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

Unlicensed

5-AMINOLAEVULINIC ACID GEL (Ameluz®) Do not prescribe Actinic keratosis
ABACAVIR / LAMIVUDINE (Kivexa®) Red
ABACAVIR/DOLUTEGRAVIR/LAMIVUDINE (Triumeq®) Red HIV
ABATACEPT (UPDATED) 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 ®) (NEW) Grey Treatment of moderate-to-severe atopic dermatitis in adults and adolescents 12 years and older who are candidates for systemic therapy

Not yet reviewed

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 (NACYS®) Green COPD Reduction of sputum viscosity

LMSG Mucolytic prescribing guide

 

ACITRETIN (UPDATED) 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 Psoriatic arthritis; ankylosing spondylitis; refractory Crohn's disease
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 Moderate to severe ulcerative colitis

In line with NICE TA 329

ADALIMUMAB (UPDATED) Red Moderate rheumatoid arthritis.

In line with NICE TA715

ADALIMUMAB Red Plaque psoriasis in children

In line with NICE TA 455

ADALIMUMAB Red Behcet’s disease

Alternative to infliximab once established on therapy.
Subcutaneous  preparation able to be administered at home.

ADALIMUMAB Red Non-infectious uveitis

In line with NICE TA 460

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
ADVASIL CONFORM® Yellow Hypertrophic Scars

Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform®
Guidance For Use

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)

Not approved by local committee

AGOMELATINE Orange Depression

Full SCA

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 Green Various

Historic patients who have tried or not been suitable for other sedating antihistamines or melatonin. GP to continue prescribing.
Important: Patients currently taking alimemazine should be discussed with the specialist and not have treatment stopped abruptly without a review.

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.
Important: Patients currently taking alimemazine should be discussed with the specialist and not have treatment stopped abruptly without a review.

ALIMEMAZINE Do not prescribe Various

New patients. Current patients should be discussed with the prescribing specialist and not have treatment stopped abruptly without appropriate review.

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 Orange Hypertension

Full SCA

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.

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 Parkinson's disease

Click on drug name for further detail

AMANTADINE Yellow For fatigue in Multiple sclerosis

Amantadine for fatigue in Multiple sclerosis: prescribing notes

AMIFAMPRIDINE (Firdapse®) Do not prescribe Lambert-Eaton myasthenic syndrome
AMIKACIN (Arikayce Liposomal®) Grey Non-tuberculous mycobacterial (NTM) lung infections

Not yet reviewed

AMILORIDE Orange Heart failure and hypertension in infants and children

Full SCA

AMISULPRIDE Orange Schizophrenia

Full SCA

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®) (NEW) Red Still’s disease and juvenile idiopathic arthritis

In line with NICE TA685

 

ANAKINRA (Kineret®) (NEW) Red Haemophagocytic Lymphohistiocytisis
ANASTROZOLE Yellow Adjuvant therapy in early breast cancer
ANASTROZOLE Yellow Off label chemoprevention to reduce incidence of breast cancer.

Use in line with NICE CG 164

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

In line with NICE TA697

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 Orange See shared care agreements

Full SCA

Full SCA personality disorder

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
DOAC Initiation Pack

APIXABAN Yellow Treatment and secondary prevention of DVT and PE

In line with NICE TA 341

APOMORPHINE Orange Parkinson's disease

Full SCA     Request form

APRACLONIDINE Red Glaucoma
APREMILAST (Otezla®) Red Psoriasis

In line with NICE TA 419

APREMILAST (Otezla®) Red Psoriatic arthritis

In line with NICE TA 433

ARGATROBAN (Exembol®) Red For anticoagulation in adult patients with heparin induced thrombocytopenia.
ARGININE Red Urea Cycle Disorders
ARIPIPRAZOLE LONG-ACTING INJECTION (Abilify Maintena®) Orange Maintenance treatment of schizophrenia in patients currently stabilised on oral aripiprazole

Full SCA

ARIPIPRAZOLE oral Orange Schizophrenia. Treatment and recurrence of mania. Control of agitation and disturbed behaviour in schizophrenia

Full SCA

ARMOUR THYROID Do not prescribe Thyroid replacement
ASCORBIC ACID PASCOE 150 MG/ML CONCENTRATE FOR SOLUTION FOR INJECTION / INFUSION (NEW) Grey Treatment of clinical vitamin C deficiency

Not yet reviewed

ASENAPINE Do not prescribe Manic episodes of bipolar disorder.
ATALUREN Red Duchenne muscular dystrophy

In line with NICE HST3

ATAZANAVIR Red
ATAZANAVIR / COBICISTAT (Evotaz®) Red HIV infection
ATOMOXETINE Orange Attention deficit hyperactivity disorder (ADHD)

Adults
Full SCA

Children and adolescents
Full SCA

 

ATOVAQUONE Red
ATROPINE EYE DROPS Green Palliative care in line with guidance

Conditional on recommendation from palliative care team.
Palliative Care Prescribing

AVANAFIL Grey Erectile dysfunction

Not yet reviewed

AVATROMBOPAG (Doptelet®) Grey Severe thrombocytopenia

Not yet reviewed

AVIPTADIL/PHENTOLAMINE intracavernosal injection (Invicorp®) Green Erectile dysfunction
AXITINIB Red
AZATHIOPRINE Orange Dermatological disease

Full SCA

AZATHIOPRINE Orange Paediatric Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease)

Full SCA

 

AZATHIOPRINE Orange Rheumatological disease

Full SCA     Request form

AZATHIOPRINE Orange Inflammatory Bowel Disease (Ulcerative Colitis, Crohn's Disease) & Autoimmune Hepatitis

Full SCA

AZATHIOPRINE Orange Autoimmune neurological disorders

Please see shared care agreement for individual indications

AZELAIC ACID 20% TOPICAL Green Acne

See local algorithm for more information.

AZILSARTAN Do not prescribe Hypertension
AZTREONAM Red Infection in cystic fibrosis
BALSALAZIDE Orange Ulcerative colitis

Full SCA

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 DIPROPIONATE / FORMOTEROL (Fostair®) Green Asthma
COPD

Prescribe in line with Adult Asthma Guideline

BECLOMETASONE Inhaler - CFC free Green Asthma

QVAR brand recommended for adults. Clenil Modulite brand recommended only for children.

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 (UPDATED) Red Active autoantibody-positive systemic lupus erythematosus. Rheumatology only
BEMPEDOIC ACID (Nilemdo®) Red Primary hypercholesterolaemia or mixed dyslipidaemia in adults

In line with NICE TA694

 

BEMPEDOIC ACID / EZETIMIBE (Nustendi®) Red Primary hypercholesterolaemia or mixed dyslipidaemia in adults

In line with NICE TA694

 

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®) (UPDATED) 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 plaster (Betesil®) Do not prescribe Inflammatory skin disorders not responding to less potent corticosteroids

Not approved by local committee

BEVACIZUMAB Red Retinopathy of prematurity either first line or as a second line rescue treatment.
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

BILASTINE Do not prescribe Allergic rhinoconjunctivitis and urticaria
BIMATOPROST / TIMOLOL eye drops (Ganfort®) Green Glaucoma

If prescribed in line with Glaucoma Algorithm

BIMATOPROST / TIMOLOL preservative free eye drops (Ganfort UD®) Green Glaucoma

If prescribed in line with Glaucoma Algorithm

BIMATOPROST preservative free eye drops Green Glaucoma

If prescribed in line with Glaucoma Algorithm

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

In line with NICE TA723

Bio-Oil® Do not prescribe Skincare product
BIOBRAN MGN-3 Do not prescribe Adjuvant to cancer treatment

Cancer Research UK statement

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®) (UPDATED) 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

BRINZOLAMIDE / BRIMONIDINE (Simbrinza®) eye drops Green Glaucoma

If prescribed in line with Glaucoma Prescribing Algorithm

BRINZOLAMIDE / TIMOLOL (Azarga®) Green Glaucoma

If prescribed in line with Glaucoma Prescribing Algorithm

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

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

NICE TA708

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

BUPRENORPHINE Green Severe pain

including transdermal patch

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®) Red IVF
BUSPIRONE Red Gastroparesis/functional dyspepsia
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
CALCIPOTRIOL/BETAMETHASONE CUTANEOUS FOAM (Enstilar®) Green Psoriasis vulgaris

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

CANNABIS Derivative (Sativex®) Do not prescribe Multiple sclerosis

see East Midlands policy

The BMA cancard statement can be found here

CANNABIS OIL Do not prescribe ALL

Not yet reviewed

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®) Red Peripheral neuropathic pain

Only if unresponsive to other treatments in local guidance.

CAPSAICIN 8% PATCH (Qutenza®) Do not prescribe Diabetic neuropathy
CAPTOPRIL Orange Heart failure and hypertension in infants and children

Full SCA

CARIPRAZINE Do not prescribe Bipolar disorder
CARIPRAZINE(Reagila®) Red Schizophrenia

 

 

CASIRIVIMAB AND IMDEVIMAB (Ronapreve®) (NEW) Red For patients hospitalised due to COVID-19
CASPOFUNGIN Red
CEFEPIME (Renapime®) Grey Antibiotic

Not yet reviewed

CEFIDEROCOL (Fetcroja®) Red Infections caused by extensively antibiotic resistant Gram negative bacteria
CEFIXIME Green Gonorrhoea
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 For pain and inflammation for asthmatic patients with NSAID allergy

To be initiated in a specialist clinic with resuscitation facilities

CELECOXIB Yellow Inflammatory pain associated with cancer or other palliative conditions
CELECOXIB Do not prescribe Indications not traffic lighted yellow
CELECOXIB (Onsenal®) Do not prescribe Familial adenomatous polyposis
CENEGERMIN (Oxervate®) Do not prescribe Neurotrophic keratitis

Not recommended in NICE TA 532

CERTOLIZUMAB PEGOL Red Rheumatoid arthritis

In line with  NICE TA 375 and NICE TA 415

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 (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 (NEW) Red Insomnia in children and adolescents

Traffic light change following MHRA restrictions.

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

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

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

In line with NICE TA720

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

Reviewed by TAS September 2021

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®
Guidance For Use

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 Orange Dermatological disease

Full SCA

CIDOFOVIR Red CMV retinitis
CINACALCET Orange Secondary hyperparathyroidism

Shared care request is mandatory
Full SCA

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 TRANSDERMAL PATCH (Catapres®) Red Hypertension
CLOZAPINE Red

Leicestershire Partnership Trust consultants only

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 (NEW) Red Nebulised for Cystic fibrosis
COLISTIN Red IV for cystic fibrosis
COLISTIN (Colomycin ® and Promixin®) Yellow Bronchiectasis

Please see guide for more information. Must be prescribed by brand as the brands are not interchangeable.

COLISTIN (Colomycin® and Promixin ®) 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

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

In line with NICE TA743

CRIZOTINIB Red
CYANOCOBALAMIN Do not prescribe Vitamin B12

Initially for new patients only. Implementation date for all patients September 2020 to allow time for review. Exception to this traffic light was use as per the previous Covid pandemic vitamin B12 advice.

CYCLOPHOSPHAMIDE Red
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
DOAC Initiation Pack

DABIGATRAN Red Prevention of Venous Thromboembolism (VTE) following knee / hip replacement surgery

In line with NICE  TA 157

DABRAFENIB Red
DACLATASVIR Red Hepatitis C

In line with NICE TA 364

DACLATASVIR Red Patients with hepatitis C who have Cirrhosis

NHSE policy statement

Reviewed by TAS

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®) (NEW) Red Osteoarticular infections (unlicensed)
DALTEPARIN Green Low INR

In line with Warfarin Guidelines for Primary Care

DALTEPARIN Yellow Antenatal Indications
DALTEPARIN Green Thromboprophylaxis and Treatment of DVT & PE
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 (NEW) Do not prescribe Type 1 diabetes

New patients

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

Now unlicensed due to commercial reasons

 

DAPAGLIFLOZIN (Forxiga®) Yellow Chronic Heart failure with reduced ejection fraction

In line with NICE TA679

DAPAGLIFLOZIN / METFORMIN (Xigduo®) Grey Type 2 diabetes

Not yet reviewed

DAPOXETINE Do not prescribe Premature ejaculation
DAPTOMYCIN Red Complicated Gram +ve skin/soft tissue infections
DARBEPOETIN Red Anaemia of chronic kidney disease
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

NHSE policy statement

Reviewed by TAS

DASATINIB Red
DEFERASIROX Red Iron overload
DEFERIPRONE Red
DEFLAZACORT (Calcort®) Red 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®) Grey Acute bacterial skin and skin structure infections

Not yet reviewed

DENOSUMAB (Prolia®) Orange Osteoporosis

Full SCA

Request form

DENOSUMAB (Xgeva®) Orange Prevention of skeletal related events in adults with bone metastases from solid tumours other than prostate

Full SCA

DENOSUMAB (Xgeva®) Red Prevention of skeletal related events in adults with bone metastases from solid tumours other than prostate

Red for patients with severe renal impairment (creatinine clearance less than 30ml/min)

DEQUALINIUM CHLORIDE VAGINAL TABLETS (Fluomizin®) Do not prescribe Bacterial vaginosis
Dermatix® Do not prescribe Dressing for treatment of scars
DERMATOPHAGOIDES PTERONYSSINUS ALLERGEN EXTRACT (Acarizax®) Red Immunotherapy treatment for house dust mite and allergic rhinitis.
DESFERRIOXAMINE Red
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.

DEXAMETHASONE intravitreal implant Red Non-infectious uveitis. Macular oedema due to retinal vein occlusion

In line with  NICE TA 460
NICE TA 229
NICE TA349

DEXAMFETAMINE Orange Attention deficit hyperactivity disorder (ADHD)

Adults
Full SCA

Children and adolescents
Full SCA

DEXIBUPROFEN Do not prescribe Pain and inflammation
DEXMEDETOMIDINE (Dexdor ®) (NEW) Red Pre procedure sedation in children
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 (Zalkya®) Grey Treatment of endometriosis.

Not yet reviewed

DIMETHYL FUMARATE Red Multiple sclerosis

In line with  NICE TA 320

 

DIMETHYL FUMARATE Red Moderate to severe plaque psoriasis

In line with NICE TA 475

DINOPROSTONE Red Induction of labour
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 Yellow Cystic fibrosis
DOXEPIN oral Red Urticaria paediatrics

Unlicensed

DOXYCYCLINE Controlled release (Efracea®) Do not prescribe Rosacea

Not approved by local committee

DOXYLAMINE SUCCINATE AND PYRIDOXINE (Xonvea®) Grey Nausea and vomiting in pregnancy

Not yet reviewed

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 Anxiety and depression
DULOXETINE Green Diabetic neuropathy

To be used in conjunction with Neuropathic Pain Guidelines

DULOXETINE Green Stress incontinence
DULOXETINE Green Fibromyalgia & Neuropathic Pain
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
NICE TA355

EFAVIRENZ Red
EFAVIRENZ / EMTRICITABINE / TENOFOVIR (Atripla®) Red
EFLORNITHINE Do not prescribe Female facial hirsuitism

Not approved by local committee

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 Yellow Type 2 diabetes

Amber if GP does not feel competent to initiate.
Use in line with NICE TA 336

EMPAGLIFLOZIN Green Type 2 diabetes

Conditional on prescriber being competent to select appropriate patients

EMPAGLIFLOZIN / LINAGLIPTIN (Glyxambi®) Grey Type 2 diabetes mellitus in adults

New formulation
Not yet reviewed

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

Full SCA

ENFUVIRTIDE Red
ENOXAPARIN Red Acute coronary syndrome
ENOXAPARIN Red Thromboprophylaxis and treatment of DVT

Courses started during the dalteparin shortage can be continued to be supplied in primary care

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
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
Conditional on prescriber being competent to select appropriate patients

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®) (UPDATED) 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 / NOMEGESTROL (Zoely®) Do not prescribe Combined oral contraceptive
ESTRADIOL VAGINAL TABLETS (Vagirux®) (NEW) Green Vaginal atropy in post menopausal women
ESTRAMUSTINE Red
ETANERCEPT Red Juvenile idiopathic arthritis

In line with NICE TA 373

ETANERCEPT (NEW) Red Moderate rheumatoid arthritis.

In line with NICE TA715

ETANERCEPT Red Plaque psoriasis in children

In line with NICE TA 455

ETANERCEPT Red DMARD for RA, including weekly SC injection
ETANERCEPT Red Plaque psoriasis

In line with NICE TA103

ETELCALCETIDE injection (Parsabiv) Red Secondary hyperparathyroidism in adult patients with chronic kidney disease on haemodialysis therapy

Inline with NICE TA 448

ETHINYLESTRADIOL / DESOGESTREL (Alenvona®) Grey Oral contraceptive

Not yet reviewed

ETOPOSIDE Red
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.
Marketing authorisations were withdrawn in 2002

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.
To be used in line with NICE Guidelines CG66
Once a week preparation (Bydureon®) is formulary.
Twice daily preparation (Byetta®) is non-formulary. However, existing patients may remain on treatment.

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
FAMPRIDINE Do not prescribe Multiple Sclerosis
FEBUXOSTAT Green Gout (2nd line after allopurinol)

In line with NICE TA 164

FENTANYL BUCCAL FILM (Breakyl®) Grey Breakthrough cancer pain in patients already on opioids

Not yet reviewed

FENTANYL BUCCAL Tablets (Effentora buccal®) Grey Breakthrough pain for patients with cancer

Not yet reviewed

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.
See: Palliative care – drugs for use only after specialist recommendation

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
FERUMOXYTOL INJECTION (Rienso®) Do not prescribe Iron deficiency anaemia in chronic kidney disease
FESOTERODINE Do not prescribe Urinary frequency
FIBRINOGEN (Riastap®) Red Treatment of severe bleeding in acquired hypofibrinogenemia resulting from operative interventions, in particular after cardiac surgery
FIBRINOGEN CONCENTRATE (Human) (FibCLOT®) Grey Treatment and perioperative prophylaxis of bleeding in patients with congenital hypo- or afibrinogenaemia with bleeding tendency

New formulation
Not yet reviewed

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

 

FILGRASTIM Red
FINGOLIMOD Red Multiple Sclerosis

NICE supported.
EMSCG funding.

FLUDARABINE Red
FLUNARIZINE Red Migraine prophylaxis in adults
FLUNARIZINE Red Alternating hemiplegia/refractory migraine in children

Unlicensed

FLUOCINOLONE ACETONIDE (Iluvien®) intravitreal implant Red Diabetic macular oedema

In line with NICE TA301

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) Green Schizophrenia and other psychoses

If used for schizophrenia or psychoses to be initiated only after diagnosis and advice to use this typical antipsychotic has been discussed with specialist

FLUPENTIXOL DECANOATE Orange Schizophrenia

Full SCA     Request form

FLUPHENAZINE DECANOATE Orange Schizophrenia

Full SCA     Request form

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 / VILANTEROL INHALER (Relvar®) Do not prescribe Asthma

Reviewed by LLR Respiratory Prescribing Group.

FLUTICASONE FUROATE (Avamys®) Green Allergic rhinitis
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 Aerospace®) Grey Moderate to severe COPD

Not yet reviewed

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®) Grey Chronic immune thrombocytopenia

Not yet reviewed

FOSTEMSAVIR (Rukobia ®) (NEW) Red HIV Infections
FreeStyle Libre® Sensor Yellow Diabetes glucose monitoring inline with NHSE criteria.

As per LMSG freestyle libre documents An initiation letter is required for an initial  six month trial. Continuation dependent on letter detailing improvement in the NHSE England parameters. 

 

FREMANEZUMAB (Ajovy®) Red Prevention of migraine

In line with NICE TA631

 

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

Full SCA

GABAPENTIN Green Neuropathic pain

To be used in conjunction with

Neuropathic Pain Guidelines

GALANTAMINE Gazylan XL ® (UPDATED) Yellow Alzheimer's disease
GALANTAMINE LIQUID (UPDATED) 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.To be used in line with local guidance Ganciclovir 0.15% eye gel

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
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
GLYCEROL PHENYLBUTYRATE (Ravicti®) (UPDATED) Red Chronic management of patients with urea cycle disorders (UCDs)
GLYCERYL TRINITRATE Ointment 0.4% Green Anal fissure
GLYCOPROTEIN IIb/IIIa inhibitors Red
GLYCOPYRONIUM/BECLOMETASONE/FORMETEROL DPI (Trimbow NEXThaler) (NEW) Green Maintenance treatment of adults with moderate to severe COPD

Reviewed by the Respiratory Prescribing Group September 2021

GLYCOPYRRONIUM (Sialanar®) Do not prescribe Persistent drooling in children and adolescents with neurological conditions, such as cerebral palsy, epilepsy and neurodegenerative diseases
GLYCOPYRRONIUM / BECLOMETASONE / FORMOTEROL metered dose Inhaler (Trimbow®) Green Maintenance of COPD.
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
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
RA see NICE TA 225

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 Green Prostate cancer

GP can give first injection to patients in whom anti-androgen treatment has been started by secondary care clinician.

GONADORELIN ANALOGUES Yellow Gender reassignment

Must be prescribed in line with recommendations from specialist. The nearest specialist is Nottingham.

GOSERELIN Green Prostatic carcinoma

GP can give first injection to patients in whom anti-androgen treatment has been started by secondary care clinician.

Local guidance

GOSERELIN Yellow Endometriosis, uterine fibroids
GOSERELIN 3.6mg (Zoladex®) 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.
Palliative Care Prescribing

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®) Orange Grass pollen allergies

Full SCA

GUANFACINE Orange ADHD - Adult

Adult Full SCA and Request Form

GUANFACINE Orange ADHD - Peadiatric

Paediatric Full SCA and Request Form

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

In line with NICE TA711

GUSELKUMAB Red Moderate to severe plaque psoriasis in adults

In line with NICE TA 521.

 

HALOPERIDOL (oral) Green Schizophrenia and psychoses

If used for schizophrenia or psychoses to be initiated only after diagnosis and advice to use typical antipsychotic has been discussed with specialist

HALOPERIDOL DECANOATE Orange Schizophrenia

Full SCA     Request form

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

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

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®) (NEW) 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®) Do not prescribe Black in all indications EXCEPT for pain relief in osteoarthritis of shoulder joint (RED)
HYALURONIC ACID DERIVATIVE (Synvisc®) Red Pain relief in osteoarthritis of shoulder joint.
HYDROCORTISONE (Alkindi®)(Granules in capsules for opening) Grey Adrenal insufficiency in infants

Not yet reviewed

HYDROCORTISONE 1% / OXYTETRACYCLINE 3% (Terra-Cortril®) Do not prescribe Overgranulation of wounds

Not approved by local committee

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.
HC Emergency Kit for Paediatrics: Prescribing and supply details

HYDROCORTISONE modified release (Plenadren®) Do not prescribe Hypoadrenalism (once daily dose)
HYDROXYCARBAMIDE Orange Myeloproliferative disorders, sickle cell anaemia

Full SCA

HYDROXYCARBAMIDE SOLUTION (Xromi®) Grey Prevention of vaso-occlusive complications of Sickle Cell disease

Not yet reviewed

HYDROXYCHLOROQUINE (UPDATED) Yellow Rheumatological disease

Eye checks to be organised by secondary care.

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
Use only when compliance with oral therapy is an issue

ICATIBANT acetate Red Hereditary angioedema
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®) (UPDATED) 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

In line with Actinic Keratoses treatment pathway

IMMUNOGLOBULINS Red
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
INFLIXIMAB Red All indications
INFLIXIMAB (NEW) Red Moderate rheumatoid arthritis.

In line with NICE TA715

INGENOL MEBUTATE GEL (Picato®) Do not prescribe Actinic keratosis (non hypertrophic)

MHRA alert

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

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

 

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
MUST BE PRESCRIBED BY BRAND NAME

INSULIN DEGLUDEC (Tresiba®) Yellow Diabetes mellitus in adults

Simple amber if prescriber has not received specific training.
MUST BE PRESCRIBED BY BRAND NAME

INSULIN DEGLUDEC / LIRAGLUTIDE (combination product) (Xultophy®) Green Diabetes

Conditional on prescriber being trained to select and train patients.

INSULIN DEGLUDEC/LIRAGLUTIDE (combination product) (Xultophy®) Yellow Diabetes

For those who have not had the training.

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.
UKMI – Product Safety Assessment Report
MUST BE PRESCRIBED BY BRAND NAME

INSULIN GLARGINE / LIXISENATIDE (Suliqua®) Grey Type 2 Diabetes mellitus in combination with metformin

New formulation
Not yet reviewed

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
IRON(III) ISOMALTOSIDE 1000 (Diafer®) Red Iron deficiency (renal use only)
ISAVUCONAZOLE Red Invasive aspergillosis and mucormycosis
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
IXEKIZUMAB Red Psoriatic arthritis after inadequate response to DMARDs

In line with NICE TA 537

 

IXEKIZUMAB Red Psoriasis

In line with NICE TA 442

IXEKIZUMAB (Taltz®) (NEW) Red Axial spondyloarthritis

In line with NICE TA718

Implementation date 21st October

KELO-COTE® Yellow Hypertrophic Scars

Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform®
Guidance For Use

KETAMINE Green Palliative care in line with guidance

Conditional on recommendation from palliative care team.
Palliative Care Prescribing

 

KETOCONAZOLE TABLETS Do not prescribe Fungal infections

Risk of hepatotoxicity outweighs benefit
MHRA alert

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.

Palliative Care Prescribing

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 preservative free eye drops Green Glaucoma

If prescribed in line with Glaucoma Prescribing Algorithm

LAUROMACROGOL 400 (Aethoxysklerol®) Grey Sclerotherapy of varicose veins of the lower extremities

Not yet reviewed

LECICARBON A® suppositories Grey Laxative or bowel preparation

Not yet reviewed

LEDIPASVIR/SOFOSBUVIR (Harvoni®) Red Hepatitis C

In line with NICE TA 363

LEFLUNOMIDE Orange Rheumatological disease

Full SCA     Request form

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 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.

Local guidance

LEUPRORELIN (PROSTAP 3 DCS ®) Yellow Breast cancer

3 monthly preparation

LEVETIRACETAM Green Palliative care in line with guidance

Conditional on recommendation from palliative care team.
Palliative Care Prescribing

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-RELEASING INTRAUTERINE SYSTEM (Levosert®) Green Contraception or heavy menstrual bleeding
LIDOCAINE HYDROCHLORIDE + PHENAZONE EAR DROPS (Otigo®) Grey Local symptomatic treatment and relief of pain in specified diseases of the middle ear without tympanic perforation.

Not yet reviewed

LIDOCAINE patch Green Postherpetic neuralgia
LIDOCAINE Patch Do not prescribe All indications except post herpetic neuralgia

New patients initially. Further advice to come regarding historic patients

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
LIOTHYRONINE Red New patients

For patients who have hypothyroidism who have had inadequate response to thyroxine alone, in line with guidance

LIPEGFILGRASTIM Grey Chemotherapy-induced neutropenia

Not yet reviewed locally

LIRAGLUTIDE (Saxenda®) Red Obesity as part of a tier 3 specialist weight management service

In line with NICE TA664

LIRAGLUTIDE (Victoza®) Green Type 2 diabetes

For patients unable to tolerate lixisenatide. Conditional on prescriber being trained to select and train patients – Use in conjunction with Updated NICE Clinical Guideline

LIRAGLUTIDE (Victoza®) Yellow Type 2 diabetes

If prescriber has not received specific training.

 

LISDEXAMFETAMINE DIMESYLATE Orange ADHD when response to methylphenidate is inadequate

Adults
Full SCA

Children and adolescents
Full SCA

LISINOPRIL Orange Heart failure and hypertension in infants and children

Full SCA

LITHIUM SALTS Orange Mania, Bipolar Disorder, Recurrent Depression or Aggressive or Self-mutilating behaviour.

Full SCA     Request form

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

Full SCA

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 (UPDATED) Orange schizophrenia in adults aged over 18 years

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

SCA

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

Full SCA  Request form

LUSUTROMBOPAG (Mulpleo®) Grey Severe thrombocytopenia

Not yet reviewed

LUTROPIN ALFA, FOLLITROPIN ALFA (Pergoveris®) Grey Stimulation of follicular development

Not yet reviewed

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
MBrIDA Red Diagnosis of hepatobiliary tract patency and differentiation of jaundice
MEDROXYPROGESTERONE ACETATE DEPOT INJECTION (Sayana Press®) Green Long-term contraception
MELATONIN Do not prescribe Primary insomnia in adults. Circadian asynchrony in elderly institutionalised patients
MELATONIN Yellow Free running circadian rhythm and delayed sleep phase syndrome

Simple Amber only applies to Circadin m/r tablets or oral solution 5mg/5ml. Other formulations are secondary care only.

MELATONIN Red Learning disability (Adult). Huntington's disease. Parkinson's disease.
MELATONIN Red Acute circadian asynchrony in hospitalised patients on ITU, HDU and other care areas
MELATONIN Do not prescribe Jet lag
MELATONIN (doses of 10mg daily or less) Yellow Sleep disorders children (see comments) continued in adults if proven efficacy in childhood

Sleep onset insomnia and delayed sleep phase syndrome.
Simple Amber only applies to Circadin m/r tablets or oral solution 5mg/5ml.
Other formulations are secondary care only.
See LMSG guidance for further information.

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®) (UPDATED) Yellow Insomnia for children aged 2-18 years with Autism Spectrum Disorder and or Smith-Magenis syndrome
MELPHALAN Red
MEMANTINE Red Nystagmus
MEMANTINE Yellow Alzheimer's disease

in line with NICE NG 97

 

MENOTROPHIN (Menopur®) Red IVF
MEPIFORM® Yellow Hypertrophic Scars

Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform®
Guidance For Use

MEPOLIZUMAB (Nucala®) (UPDATED) 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
Not yet reviewed

MERCAPTOPURINE Orange Paediatric Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease)

Full SCA

MERCAPTOPURINE Red Leukaemia
MERCAPTOPURINE Orange Inflammatory Bowel Disease (Ulcerative Colitis, Crohn's Disease) & Autoimmune Hepatitis

Full SCA

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) Orange Ulcerative colitis, Crohn' s disease and paediatric colitis

Full SCA adult

Full SCA paediatric

MESALAZINE RECTAL Yellow Ulcerative colitis and Crohn's disease
METHADONE Green Palliative care in line with palliative care guidance.

Conditional on recommendation from palliative care team.
Palliative Care Prescribing

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.

METHOTREXATE Injection Red
METHOTREXATE Oral Orange Rheumatological disease

Full SCA     Request form

METHOTREXATE Oral Orange Dermatological disease

Full SCA

METHOTREXATE Oral Red Severe refractory asthma
METHOTREXATE Oral Orange Crohn's Disease

Full SCA

METHYLNATREXONE Green Palliative care in line with guidance.

Conditional on recommendation from palliative care team.
Palliative Care Prescribing

METHYLPHENIDATE Green Palliative care in line with guidance

Conditional on recommendation from palliative care team.
Palliative Care Prescribing

METHYLPHENIDATE (+'CR') Orange Attention deficit hyperactivity disorder (ADHD)- prescribe CR formulation by brand name only

For information about products please see relevant Shared Care.
Adults:  Full SCA
Children & adolescents:  Full SCA

MEXILETINE Red Ventricular arrhythmia

New patients. Existing prescribing in primary care to continue.

MEXILETINE (Namuscla®) Grey Symptomatic treatment of myotonia in adult patients with non-dystrophic myotonic disorders

Not yet reviewed

MIANSERIN Yellow Depression

Mianserin is simple amber 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.

MIDAZOLAM (Buccolam®) Yellow Status epilepticus
MIDAZOLAM buccal Green Palliative care in line with guidance.

Conditional on recommendation from palliative care team.

Palliative Care Prescribing

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

MITOTANE Red
MODAFINIL Orange Daytime sleepiness associated with Narcolepsy and existing patients being treated for Daytime Sleepiness associated with Obstructive Sleep Apnoea Syndrome, Idiopathic Hypersomnia & Shift Work Sleep Disorder.

Full SCA

MOLLUDAB® Grey Molluscum contagiosum

Not yet reviewed.

MOLOGRAMOSTIN Red
MOLUTREX® Grey Molluscum contagiosum

Not yet reviewed

MOMETASONE/ OLOPATADINE NASAL SPRAY (Ryaltris ®) (NEW) Grey Moderate to severe nasal symptoms associated with allergic rhinitis

Not yet reviewed

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 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.

Full SCA

MYCOPHENOLATE Red Immunosuppression following renal transplantation
MYCOPHENOLATE MOFETIL Red Specialist heamatology use in graft versus host disease in bone marrow transplant
MYCOPHENOLATE MOFETIL 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.
Palliative Care Prescribing

NALOXONE nasal spray (Nyxoid®) Red Opioid overdose

Turning Point Only

NALTREXONE Red Pruritus in liver disease

Unlicensed indication

NALTREXONE Yellow Opioid dependence

To be initiated by specialists for maintenance treatment to help prevent relapse in opioid dependence.

NICE TA 115

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)
NELFINAVIR Do not prescribe
NETAZEPIDE Do not prescribe Fundic gland polyps

Not supported TAS 2012

NETUPITANT/PALONOSETRON capsules (Akynzeo®) Grey Prevention of nausea and vomiting associated with chemotherapy

Not yet reviewed

NEVIRAPINE Red
NILOTINIB Red
NINTEDANIB (Ofev®) Red Idiopathic Pulmonary Fibrosis

In line with NICE TA 379

NONACOG BETA PEGOL (Refixia®) Red Haemophilia
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 Green Palliative care in line with guidance

Conditional on recommendation from palliative care team.
Palliative Care Prescribing

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

In line with NICE TA699

Implementation date 19th August 2021

OLANZAPINE Green Palliative care in line with guidance

Conditional on recommendation from palliative care team.
Palliative Care Prescribing

OLANZAPINE Oral Orange 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.

Full SCA

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

NICE TA 339

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®) Yellow Hypertriglyceridaemia
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

Further information when used for palliative care can be found in the Palliative Care Prescribing Guide

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

Reviewed by TAS 22nd June 2021

OPICAPONE capsules (Ongentys®) Yellow Parkinson's disease
OPTIVE PLUS (UPDATED) Do not prescribe Dry eye
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 (UPDATED) 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 (Targinact®) Yellow Severe pain in patients with opioid-induced bowel dysfunction
OXYCODONE HYDROCHLORIDE / NALOXONE (combination product) prolonged release tablet (Targinact®) Do not prescribe Post colorectal surgery

Reviewed by TAS – No evidence to support use for this indication.

OZANIMOD (Zeposia®) Grey Adults with active disease as part of relapsing-remitting Multiple Sclerosis.

Not yet reviewed

PALIPERIDONE PALMITATE Long-Acting Injection Orange Maintenance in schizophrenia in patients previously responsive to risperidone.

Full SCA

PALIVIZUMAB Red
PALONOSETRON Do not prescribe Nausea and vomiting with chemotherapy
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(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

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
PEGINTERFERON BETA-1a (Plegridy®) Red Relapsing-remitting multiple sclerosis

In line with NICE TA624

PEGLOTICASE Do not prescribe Gout

Not supported by NICE

PENICILLAMINE Red Wilson's disease
PENICILLAMINE Orange Rheumatoid arthritis

Full SCA     Request form

PENTHROX® Red Emergency relief of moderate to severe pain in conscious adults

Emergency department use 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 (UPDATED) Do not prescribe Parkinson's disease

No longer recommended

PIMECROLIMUS cream Green Dermatitis
PIRFENIDONE (Esbriet®) Red For Idiopathic pulmonary fibrosis

In line with NICE TA 504 (Replaces NICE TA 282)

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 & 5% GLUCOSE solution for infusion Red Source of water, electrolyte and calories or as a alkalinising agent
POLIHEXANIDE 0.02% eye drops Red
Pollinex Quattro Do not prescribe Severe hayfever caused by tree & grass pollen
POMALIDOMIDE Red
PONATINIB Red
PONESIMOD (Ponvory®) (NEW) Grey Relapsing forms of multiple sclerosis with active disease.

Not yet reviewed

POSACONAZOLE Red Severe fungal infections
PRAMIPEXOLE Orange Parkinson's Disease, Restless Legs Syndrome and other limb movement disorders

Click on drug name for further details

Full SCA

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
PRO-SIL® Yellow Hypertrophic Scars

Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform®
Guidance For Use

PROCARBAZINE Red
PROGESTERONE PESSARIES (Cyclogest®) Yellow Maintenance of pregnancy following IVF or when there is a risk of pre-term delivery
PROGESTERONE SC INJECTION (Lubion®) (NEW) Do not prescribe Luteal Phase Support for assisted reproduction treatment (IVF/ICSI)

Reviewed by TAS September 2021

PROXYMETACAINE HYDROCHLORIDE Red Local anaesthetic
PRUCALOPRIDE Green Chronic refractory constipation
PYRIDOSTIGMINE Yellow Myasthenia gravis

Includes sustained release formulation (Mestinon Timespan).

QLAIRA® Do not prescribe Contraception

Not approved by local committee

QUETIAPINE Orange Schizophrenia. Mania (either alone or in combination with mood stabilisers). Depression in bipolar disorder. Adjunctive treatment in major depressive disorder. Personality disorder.

Full SCA

Full SCA personality disorder

QUETIAPINE Green Palliative care in line with guidance.

Conditional on recommendation from palliative care team.
Palliative Care Prescribing

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

Reviewed by TAS September 2021

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 (Lucentis®) Red Age-related macular degeneration, diabetic macular oedema, retinal vein occlusion
RANOLAZINE Green Chronic stable angina

In line with NICE CG 126

RASAGILINE Yellow Parkinson's disease

Click on drug name for further details

 

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

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

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

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

REGORAFENIB Red
REMDESIVIR (Veklury®) Red Treatment of coronavirus disease 2019
REMIMAZOLAM (Byfavo®) (NEW) 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/ISONIAZID/PYRAZINAMIDE/ETHAMBUTOL (Voractiv) Red Tuberculosis
RIFAPENTINE (Priftin®) Red Latent TB
RIFAXIMIN Yellow Reduction in recurrence of hepatic encaphalopathy
RIFAXIMIN Do not prescribe Traveller's diarrhoea
RILPIVIRINE Red
RILUZOLE Orange Amylotrophic lateral sclerosis form of motor neurone disease

Full SCA

RIMEXOLONE Red
RIOCIGUAT Do not prescribe Pulmonary hypertension
RISANKIZUMAB (Skyrizi®) Red Moderate to severe plaque psoriasis

In line with NICE TA596

RISEDRONATE SODIUM Green Osteoporosis

In line with NICE TA 464

RISPERIDONE LONG-ACTING INJECTION (Risperdal Consta®) Orange Schizophrenia and other psychoses in patients tolerant to oral risperidone.

Full SCA

RISPERIDONE Oral Orange 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.

Full SCA

RITONAVIR Red
RITUXIMAB Red Prevention and management of delayed haemolytic transfusion reactions and hyperhaemolysis in patients with haemoglobinopathies
RITUXIMAB Red Immunobullous diseases

In line with NHS England policy

RITUXIMAB Red Lymphoma, Rheumatoid arthritis
RIVAROXABAN Yellow Cardioversion
RIVAROXABAN (UPDATED) Yellow ACS

In line with NICE TA335

RIVAROXABAN Green Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation
RIVAROXABAN Do not prescribe Prevention of VTE in adults undergoing hip or knee replacement
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

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 SOLUTION FOR INJECTION (Evenity®) Grey Severe osteoporosis in postmenopausal women at high risk of fracture

Not yet reviewed

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 Orange Parkinson's disease, Restless Legs Syndrome and other limb movement disorders

Click on drug name for further details

Full SCA

RUFINAMIDE Yellow Lennox-Gastaut syndrome in patients aged over 4 years
RURIOCTOCOG ALFA PEGOL (Adynovi®) Grey Treatment and prophylaxis of bleeding in patients with haemophila A

Not yet reviewed

RUXOLITINIB Red
SACUBITRIL / VALSARTAN (Entresto®) Yellow Heart failure

For background and information and monitoring requirements, (in line with ACEI/ARB monitoring for heart failure), please see interim information whilst the heart failure guide is being updated.

 

SAFINAMIDE (Xadago®) Yellow Parkinson’s Disease
Salmeterol and Fluticasone inhalation powder (Fixkoh Airmaster®) Grey Asthma and COPD

Not yet reviewed

SAPROPTERIN (NEW) 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 Psoriatic arthritis

In line with NICE TA 445

SECUKINUMAB Red Psoriasis

In line with NICE TA 350

SECUKINUMAB Red Ankylosing spondylitis.

Use in line with NICE TA 407

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

In line with NICE TA719

Implementation date 21st October 2021

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

In line with NICE TA734

Implementation date  7th January 2022

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(Ozempic®) injection Yellow GLP 1 analogue

Simple amber if prescriber not competent to select appropriate patients

SERTRALINE Yellow Mental health indications as per the children’s BNF for children and young people
SEVELAMER Yellow Hyperphosphataemia
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®
Guidance For Use

SILK GARMENTS Do not prescribe Skin
SIMEPREVIR Red Hepatitis C
SIMPLE EYE OINTMENT (UPDATED) 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 (UPDATED) 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 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 SR (Episenta®) Do not prescribe Epilepsy

Not approved by local committee

SODIUM ZIRCONIUM CYCLOSILICATE (Lokelma®) Red Hyperkalaemia

In line with NICE TA599.

 

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

In line with Male LUTS Pathway

SOLRIAMFETOL (Sunosi ®) (UPDATED) Red Excessive daytime sleepiness in narcolepsy
SOLRIAMFETOL (Sunosi ®) (UPDATED) Red Residual sleepiness in optimally CPAP treated obstructive sleep apnoea
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

Full SCA

STAVUDINE Do not prescribe
STRIBILD Red HIV
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

Full SCA     Request form

SULFASALAZINE Red Inflammatory Bowel Disease in Paediatrics
SULFASALAZINE ORAL & RECTAL Orange Ulcerative colitis and Crohn's disease

Shared care request is mandatory
Full SCA

SULPIRIDE Green Schizophrenia

If for use in schizophrenia or psychoses–to be initiated after discussion with specialist

SUNITINIB Red
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 Yellow Ocular lubricants
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
TACROLIMUS SR (Envarsus®) Red Prophylaxis of transplant rejection in adult kidney transplants
TADALAFIL Do not prescribe Benign prostatic hyperplasia
TADALAFIL Green Erectile dysfunction

For patients who have not responded to sildenafil or to vardenafil. Daily dose not supported

TADALAFIL (Adcirca®) Do not prescribe Pulmonary arterial hypertension
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)
TEDIZOLID PHOSPHATE tablets and infusion (Sivextro®) Grey Skin infection

Not yet reviewed

TEDUGLUTIDE injection Grey Short bowel syndrome

Not yet reviewed

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
TENOFOVIR Red
TENOFOVIR / EMTRICITABINE (Truvada®) Red
TENOFOVIR ALAFENAMIDE (Vemlidy®) Grey Hepatitis B

New formulation
Not yet reviewed

TERIFLUNOMIDE Red Multiple sclerosis

In line with NICE TA 303

TERIPARATIDE Red Osteoporosis in men and women
TESTOSTERONE Orange Replacement therapy in children and adolescents

Full SCA

TESTOSTERONE Orange Adult male hypogonadism

Full SCA

 

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*)
(NB no formal SCA in place but written guidance from specialist)
Gender dysphoria services: a guide for GPs and other healthcare professionals

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
THALIDOMIDE Red Angiodysplasias

Historical entry to match formulary

THALIDOMIDE Do not prescribe Multiple myeloma
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 LA Gel-Forming Eye Drops Red Small infantile haemangiomas

In line with GOSH guidance

TIOGUANINE Red
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 Red HIV infection
TIPRANAVIR Red
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
Not yet reviewed

TOBRAMYCIN inhalation Red Cystic fibrosis
TOBRAMYCIN injection 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 Rheumatoid arthritis

In line with NICE  TA247

Both the intraveneous and subcutaneous preparations are RED

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 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 (NEW) Red Juvenile idiopathic arthritis

In line with NICE TA735

Implementation date 20th January 2022

TOFACITINIB Red Moderate to Severe Rheumatoid Arthritis

In line with NICE TA 480

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®) Do not prescribe Hyponatraemia secondary to SIADH
TOPIRAMATE Green Migraine
TOPIRAMATE Yellow Epilepsy
TOPIRAMATE Yellow Idiopathic Intracranial hypertension
TOPOTECAN Red
TRALOKINUMAB (Adtralza ®) (NEW) Grey Treatment of moderate-to-severe atopic dermatitis in adult

Not yet reviewed

TRAMADOL Green Severe pain

Including SR tablets

TRAMADOL HYDROCHLORIDE / DEXKETOPROFEN (Skudexa®) Do not prescribe Pain
TRANSDERMAL ESTRADIOL SPRAY (Lenzetto®) (NEW) Green Symptoms of menopause
TREOSULFAN Red
TRI-IODOTHYROACETIC ACID (TRIAC) (Emcitate®) (NEW) 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
TRIFLURIDINE 1% eye drops Red
TRIPLE BROMIDES Do not prescribe Intractable epileptic seizures

Not approved by local committee

TRIPTORELIN Yellow Endometriosis, uterine fibroids
TRIPTORELIN Yellow Precocious puberty

GP Guidance

TRIPTORELIN Green Prostatic carcinoma

GP can give first injection to patients in whom anti-androgen treatment has been started by secondary care clinician.

Local guidance

TROSPIUM (immediate release) Green Urinary frequency, urgency and incontinence
TROSPIUM XL Do not prescribe Urinary incontinence
TYPICAL ORAL ANTIPSYCHOTICS Green See individual entries

If used for schizophrenia or psychoses to be initiated only after diagnosis and advice to use typical antipsychotic has been discussed with specialist (green for other licensed indications)

UBIQUINONE Q10 Do not prescribe Statin-induced myopathy

Not approved by local committee

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®) (NEW) Red Moderate rheumatoid arthritis in adults

In line with NICE TA744

Implementation date 10th February 2022

UPADACITINIB (Rinvoq®) Red Rheumatoid arthritis

In line with NICE TA665

UROFOLLITROPIN(Fostimon®) Red IVF
USTEKINUMAB Red Plaque psoriasis

Supported by NICE

USTEKINUMAB Red Crohns

In line with NICE TA 456

USTEKINUMAB Red Psoriatic arthritis

NICE TA 340

USTEKINUMAB Red Plaque psoriasis in children

In line with NICE TA 455

USTEKINUMAB (Stelara®) Red Moderate to severe ulcerative colitis

In line with NICE TA633

 

USTEKINUMAB (Stelara®) Red Psoriasis
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 Green Smoking cessation

Alternative option to NRT or buproprion subject to patient using accredited smoking cessation services

VEDOLIZUMAB Red Ulcerative colitis and Crohn's disese
VEMURAFENIB Red
VENLAFAXINE Green Depression - low dose (<300mg)
VENLAFAXINE Orange Treatment resistant depression - high dose (≥300mg)

Full SCA     Request form

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

Not yet reviewed

VIGABATRIN (UPDATED) 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
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
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

Third line option

VSL#3 Do not prescribe Probiotic
YASMIN® Green Contraception

NOTE: More expensive, with no evidence of significant advantages, compared to other similar OCs.

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.) Orange Schizophrenia

Full SCA     Request form

ZUCLOPENTHIXOL ORAL Green Schizophrenia and other psychoses

If used for schizophrenia or psychoses to be initiated only after diagnosis and advice to use typical antipsychotic has been discussed with specialist

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 or recommended by a specialist service for prescribing in primary care which do not require initiation or ongoing oversight by the specialist. There are no specific paperwork requirements between provider organisations and a verbal request may be acceptable through advice and guidance as long enough information is provided so that the transfer of care is safe.

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.

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