netFormulary North of Tyne and Gateshead Area Prescribing Committee NHS
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 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.05.01  Expand sub section  Vasodilator antihypertensive drugs
Hydralazine
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Formulary
Green
 
   
Minoxidil
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Formulary
Green plus
  • Treatment should only be on the advice of a cardiologist/nephrologist.
 
   
Diazoxide
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Formulary
Red
 
   
Sodium nitroprusside
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Formulary
Red
  • unlicensedunlicensed import
 
   
Ambrisentan
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Red
High Cost Medicine
  • Approved for pulmonary hypertension - in accordance with NHS England Commissioning policy. 
 
Link  Targeted Therapies for use in Pulmonary Hypertension in Adults
   
Bosentan
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Formulary
Red
High Cost Medicine
  • Approved for pulmonary hypertension - in accordance with NHS England Commissioning policy.
  • Approved for systemic sclerosis with ongoing digital ulcer disease (to reduce number of new digital ulcers) - in accordance with NHS England Commissioning policy.
 
Link  Sildenafil and Bosentan for the Treatment of Digital Ulceration in Systemic Sclerosis
Link  Targeted Therapies for use in Pulmonary Hypertension in Adults
   
Epoprostenol
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Formulary
Red
High Cost Medicine
  • Approved for pulmonary hypertension - in accordance with NHS England Commissioning policy. 
 
Link  Targeted Therapies for use in Pulmonary Hypertension in Adults
   
Iloprost
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Formulary
Red
High Cost Medicine
  • Approved for pulmonary hypertension - in accordance with NHS England Commissioning policy. 
 
Link  Targeted Therapies for use in Pulmonary Hypertension in Adults
   
Macitentan
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Formulary
Red
High Cost Medicine
  • Approved for pulmonary hypertension - in accordance with NHS England Commissioning policy. 
 
Link  Targeted Therapies for use in Pulmonary Hypertension in Adults
   
Riociguat
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Formulary
Red
High Cost Medicine
  • Approved for Chronic Thromboembolic Pulmonary Hypertension - in accordance with NHS England Commissioning policy. 
 
Link  Clinical Commissioning Policy: Riociguat for pulmonary arterial hypertension Reference: NHS England: 16055/P
Link  Targeted Therapies for use in Pulmonary Hypertension in Adults
   
Sildenafil
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Formulary
Red
  • 20mg tablets
  • 25mg, 50mg & 100mg tablets unlicensedunlicensed indication
  • Approved for pulmonary hypertension - in accordance with NHS England Commissioning policy. 
  • Approved for systemic sclerosis with ongoing digital ulcer disease (to reduce number of new digital ulcers) - in accordance with NHS England Commissioning policy.
  • Approved for secondary Raynaud's.

 

 
Link  Targeted Therapies for use in Pulmonary Hypertension in Adults
   
Tadalafil
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Formulary
Red
  • Approved for pulmonary hypertension in adults for whom treatment with sildenafil is not tolerated or effective (in accordance with NHS England Commissioning policy).
  • Approved for systemic sclerosis with ongoing digital ulcer disease (to reduce number of new digital ulcers) - in accordance with NHS England Commissioning policy.
  • Approved for secondary Raynaud's.
 
Link  Targeted Therapies for use in Pulmonary Hypertension in Adults
   
Treprostinil
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Unlicensed Drug Unlicensed
Red
  • Approved for pulmonary hypertension - in accordance with NHS England Commissioning policy. 
 
Link  Targeted Therapies for use in Pulmonary Hypertension in Adults
   
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red

Drugs for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician and the drug should be supplied through the hospital throughout the duration of treatment. In some very exceptional circumstances (e.g. due to distance from the hospital, storage, supply or mobility/transport problems) it may be appropriate for the GP to be asked to prescribe a Red drug. This should be negotiated on an individual patient basis and should only be done with the GP’s prior informed agreement where the roles of the GP and hospital services are clearly defined and agreed. The GP should not feel under pressure to prescribe in these circumstances.   

Amber

Drugs initiated by hospital specialist, but where continuing treatment by GPs may be appropriate under a shared care arrangement. The specialist should send the GP a copy of the shared care agreement to sign. The GP should sign the shared care agreement, or indicate they do not want to be part of such an agreement, and return a copy back to the specialist. Shared care guidelines are available or are being developed for most of the drugs listed as Amber. If no shared care guideline is available, the hospital specialist should provide the patient’s GP with sufficient information and support to allow treatment to be continued and managed safely in primary care.  

Green plus

Drugs normally recommended or initiated by hospital specialist, but where the provision of an information leaflet may be appropriate to facilitate continuing treatment by GPs. Many of these information sheets are in the process of development.  

Green

Drugs where prescribing by GPs is appropriate. Drugs not classified as Red, Amber or Green Plus (formerly blue in North of Tyne) are generally classified as ‘Green’ by default. The Green drugs listed here include those products normally initiated by hospital specialists where there was a need for discussion and debate as to the category in which they should be placed.  

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