye, tree or weed pollen. | |
| POMALIDOMIDE | Red | ||
| PONATINIB | Red | ||
| PONESIMOD (Ponvory®) | Red | Relapsing forms of multiple sclerosis with active disease. |
In line with NICE TA767 Implementation date 2nd May 2022 |
| POSACONAZOLE | Red | Severe fungal infections | |
| POTASSIUM PERMANGANATE | Red | Dermatology |
External use only |
| PRAMIPEXOLE (UPDATED) | Yellow | Parkinson’s disease, Restless leg syndrome and other limb movement disorders. |
Click on drug name for further details
|
| PRASTERONE PESSARY (Intrarosa®) | Yellow | Vulvar and vaginal atrophy in postmenopausal women having moderate to severe symptoms | |
| PRASUGREL | Yellow | ACS where immediate primary percutaneous coronary intervention for ST segment-elevation MI is necessary or stent thrombosis has occurred during clopidogrel treatment. |
Excludes pts over 75yrs and /or weight less than 60kg Duration summary for primary care |
| PREGABALIN | Green | Neuropathic pain |
To be used in conjunction with Neuropathic Pain Guidelines |
| PREGABALIN | Yellow | Refractory epilepsy | |
| PREGABALIN | Yellow | Generalised anxiety disorder | |
| PRIDINOL (Myopridin®) | Grey | Central and peripheral muscle spasms, lumbar pain, torticollis and general muscle pain |
Not yet reviewed |
| PRILOCAINE | Red | Spinal Anaesthesia | |
| Primidone | Yellow | Epilepsy | |
| PRO-SIL® | Yellow | Hypertrophic Scars |
Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform® |
| PROBENECID | Red | Prevention of nephrotoxicity associated with cidofovir treatment | |
| PROCARBAZINE | Red | ||
| PROFLAVINE CREAM (NEW) | Red | To lubricate packing used for securing applicators in gynaecological brachytherapy | |
| PROGESTERONE (Gepretix®) (UPDATED) | Green | For adjunctive use with an oestrogen in post-menopausal women with an intact uterus, as hormone replacement therapy (HRT). | |
| PROGESTERONE PESSARIES (Cyclogest®) | Yellow | Maintenance of pregnancy following IVF or when there is a risk of pre-term delivery | |
| PROGESTERONE SC INJECTION (Lubion®) | Yellow | Patients not absorbing sufficient progesterone from cyclogest or unable to tolerate cyclogest following IVF |
Yellow once pregnancy confirmed. Initial treatment before the pregnancy occurs to be provided by secondary care. |
| PROLONGED RELEASE PREGABALIN (Misabri®) (NEW) | Do not prescribe |
Not to be used across LLR. |
|
| PROPANTHELINE (NEW) | Green | Hyperhidrosis |
Non-formulary for all other indications. |
| PROVOCHOLINE (NEW) | Red | Asthma diagnosis in paediatrics | |
| PROXYMETACAINE HYDROCHLORIDE | Red | Local anaesthetic | |
| PRUCALOPRIDE | Green | Chronic refractory constipation | |
| PYRAZINAMIDE | Red | Tuberculosis treatment |
Red for treatment of TB |
| PYRIDOSTIGMINE | Yellow | Myasthenia gravis |
Includes sustained release formulation (Mestinon Timespan). |
| QLAIRA® | Do not prescribe | Contraception |
Not approved by local committee |
| QUETIAPINE | Yellow | Schizophrenia. Mania (either alone or in combination with mood stabilisers). Depression in bipolar disorder. Adjunctive treatment in major depressive disorder. Personality disorder. | |
| QUETIAPINE | Green | Palliative care in line with guidance. |
Conditional on recommendation from palliative care team. |
| QUINAGOLIDE | Yellow | Hyperprolactinaemia | |
| Quinidine | Red | KCNT1 gene mutation related Early Infantile epileptic encephalopathy | |
| QUINIDINE | Red | KCNT1 gene mutation related Early Infantile Epileptic Encephalopathy |
Reviewed by TAS September 2021 |
| QUINIDINE | Red | Brugada syndrome |
Reviewed by TAS November 2022 |
| QUOFENIX | Red | Antibiotic | |
| RABBIT ANTI-HUMAN THYMOCYTE IMMUNOGLOBULIN (Thymoglobuline®) | Red | Immunosuppressive therapy for Kidney Transplant in Adults and Children/Young People |
In line with NICE TA 481, NICE TA 482 |
| RACECADOTRIL (Hidrasec®) | Do not prescribe | Diarrhoea | |
| RALOXIFENE | Yellow | Off label chemoprevention to reduce incidence of breast cancer. |
Use in line with NICE CG 164 |
| RALOXIFENE | Do not prescribe | Primary prevention of osteoporotic fragility in menopausal women |
Not recommended in NICE TA 160 |
| RALOXIFENE | Yellow | Secondary prevention of osteoporotic fragility in menopausal women |
In line with NICE TA 161 |
| RALTEGRAVIR | Red | Multi-resistant HIV, Needlestick injury | |
| RANIBIZUMAB (Ongavia®) (UPDATED) | Red | Age-related macular degeneration, diabetic macular oedema, retinal vein occlusion, Retinopathy of prematurity | |
| RANOLAZINE | Green | Chronic stable angina |
In line with NICE CG 126 |
| RASAGILINE | Yellow | Parkinson's disease |
Click on drug name for further details
|
| RAVULIZUMAB | 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®) | 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. |
| REGORAFENIB | Red | ||
| Rekambys (Rilpivirine) | Red | Stable HIV infection | |
| Relugolix (NEW) | Red | For treating hormone sensitive prostate cancer | |
| REMDESIVIR (Veklury®) | Red | Treatment of coronavirus disease 2019 | |
| Remdesivir and Tixagevimab Plus Cilgavimab | Red | for treating COVID-19 | |
| REMIMAZOLAM (Byfavo®) | Grey | Procedural sedation in adults. |
Not yet reviewed |
| REPAGLINIDE | Green | ||
| RESLIZUMAB | Red | Severe Eosinophilic Asthma |
In line with NICE TA 479 |
| RESPERATE device | Do not prescribe | Hypertension |
Reviewed by Dr A. Stanley, Hypertension Clinic |
| RETAPAMULIN | Do not prescribe | Bacterial skin infections | |
| RETIGABINE | Do not prescribe | Treatment resistant epilepsy | |
| RIBAVIRIN | Red | ||
| RIBOFLAVIN eye drops | Red | Peri-operative use during collagen cross linkage | |
| Rifampicin | Red | Tuberculosis treatment |
Red for treatment of TB |
| Rifampicin (UPDATED) | Yellow | Hidradenitis Suppurativa |
Used in Hidradenitis Suppurativa in patients who are unresponsive (or have contraindications) to oral tetracyclines. See micro guide for full details. Initiated under specialist dermatology supervision. |
| RIFAMPICIN /ISONIAZID AND PYRAZINAMIDE | Red | Tuberculosis treatment |
Red for treatment of TB |
| RIFAMPICIN/ISONIAZID/PYRAZINAMIDE/ETHAMBUTOL (Voractiv) (UPDATED) | Red | Tuberculosis Treatment |
Treatment of TB |
| Rifapentine | Red | Treatment of latent tuberculosis, especially in patients with social exclusion and at high risk of noncompletion, or those with preexisting liver disease | |
| RIFAPENTINE (Priftin®) | Red | Latent TB | |
| Rifaximin | Red | small intestinal bacterial overgrowth | |
| RIFAXIMIN | Do not prescribe | Traveller's diarrhoea | |
| Rifaximin | Yellow | Hepatic encephalopathy |
Specialist hepatologist initiation only for hepatic encephalopathy. |
| RIFAXIMIN(Targaxan®) (UPDATED) | Red | Small intestinal overgrowth |
Small intestinal overgrowth |
| Rilecitinib (NEW) | Red |
50 mg once daily, consider discontinuation of treatment if no response after 36 weeks. A patient card should be provided. NICE TA 958 The manufacturer of Litfulo® has provided a Prescriber Guide, which includes a prescriber checklist. |
|
| RILPIVIRINE | Red | ||
| RILUZOLE | Orange | Amylotrophic lateral sclerosis form of motor neurone disease | |
| RIMEGEPANT (Vydura®) (UPDATED) | Yellow | For preventing migraine |
In line with NICE TA906 |
| RIMEGEPANT (Vydura®) (UPDATED) | Green | For treating acute migraine |
As per NICE TA919 Subject to a confirmed diagnosis of migraine by specialist or if patient cannot tolerate triptans. |
| RIMEXOLONE | Red | ||
| RIOCIGUAT | Do not prescribe | Pulmonary hypertension | |
| RISANKIZUMAB (Skyrizi®) | Red | Moderate to severe plaque psoriasis |
In line with NICE TA596 |
| RISANKIZUMAB (Skyrizi®) | Red | Active psoriatic arthritis after inadequate response to DMARDs |
In line with NICE TA803 |
| RISANKIZUMAB (Skyrizi®) (NEW) | Red | For previously treated moderately to severely active Crohn's disease |
In line with NICE TA888 |
| RISDIPLAM | Do not prescribe | Spinal Muscular Atrophy |
Approved centres only. LLR is currently not an approved centre. |
| RISEDRONATE SODIUM | Green | Osteoporosis |
In line with NICE TA 464 |
| RISPERIDONE LONG-ACTING INJECTION (Risperdal Consta®) | Yellow | Schizophrenia and other psychoses in patients tolerant to oral risperidone. |
See the LLR Antipsychotic Prescribing Guide |
| RISPERIDONE Oral | Yellow | Acute and chronic psychoses. Mania. Short term (up to 6 weeks) of persistent aggression in patients with moderate to severe AD. Short term (up to 6 weeks) treatment of persistent aggression in conduct disorder. Personality disorder. |
See the LLR Antipsychotic Prescribing Guide |
| RITONAVIR | Red | ||
| RITUXIMAB | Red | Lymphoma, Rheumatoid arthritis | |
| RITUXIMAB | Red | Immunobullous diseases |
In line with NHS England policy |
| RITUXIMAB | Red | Prevention and management of delayed haemolytic transfusion reactions and hyperhaemolysis in patients with haemoglobinopathies | |
| RITUXIMAB | Do not prescribe | IgM paraproteinaemic demyelinating peripheral neuropathy in adults |
Approved centres only. LLR is currently not an approved centre. |
| RITUXIMAB | Red | Idiopathic membranous nephropathy | |
| RITUXIMAB (NEW) | Red | Management of Thrombotic Thrombocytopenic Purpura (TTP) | |
| RIVAROXABAN | Yellow | Cardioversion | |
| RIVAROXABAN | Yellow | ACS |
In line with NICE TA335 |
| RIVAROXABAN | Green | Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation | |
| RIVAROXABAN | Yellow | Treatment and secondary prevention of DVT and PE |
In line with NICE TA 261 or NICE TA 287 |
| RIVAROXABAN (Xarelto®) | Yellow | Preventing atherothrombotic events in people with coronary or peripheral artery disease |
In line with NICE TA607 |
| RIVAROXABAN (Xarelto®) | Yellow | Treatment of VTE in paediatric patients | |
| RIVAROXABAN(Xarelto®) | Do not prescribe | Prevention of VTE in adults undergoing hip or knee replacement | |
| RIVASTIGMINE | Yellow | Alzheimer's disease |
in line with NICE NG 97
|
| ROFLUMILAST | Yellow | COPD |
In line with NICE TA 461 |
| ROMIPLOSTIM (Nplate®) | Red | Chronic immune (idiopathic) thrombocytopenic purpura (ITP) |
Use in line with NICE TA 221 |
| ROMOSOZUMAB (Evenity®) | Red | Severe osteoporosis |
In line with NICE TA791
|
| ROPINIROLE | Yellow | Parkinson's Disease, Restless Legs Syndrome and other limb movement disorders |
Click on drug name for further details |
| ROPIVACAINE 2 mg/ml solution for infusion dispensed via ReadyfusOR® infusion pump | Do not prescribe | For acute post operative pain in adults | |
| ROSIGLITAZONE (Avandia®, Avandamet®) | Do not prescribe | Withdrawn | |
| ROSUVASTATIN | Green | Hypercholesterolaemia | |
| ROTIGOTINE (UPDATED) | Yellow | Parkinson’s disease, Restless leg syndrome and other limb movement disorders. |
|
| ROXADUSTAT (Evrenzo ®) | Red | Symptomatic anaemia associated with chronic kidney disease (CKD) in adults |
In line with NICE TA807 |
| RUFINAMIDE | Yellow | Lennox-Gastaut syndrome in patients aged over 4 years | |
| RUPATADINE | Red | Urticaria in paediatrics | |
| RURIOCTOCOG ALFA PEGOL (Adynovi®) | Grey | Treatment and prophylaxis of bleeding in patients with haemophila A |
Not yet reviewed |
| RUXOLITINIB | Red | ||
| SACUBITRIL and VALSARTAN (Entresto®) | Yellow | Heart failure |
|
| SACUBITRIL AND VALSARTAN (Entresto®) (NEW) | Red | Paediatric heart failure | |
| SAFINAMIDE (Xadago®) | Yellow | Parkinson’s Disease | |
| SALMETEROL / FLUTICASONE INHALATION POWDER (Seffalair Spiromax ®) | Grey | Asthma | |
| Salmeterol and Fluticasone inhalation powder (Fixkoh Airmaster®) | Grey | Asthma and COPD |
Not yet reviewed |
| SAPROPTERIN | Red | Hyperphenylalaninaemia in phenylketonuria |
In line with NICE TA729 |
| SAQUINAVIR | Do not prescribe | ||
| SARILUMAB | Red | Moderate to Severe Rheumatoid Arthritis |
In line with NICE TA 485 |
| SAXAGLIPTIN (Onglyza®) | Green | Type 2 Diabetes. |
Non-formulary choice. |
| SAXAGLIPTIN / METFORMIN (Komboglyze®) | Do not prescribe | Type 2 Diabetes | |
| SECUKINUMAB | Red | Ankylosing spondylitis. |
Use in line with NICE TA407 |
| SECUKINUMAB | Red | Psoriatic arthritis |
In line with NICE TA445 |
| SECUKINUMAB | Red | Psoriasis |
In line with NICE TA350 |
| SECUKINUMAB (Cosentyx®) | Red | Non-radiographic axial spondyloarthritis |
In line with NICE TA719
|
| SECUKINUMAB (Cosentyx®) | Red | Treating moderate to severe plaque psoriasis in children and young people |
In line with NICE TA734
|
| SECUKINUMAB (Cosentyx®) (NEW) | Red | For treating moderate to severe hidradenitis suppurativa. |
As per NICE TA935 |
| SELEGILINE | Yellow | Parkinson's disease |
Click on drug name for further details |
| SELEXIPAG (Uptravi®) | Grey | Pulmonary arterial hypertension |
Not yet reviewed |
| SEMAGLUTIDE (Ozempic®) injection | Green | GLP 1 analogue |
Conditional on prescriber being competent to select appropriate patients. |
| SEMAGLUTIDE (Rybelsus®) | Green | Type 2 diabetes | |
| SEMAGLUTIDE (Wegovy®) (UPDATED) | Red | Management of obesity in adolescents |
Only through a specialist weight management service. |
| SEMAGLUTIDE(Ozempic®) injection | Yellow | GLP 1 analogue |
Yellow if prescriber not competent to select appropriate patients |
| SERTRALINE | Yellow | Mental health indications as per the children’s BNF for children and young people | |
| SETMELANOTIDE (Imcivree®) | Grey | For the treatment of obesity & control of hunger associated with genetically confirmed loss-of-function biallelic pro-opiomelanocortin, including PCSK1, deficiency or biallelic leptin receptor deficiency | |
| SEVELAMER | Yellow | Hyperphosphataemia | |
| SIALANAR | Yellow | Drooling in chronic neurological disorders | |
| SILDENAFIL | Red | Pulmonary arterial hypertension | |
| SILDENAFIL ORAL SUSPENSION (Revatio®) | Do not prescribe |
Pulmonary artery hypertension |
|
| SILICONE GEL / GEL SHEETS | Yellow | Hypertrophic Scars |
Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform® |
| SILK GARMENTS | Do not prescribe | Skin | |
| SIMEPREVIR | Red | Hepatitis C | |
| SIMPLE EYE OINTMENT | Do not prescribe | Dry eye | |
| SIPONIMOD FUMARIC ACID (Mayzent®) | Red | Secondary progressive multiple sclerosis in adults |
In line with NICE TA656 |
| SIROLIMUS | Red | Immunosuppression post renal transplant | |
| SIROLIMUS Topical | Red | Angiofibromas associated with tuberous sclerosis complex | |
| SITAGLIPTIN | Green | Type 2 diabetes |
In line with NICE CG 87 |
| SITAGLIPTIN / METFORMIN (Janumet®) | Do not prescribe | Type 2 diabetes | |
| SODIUM BICARBONATE (Nephrotrans®) (NEW) | Yellow | Metabolic acidosis in patients with chronic renal impairment |
Only for patients who generic sodium bicarbonate is not tolerated under specialist advice. Prescribe as brand. |
| SODIUM CHLORIDE 5% preservative free eye drops or 5% ointment | Yellow | Ocular lubricants | |
| SODIUM CITRATE 10.11% eye drops | Red | ||
| SODIUM CROMOGLICATE CAPSULES (Nalcrom®) | Yellow | Mast cell stabalisation including Haematology and food allergy indications | |
| SODIUM HYALURONATE, CO-ENZYME Q10 AND VITAMIN E COMBINATION EYE DROP (VisuXl ®) | Green | Severe dry eye and corneal healing post-surgery | |
| SODIUM OXYBATE | Yellow | Treatment of cataplexy associated with narcolepsy | |
| Sodium Valproate | Yellow | Epilepsy | |
| SODIUM VALPROATE SR (Episenta®) | Do not prescribe | Epilepsy |
Not approved by local committee |
| SODIUM ZIRCONIUM CYCLOSILICATE (Lokelma®) (UPDATED) | Yellow | Chronic hyperkalaemia in CKD |
In line with NICE TA599. Use in line with the CKD pathway |
| SODIUM ZIRCONIUM CYCLOSILICATE (Lokelma®) (UPDATED) | Red | Acute life-threatening hyperkalaemia and Chronic hyperkalaemia in Heart Failure |
Treatment of acute life-threatening hyperkalaemia, see local ED pathway. Chronic hyperkalaemia within heart failure. Use in line with NICE TA 599 |
| SOFOSBUVIR | Red | Hepatitis C | |
| SOFOSBUVIR/VELPATASVIR (Epclusa®) | Red | Hepatitis C |
In line with NICE TA 430 |
| SOFOSBUVIR–VELPATASVIR-VOXILAPREVIR (Vosevi®) | Red | For Chronic hepatitis C |
In line with NICE TA 504 |
| SOLIFENACIN | Green | Urinary incontinence | |
| SOLIFENACIN / TAMSULOSIN (Vesomni®) | Green | Benign prostatic hyperplasia | |
| SOLRIAMFETOL (Sunosi ®) (UPDATED) | Yellow | For treating excessive daytime sleepiness caused by narcolepsy |
In line with NICE TA758 |
| SOLRIAMFETOL (Sunosi ®) | Do not prescribe | Sleepiness in patients treated with CPAP for obstructive sleep apnoea |
Not recommended by NICE for this indication |
| SOMATROGON (Ngenla®) (UPDATED) | Red | Treatment of children and adolescents from 3 years of age with growth disturbance due to insufficient secretion of growth hormone. |
In line with NICE TA863 |
| SOMATROPIN (Growth Hormone) | Red | Growth disorders |
New patients supplied through healthcare at home |
| SORAFENIB | Red | ||
| SOYBEAN OIL EYE DROPS (Emustil®) | Grey | Ocular lubricant |
Not yet reviewed |
| SPIRONOLACTONE | Orange | Heart failure and hypertension in infants and children | |
| STAVUDINE | Do not prescribe | ||
| STRIBILD | Red | HIV | |
| STRONTIUM RANELATE | 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 | Red | Radiation proctitis | |
| SUCROFERRIC OXYHYDROXIDE (Velphoro®) | Red | Treatment/prevention of hyperphosphataemia of chronic kidney disease | |
| SUFENTANIL (Zalviso®) sublingual tablets | Grey | Acute post-operative pain |
Not yet reviewed |
| SUGAMMADEX (Bridion®) | Red | Reversal of neuromuscular blockage induced by rocuronium or vecuronium | |
| SULFASALAZINE | Orange | Rheumatological disease | |
| SULFASALAZINE | Red | Inflammatory Bowel Disease in Paediatrics | |
| SULFASALAZINE ORAL & RECTAL | Orange | Ulcerative colitis and Crohn's disease |
Shared care request is mandatory |
| SULPIRIDE | Yellow | Schizophrenia | |
| SUNITINIB | Red | ||
| SURGIFLO | Red | Surgical sites as an adjunct to hemostasis when control of bleeding by ligature or conventional methods is ineffective is impractical | |
| SYMTUZA® | Red | Combination HIV treatment |
As part of NHS England Clinical Commissioning policy |
| SYNVISC® | Do not prescribe | Black in ALL indications except for Pain relief in osteoarthritis of shoulder joint (RED) | |
| SYNVISC® | Red | Pain relief in oesteoarthritis of shoulder joint. | |
| SYSTANE® ULTRA preservative free eye drops (UPDATED) | Yellow | Ocular lubricant |
Evaporative Dry Eye & Meibomian Gland Dysfunction only *Thealipid preservative free eye drops are first choice across LLR |
| TACALCITOL (Curatoderm®) (NEW) | Green | Facial and Flexural psoriasis |
To prescribe most cost effective pack size for repeated use. |
| TACROLIMUS (Advagraf®) | Red | Continuation of hepatic transplant immunosuppression for patients transferred from out of area tertiary centre only | |
| TACROLIMUS capsules (Adoport®, Prograf® or Modigraf®) | Orange | Immunosuppression post renal transplant - prescribe by brand name only as different brands are not interchangeable |
Exception agreed to red status: Full shared care to allow GPs to continue supplying to historical patients still on shared care where appropriate for patient and the GP agrees. |
| TACROLIMUS capsules (Adoport®, Prograf® or Modigraf®) | Red | Immunosuppression post renal transplant - prescribe by brand name only as different brands are not interchangeable | |
| TACROLIMUS capsules (Advagraf®) | Do not prescribe | Immunosuppression |
Modified-release |
| TACROLIMUS Ointment | Green | Dermatitis |
Protopic 0.03% and 0.1% ointment |
| TACROLIMUS SR (Envarsus®) | Red | Prophylaxis of transplant rejection in adult kidney transplants | |
| TADALAFIL | Do not prescribe | Benign prostatic hyperplasia | |
| TADALAFIL (NEW) | Red | For severe digital ulceration / systemic sclerosis-related Raynaud's phenomenon (SSc-RP) |
Restricted to initiation by consultant Rheumatologists |
| TADALAFIL (10mg and 20mg) | Green | Erectile dysfunction |
For patients who have not responded to sildenafil or to vardenafil. 10mg and 20mg for PRN dosing. NHS limitations on groups and frequency of prescribing apply. FP10 prescriptions should be endorsed with “SLS“. |
| TADALAFIL (Adcirca®) | Do not prescribe | Pulmonary arterial hypertension | |
| TADALAFIL 5mg | Green | Erectile dysfunction |
Approved for daily administration for individuals requiring more than 4 doses per month. Do not prescribe 2.5mg OD dosing. NHS limitations on groups and frequency of prescribing apply. Fp10 prescriptions must be endorsed with “SLS”. |
| TAFAMIDIS | Red | Transthyretin amyloidosis with cardiomyopathy as part of EAMS | |
| TAFLUPROST/TIMOLOL preservative free eye drops (Taptiqom®) | Grey | Glaucoma |
Not yet reviewed |
| TAMOXIFEN | Yellow | Treatment and prevention of breast cancer | |
| TAMSULOSIN capsules | Green | Benign prostatic hypertrophy | |
| TAMSULOSIN tablets | Do not prescribe | Benign prostatic hypertrophy | |
| TAPENTADOL immediate release | Do not prescribe | Acute pain | |
| TAPENTADOL sustained release | Yellow | Moderate to severe chronic pain (pain clinic recommendation only) | |
| TARGETED-RELEASE BUDESONIDE (NEW) | Red | for treating primary IgA nephropathy |
In line with NICE TA937 |
| TECOVIRIMAT | Red | Patients hospitalized with Monkey Pox |
Only available in specified hubs |
| TEDIZOLID PHOSPHATE tablets and infusion (Sivextro®) | Grey | Skin infection |
Not yet reviewed |
| TEDUGLUTIDE (Resvestive®) | Red | Short bowel syndrome |
In line with NICE TA804 |
| TEGAFUR / GIMERACIL / OTERACIL | Red | ||
| TEGAFUR / URACIL | Red | ||
| TEICOPLANIN | Green | Cellulitis (in primary care) |
To be used in conjunction with the Cellulitis-Teicoplanin Pathway |
| TEICOPLANIN | Red | All indications except cellulitis in primary care | |
| TEMOZOLOMIDE | Red | ||
| Tenecteplase (NEW) | Red | For treating acute ischaemic stroke | |
| TENOFOVIR | Red | ||
| TENOFOVIR / EMTRICITABINE (Truvada®) | Red | ||
| TENOFOVIR ALAFENAMIDE (Vemlidy®) | Grey | Hepatitis B |
New formulation |
| TERIFLUNOMIDE | Red | Multiple sclerosis |
In line with NICE TA 303 |
| TERIPARATIDE | Red | Osteoporosis in men and women | |
| TESTOSTERONE | Orange | Adult male hypogonadism |
|
| TESTOSTERONE | Orange | Gender reassignment |
To be used and monitored in line with guidance/written information from specialist centre consultant/team (nearest clinic is in Nottinghamshire*) |
| TESTOSTERONE | Orange | Replacement therapy in children and adolescents | |
| TESTOSTERONE buccal | Do not prescribe | Male hypogonadism | |
| TESTOSTERONE GEL (Tostran ®) | Yellow | Testosterone deficiency in menopausal women (unlicensed) |
Tostran brand only. As per NICE NG 23 |
| TESTOSTERONE Patches (Intrinsa®) | Do not prescribe | Hypoactive sexual desire disorder in women |
Not approved by local committee |
| TEZACAFTOR AND IVACAFTOR (Symkevi ®) | Red | Cystic Fibrosis | |
| TEZEPELUMAB (Tezspire®) (NEW) | Red | Severe Asthma |
In line with NICE TA880. |
| THALIDOMIDE | Red | Angiodysplasias |
Historical entry to match formulary |
| THALIDOMIDE | Do not prescribe | Multiple myeloma | |
| TheaLipid eye drops (NEW) | Yellow | Evaporative Dry Eye & Meibomian Gland Dysfunction |
First line for evaporative dry eye & meibomian gland dysfunction only |
| TICAGRELOR | Yellow | Troponin positive Acute Coronary Syndromes in NSTEMI patients |
Duration summary for primary care |
| TIGECYCLINE | Red | Skin and soft tissue infections | |
| TILDRAKIZUMAB (Ilumetri®) | Red | Moderate to severe plaque psoriasis |
In line with NICE TA575
|
| TIMOLOL eye drops (UPDATED) | Green | Glaucoma |
Prescribe generically. |
| TIMOLOL LA Gel-Forming Eye Drops | Red | Small infantile haemangiomas |
In line with GOSH guidance |
| TIOGUANINE | Red | ||
| Tiopronin (NEW) | Red | Cystinuria | |
| TIOTROPIUM (Braltus Zonda®) | Green | COPD |
Use in line with Leicestershire LAMA Prescribing Guide
|
| TIOTROPIUM (Spiriva HandiHaler® or Spiriva Respimat®) | Green | COPD | |
| TIOTROPIUM (Spiriva Respimat®) | Yellow | Asthma | |
| TIOTROPIUM/OLODATEROL (Spiolto Respimat®) | Green | COPD |
NEW LABA/LAMA combination product – to be used in line with updated COPD Guidelines |
| TIPRANAVIR | Do not prescribe | HIV infection |
Discontinued |
| TIRBANIBULIN (Klisyri®) (NEW) | Green | Grade 1 Actinic Keratoses for the face and scalp |
Single treatment course only – not to be repeated. |
| TIRZEPATIDE (Mounjaro®) (UPDATED) | Yellow | For treating type 2 diabetes |
As per NICE TA924 |
| TIZANIDINE | Yellow | Generalised spasticity for patients who have been stabilised on a dose |
To revert to secondary care only, when there are any dose changes and doses of 12mg a day or more require secondary care prescribing for 4 months whilst monthly LFTs are undertaken by secondary care. |
| TOBRAMYCIN (Vantobra®) | Do not prescribe | Chronic pulmonary infection due to Pseudomonas aeruginosa |
New formulation |
| TOBRAMYCIN inhalation | Red | Cystic fibrosis | |
| TOBRAMYCIN injection | Red | ||
| TOCILIZUMAB | Red | Rheumatoid arthritis |
In line with NICE TA247 Both the intraveneous and subcutaneous preparations are RED |
| TOCILIZUMAB | Red | Juvenile idiopathic arthritis |
In line with NICE TA 373 |
| TOCILIZUMAB | Red | Treating giant cell arteritis. |
In Line with NICE TA 518
|
| TOCILIZUMAB | Red | Adult onset stills disease |
Requested for UHL as part of NHS England commissioning policy. |
| TOCILIZUMAB | Grey | Treatment of chimeric antigen receptor induced cytokine release syndrome |
Not yet reviewed. |
| TOFACITINIB | Red | Moderate to Severe Rheumatoid Arthritis |
In line with NICE TA 480 |
| TOFACITINIB | Red | Active psoriatic arthritis after inadequate response to DMARDS |
In line with NICE TA543
|
| TOFACITINIB | Red | Moderately to severely active ulcerative colitis |
In line with NICE TA 547
|
| TOFACITINIB | Red | Juvenile idiopathic arthritis |
In line with NICE TA735 Implementation date 20th January 2022 |
| TOFACITINIB (Xeljanz®) (NEW) | Red | For treating active ankylosing spondylitis. |
As per NICE TA920 |
| TOLCAPONE | Do not prescribe | Parkinson's disease |
For exceptions please see red traffic light |
| TOLCAPONE | Red | Parkinson's disease |
For patient’s requiring continuation of treatment after review only |
| TOLVAPTAN (Jinarc®) | Red | Autosomal dominant polycystic kidney disease |
In line with NICE TA 358 |
| TOLVAPTAN (Samsca®) | Red | Hyponatraemia secondary to SIADH in patients requiring cancer chemotherapy | |
| TOPIRAMATE | Green | Migraine | |
| TOPIRAMATE | Yellow | Epilepsy | |
| TOPIRAMATE | Yellow | Idiopathic Intracranial hypertension | |
| TOPOTECAN | Red | ||
| TRALOKINUMAB (Adtralza ®) | Red | Moderate to severe atopic dermatitis |
In line with NICE TA814 |
| TRAMADOL | Green | Severe pain |
Including SR tablets |
| TRAMADOL HYDROCHLORIDE / DEXKETOPROFEN (Skudexa®) | Do not prescribe | Pain | |
| TRANEXAMIC ACID (injection) | Yellow | To prevent bleeding or treat bleeding in palliative care medicine |
To be used on the advice of specialist palliative care team only. |
| TRANEXAMIC ACID (oral) | Green | To prevent bleeding or treat bleeding associated with excessive fibrinolysis | |
| TRANSDERMAL ESTRADIOL SPRAY (Lenzetto®) | Green | Symptoms of menopause | |
| TransiSoft® | Do not prescribe | Chronic constipation, use usually limited to 2 weeks |
Not to be confused with other macrogol products such as Macrogol oral powder compound e.g. Laxido or Movicol |
| TREOSULFAN | Red | ||
| TRI-IODOTHYROACETIC ACID (TRIAC) (Emcitate®) | Do not prescribe | Allan-Herndon Dudley syndrome associated with MCT-8 deficiency |
Reviewed by TAS 22nd June 2021 |
| TRICHLOROACETIC ACID | Red | Resolution of cyst in enucleated socket | |
| TRICLABENDAZOLE | Red | Hepatic fascioliasis |
Approved by the Antimicrobial Working Party |
| TRIENTINE | Red | Wilson's disease | |
| TRIFAROTENE (Aklief®) | Grey | Cutaneous treatment of Acne Vulgaris | |
| TRIFLURIDINE 1% eye drops | Red | ||
| Trihexyphenidyl | Green | Parkinson, Drug-induced extrapyramidal symptoms, Dystonia | |
| TRIHEXYPHENIDYL HCL 2mg tablet or 5mg/5ml liquid | Yellow | Hypersalivation and sialorrhoea management in children |
Initiated and stabilised in secondary care before transfer to primary care. THIRD line LPT recommendation. |
| TRIPLE BROMIDES | Do not prescribe | Intractable epileptic seizures |
Not approved by local committee |
| TRIPTORELIN | Yellow | Endometriosis, uterine fibroids | |
| TRIPTORELIN (UPDATED) | Yellow | Precocious puberty |
Regulation restricts the prescribing and supply of puberty-suppressing hormones to children and young people under 18
|
| TRIPTORELIN | Green | Prostatic carcinoma |
GP can give first injection to patients in whom anti-androgen treatment has been started by secondary care clinician. |
| TROPOLONE (NEW) | Red | Platelet labelling in nuclear medicine | |
| TROSPIUM (immediate release) | Green | Urinary frequency, urgency and incontinence | |
| TROSPIUM XL | Do not prescribe | Urinary incontinence | |
| Trurapi® | Green | INSULIN ASPART |
First line cost effective choice of rapid acting insulin aspart (biosimilar). |
| TYPICAL ORAL ANTIPSYCHOTICS | Yellow | See individual entries | |
| UBIQUINONE Q10 | Do not prescribe | Statin-induced myopathy |
Not approved by local committee |
| UBLITUXIMAB (Briumvi) (NEW) | Red | Relapsing multiple sclerosis | |
| ULIPRISTAL ACETATE (ellaOne®) | Green | Emergency contraception |
To be taken from between 72 hours (3 days) to 120 hours (5 days) of unprotected sexual intercourse or contraceptive failure. Within the first 72 hours use Levonelle®. (Levonelle® 1500 is available on prescription. Levonelle One Step® can be sold to women over the age of 16 years)
|
| ULIPRISTAL ACETATE (Esmya ®) | Do not prescribe | Uterine fibroids |
In line with MHRA alert March 2020 regarding risks of liver injury. |
| UMECLIDINIUM / VILANTEROL inhaler (Anoro Ellipta®) | Grey | COPD |
Not yet reviewed |
| UMECLIDINIUM inhaler (Incruse Ellipta®) | Grey | COPD |
Not yet reviewed |
| UPADACITINIB (Rinvoq®) | Red | Rheumatoid arthritis |
In line with NICE TA665 |
| UPADACITINIB (Rinvoq®) | Red | Moderate rheumatoid arthritis in adults |
In line with NICE TA744
|
| UPADACITINIB (Rinvoq®) | Red | Active psoriatic arthritis after inadequate response to DMARDs |
Comments: In line with NICE TA768 |
| UPADACITINIB (Rinvoq®) | Red | Moderate to severe atopic dermatitis |
In line with NICE TA814
|
| UPADACITINIB (Rinvoq®) | Red | Active ankylosing spondylitis |
In line with NICE TA829 |
| UPADACITINIB (Rinvoq®) (NEW) | Red | For treating moderately to severely active ulcerative colitis |
In line with NICE TA856 |
| UPADACITINIB (Rinvoq®) (NEW) | Red | Active non-radiographic axial spondyloarthritis |
In line with NICE TA861
|
| UPADACITINIB (Rinvoq®) (NEW) | Red | Previously treated moderately to severely active Crohn’s disease |
In line with NICE TA905 |
| URIDINE TRIACETATE (NEW) | Red | For the treatment of patients exhibiting early-onset severe toxicities following 5-fluorouracil or capecitabine. | |
| UROFOLLITROPIN(Fostimon®) | Red | IVF | |
| USTEKINUMAB | Red | Plaque psoriasis |
Supported by NICE |
| USTEKINUMAB | Red | Psoriatic arthritis | |
| USTEKINUMAB | Red | Crohns |
In line with NICE TA 456 |
| USTEKINUMAB | Red | Plaque psoriasis in children |
In line with NICE TA 455 |
| USTEKINUMAB (Stelara®) | Red | Psoriasis | |
| USTEKINUMAB (Stelara®) | Red | Moderate to severe ulcerative colitis |
In line with NICE TA633
|
| VALGANCICLOVIR (Valcyte®) | Red | Cytomegalovirus retinitis | |
| VALPROATE SEMISODIUM (Depakote®) | Yellow | Mania in bipolar disorder | |
| VALSARTAN / AMLODIPINE (Exforge®) | Do not prescribe | Hypertension |
Not approved by local committee |
| VANDETANIB | Red | ||
| Varenicline Tartrate | Green | Smoking cessation in adults | |
| VEDOLIZUMAB | Red | Ulcerative colitis and Crohn's disese | |
| VEDOLIZUMAB (Entyvio®) | Red | Moderate to severe active UC or Crohn’s disease |
Devices: pen, pre-filled syringe or solution for infusion |
| VELMANASE ALFA (Lamzede ®) | Grey | Enzyme replacement therapy for the treatment of non-neurological manifestations in patients with mild to moderate alpha mannosidosis | |
| VEMURAFENIB | Red | ||
| VENLAFAXINE | Green | Depression - low dose (<300mg) | |
| VENLAFAXINE (UPDATED) | Orange | Treatment resistant depression - high dose (≥300mg) | |
| VERICIGUAT (Verquvo®) | 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 |
| Verkazia (Ciclosporin) eye drops | Yellow | Treatment of severe vernal keratoconjunctivitis (VKC) in children from 4 years of age and adolescence | |
| Vibegron (NEW) | Green | Overactive bladder syndrome in adults | |
| VIGABATRIN | Yellow | Epilepsy |
Clarification of historical status |
| VILDAGLIPTIN | Do not prescribe | Type 2 diabetes | |
| VILDAGLIPTIN / METFORMIN (Eucreas®) | Do not prescribe | Type 2 diabetes | |
| VIMOVO® (esomeprazole +naproxen) | Do not prescribe | Rheumatoid arthritis, osteoarthritis and ankylosing spondylitis | |
| VINORELBINE | Red | ||
| VISMODEGIB | Red | ||
| Visuxl | Green | Visuxl is indicated for the treatment of dry eye and corneal healingpost surgery |
Sodium hyaluronate |
| VITAMIN A CAPSULES (Phebra ®) | Yellow | Severe Vitamin A deficiency due to bariatric surgery or malabsorptive disorder | |
| VITAMIN A IM INJECTION | Red | Severe Vitamin A deficiency due to bariatric surgery or malabsorptive disorder where enteral routes are compromised | |
| VOCABRIA | Red | Stable HIV infection |
Cabotegravir (Vocabria) |
| VOCLOSPORIN(Lupkynis®) (NEW) | Red | Lupus nephritis in adults (active class 3 to 5) with mycophenolate mofetil. |
In line with NICE TA882. |
| VOLANESORSEN (Waylivra®) | Red | Familial chylomicronaemia syndrome in adults |
In line with NICE HST13 |
| VONICOG ALFA (Veyvondi®) | Red | Von Willebrand disease | |
| VORETIGENE NEPARVOVEC (Luxturna®) | Grey | Vision loss due to inherited retinal dystrophy caused by confirmed biallelic RPE65 mutations |
Not yet reviewed |
| VORICONAZOLE | Red | All indications - High cost drug - use on microbiologist advice only | |
| VORTIOXETINE | Yellow | Major depressive disorder |
In adults whose condition has responded inadequately to 2 antidepressants within the current episode |
| Voxelotor | Red | Reducing need for transfusion in sickle cell disease |
Oxbryta 500 mg film-coated tablets |
| VOXELTOR | Red | Haemolytic anaemia in adults and paediatric patients 12 years of age and older with sickle cell disease |
Under the EAMS scheme |
| VSL#3 | Do not prescribe | Probiotic | |
| YASMIN® | Green | Contraception |
NOTE: More expensive, with no evidence of significant advantages, compared to other similar OCs. |
| Zalkya | Green | Medical treatment of endometriosis |
Dienogest (Zalkya) |
| ZANAMIVIR SOLUTION FOR INFUSION (Dectova®) | Red | Treatment of complicated and potentially life-threatening influenza | |
| ZICONOTIDE | Do not prescribe | Severe chronic pain (intrathecal) | |
| ZIDOVUDINE | Red | ||
| ZOLENDRONIC ACID infusion | Red | Pagets disease & Osteoporosis | |
| ZONISAMIDE | Yellow | Refractory epilepsy | |
| ZUCLOPENTHIXOL ACETATE (Clopixol Acuphase®) | Red | Short-term management of acute psychosis or mania |
Refer to Local Area Team letter May 2013 |
| ZUCLOPENTHIXOL DECANOATE (Clopixol® Depot and Clopixol® Conc.) | Yellow | Schizophrenia | |
| ZUCLOPENTHIXOL ORAL | Yellow | Schizophrenia and other psychoses |
See the LLR Antipsychotic Prescribing Guide |
Traffic Light Classifications
Grey
Not yet reviewed drugs with no traffic light recommendation so not yet approved for use in LLR.
- New medicines, devices, appliances.
- New indication of existing medicine.
- New NICE TA which has not been reviewed.
- Not been requested for review by either TAS/LPT MMC.
Do not prescribe
Drugs not recommended for use in LLR because of lack of evidence of clinical effectiveness, cost prioritization or concerns over safety.
Red
Medicines which should be prescribed only in a specialist setting usually within a secondary or tertiary care service. NB: Some highly specialised RED medicines e.g. injectable treatments for cancer are not included on the LLR APC website list.
Orange
Shared Care Agreement. Higher risk medicines requiring significant regular monitoring which would be initiated by or at the recommendation of a specialist service which may include mental health services, secondary care, tertiary care, community providers, private providers and GPs with a specialist interest.
Yellow
Specialist recommendation: Medicines initiated (and stabilised where appropriate) or recommended by a specialist service for prescribing in primary care. Requests should be clearly communicated either through written communication including using approved paperwork if available or verbal means as appropriate .
Green
Medicines which could be started in any health care setting and do not require oversight by a specialist and which primary care would have full responsibility for prescribing and monitoring.