netFormulary Central Lancashire Formulary NHS
Lancashire Teaching Hospitals NHS Foundation Trust
Chorley and South Ribble CCG
Greater Preston CCG
 
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 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.01  Positive inotropic drugs
02.01.01  Cardiac glycosides
Digoxin
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Green
 
   
Digoxin-specific antibody fragments 40mg (DigiFab)
(powder for solution for infusion)
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Formulary
Red
 
   
02.01.02  Phosphodiesterase type-3 inhibitors
02.02  Diuretics
02.02.01  Thiazides and related diuretics to top
Bendroflumethiazide
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Green
 
   
Indapamide
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Formulary
Green
 
   
Metolazone
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Unlicensed Drug Unlicensed
Amber
 
   
02.02.02  Loop diuretics
Bumetanide
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Green
 
   
Furosemide
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Green
 
   
02.02.03  Potassium-sparing diuretics and aldosterone antagonists
Amiloride Hydrochloride
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Green
 
   
02.02.03  Aldosterone antagonists
Spironolactone
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Green
 
   
Eplerenone
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Formulary
Amber
 
Link  NICE CG108: Chronic heart failure
   
02.02.04  Potassium-sparing diuretics with other diuretics
Co-amilofruse (furosemide and amiloride)
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Green
 
   
02.02.05  Osmotic diuretics to top
Mannitol
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Red
 
   
02.02.06  Mercurial diuretics
02.02.07  Carbonic anhydrase inhibitors
02.02.08  Diuretics with potassium
02.03  Anti-arrhythmic drugs
02.03.01  Management of arrhythmias to top
02.03.02  Drugs for arrhythmias
02.03.02  Supraventricular arrhythmias
Adenosine (Adenocor®)
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Formulary
Red
 
   
Dronedarone (Multaq®)
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Amber
 
Link  NICE TA197: Atrial fibrillation - dronedarone
Link  NHS England: Items which should not be routinely prescribed in Primary Care
   
02.03.02  Supraventricular and ventricular arrhythmias
Amiodarone
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Formulary
Amber
 
Link  Drug Safety Update August 2015: Simeprevir with sofosbuvir: risk of severe bradycardia and heart block when taken with amiodarone
Link  NHS England: Items which should not be routinely prescribed in Primary Care
   
Disopyramide
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Formulary
Amber
 
   
Flecainide
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Formulary
Amber
 
   
Propafenone
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Formulary
Amber
 
   
02.03.02  Ventricular arrhythmias
02.04  Beta-adrenoceptor blocking drugs to top
Atenolol
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Green
 
   
Bisoprolol
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Formulary
Green
 
   
Carvedilol
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Green
 
   
Labetalol
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Green
 
   
Nebivolol (Nebilet®)
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Amber
 
   
Propranolol
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Green
 
   
Sotalol
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Amber
 
   
Esmolol
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Red
 
   
02.05  Drugs affecting the renin-angiotensin system and some other antihypertensive drugs
02.05.01  Vasodilator antihypertensive drugs
Hydralazine
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Amber

injection RED

 
   
Iloprost injection
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Red
High Cost Medicine
 
   
02.05.02  Centrally acting antihypertensive drugs
Clonidine (Catapres®)
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Amber

oral Amber

injection RED

 
   
Methyldopa
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Formulary
Amber
 
   
Moxonidine
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Formulary
Amber
 
   
02.05.03  Adrenergic neurone blocking drugs
02.05.04  Alpha-adrenoceptor blocking drugs to top
Doxazosin
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Green
 
   
02.05.04  Phaeochromocytoma
Phenoxybenzamine Hydrochloride
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Formulary
Amber
 
   
02.05.05  Drugs affecting the renin-angiotensin system
02.05.05  Heart Failure
02.05.05.01  Angiotensin-converting enzyme inhibitors (ACE inhibitors)
Lisinopril (Zestril®)
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Green
 
   
Perindopril erbumine or tert-butylamine
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Green
 
   
Ramipril
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Green
 
   
02.05.05.02  Angiotensin-II receptor antagonists to top
Candesartan
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Green
 
   
Irbesartan
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Green
 
   
Losartan
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Green
 
   
Sacubitril valsartan (Entresto®)
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Amber

Restricted Item Must be stabilised by secondary care before transfer to primary care. Initiated by consultant cardiologist

 
Link  NICE TA388: Sacubitril valsartan for heart failure (updated 16/7/16 to include adoption resources)
   
02.05.05.03  Renin inhibitors
02.06  Nitrates, calcium-channel blockers, and potassium-channel activators
02.06  Angina
02.06.01  Nitrates
Glyceryl Trinitrate
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Formulary
Green

spray and patches

 
   
Glyceryl Trinitrate 50mg/50ml
(solution for infusion)
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Formulary
Red
 
   
Isosorbide Mononitrate
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Green
 
   
02.06.02  Calcium-channel blockers to top
Amlodipine
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Green
 
   
Diltiazem
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Green
 
   
Lercanidipine
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Green
 
   
Nifedipine
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Green
 
   
Verapamil
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Green
 
   
Nimodipine (Nimotop®)
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Red
 
   
02.06.03  Other anitanginal drugs
Ivabradine
(Angina)
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Formulary
Amber
 
Link  Drug Safety Update December 2014: Ivabradine (Procoralan) in the symptomatic treatment of angina: risk of cardiac side effects
Link  Drug Safety Update December 2014: Ivabradine: carefully monitor for bradycardia
Link  NICE CG126: Guidance on Stable Angina (2011)
Link  NICE TA267: Ivabradine for treating chronic heart failure
   
Nicorandil
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Formulary
Green
 
Link  Drug Safety Update January 2016: Nicorandil (Ikorel): now second-line treatment for angina - risk of ulcer complications
   
Ranolazine (Ranexa®)
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Amber
 
Link  NICE CG126: Guidance on Stable Angina (2011)
   
02.06.04  Peripheral vasodilators and related drugs
Naftidrofuryl
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Green
 
Link  NICE CG147: Lower limb peripheral arterial disease management
Link  NICE TA223: Intermittent claudication drugs
   
02.06.04  Other preparations used in peripheral vascular disease
02.07  Sympathomimetics
02.07.01  Inotropic sympathomimetics to top
Dobutamine
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Red
 
   
Dopamine
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Formulary
Red
 
   
Isoprenaline
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Red
 
   
02.07.02  Vasoconstrictor sympathomimetics
Ephedrine
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Formulary
Red
 
   
Metaraminol
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Formulary
Red
 
   
Midodrine
 Track Changes
Formulary
Amber
 
   
Noradrenaline / Norepinephrine
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Formulary
Red
 
   
02.07.03  Cardiopulmonary resuscitation
Adrenaline / Epinephrine 1 in 10,000 (dilute)
(CPR)
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Formulary
Red
 
   
02.08  Anticoagulants and protamine
Idarucizumab (Praxbind®)
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Formulary
Red
 
   
02.08.01  Parenteral anticoagulants
Argatroban (Exembol®)
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Formulary
Red
 
   
02.08.01  Heparin to top
Heparin
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Formulary
Red
 
   
02.08.01  Low molecular weight heparins
Dalteparin
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Formulary
Amber 1
 
   
Enoxaparin
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Formulary
Amber 1
 
   
Tinzaparin
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Formulary
Red
 
   
02.08.01  Heparinoids
Danaparoid (Orgaran®)
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Formulary
Red
 
   
02.08.01  Hirudins
Lepirudin
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Formulary
Red
 
   
02.08.01  Heparin flushes
Heparin
(Flush)
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Formulary
Red
 
   
02.08.01  Epoprostenol to top
Epoprostenol (Flolan®)
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Formulary
Red
High Cost Medicine
 
   
02.08.01  Fondaparinux
Fondaparinux (Arixtra®)
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Formulary
Red
 
   
02.08.02  Oral anticoagulants
Acenocoumarol (Sinthrome®)
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Formulary
Amber
 
   
Apixaban (Eliquis®)
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Formulary
Green

 Prevent of stroke and systemic embolism in people with nonvalvular atrial fibrillation

 
Link  NICE TA245: Apixaban for the prevention of venous thromboembolism after total hip or knee replacement in adults
Link  NICE TA275: Apixaban for AF
   
Dabigatran (Pradaxa®)
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Formulary  
Link  Drug Safety Update September 2008: Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee replacement surgery in adults
Link  NICE TA157: Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee replacement surgery in adults
Link  NICE TA249: Dabigatran for Stroke prevention in AF
   
Edoxaban (Lixiana®)
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Link  NICE TA354: Edoxaban for treating and for preventing deep vein thrombosis and pulmonary embolism
Link  NICE TA355:Edoxaban for preventing stroke/systemic embolism in non‑valvular atrial fibrillation
   
Rivaroxaban (Xarelto®)
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Formulary  
Link  Drug Safety Update July 2019: Rivaroxaban (Xarelto▼): reminder that 15 mg and 20 mg tablets should be taken with food
Link  NICE TA170: Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults
Link  NICE TA256: Rivaroxaban for the prevention of stroke and systemic embolism in people with atrial fibrillation
Link  NICE TA261: Rivaroxaban for the treatment of deep vein thrombosis and prevention of recurrent deep vein thrombosis and pulmonary embolism
Link  NICE TA 287: Rivaroxaban for treating pulmonary embolism and preventing recurrent venous thromboembolism
Link  NICE TA335: Rivaroxaban for preventing adverse outcomes after acute management of acute coronary syndrome
Link  NICE TA 607: Rivaroxaban for preventing atherothrombotic events in people with coronary or peripheral artery disease
   
Warfarin
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Formulary
Green
 
Link  Drug Safety Update July 2016: Warfarin: reports of calciphylaxis
Link  Drug Safety Update September 2017: https://www.gov.uk/drug-safety-update/miconazole-daktarin-over-the-counter-oral-gel-contraindicated-in-patients-taking-warfarin
   
02.08.02  Stroke prevention in AF
02.08.02  VTE treatment
02.08.02  VTE prophylaxis in hip/knee surgery to top
02.08.03  Protamine sulphate
Protamine Sulphate
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Formulary
Red
 
   
02.09  Antiplatelet drugs
Aspirin (antiplatelet)
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Formulary
Green
 
Link  Drug Safety Update October 2009: Aspirin: not licensed for primary prevention of thrombotic vascular disease
   
Clopidogrel
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Formulary
Green
 
Link  Drug Safety Update December 2014: Clopidogrel and proton pump inhibitors: interaction—updated advice
Link  Drug Safety Update December 2014: Clopidogrel: risk of acquired haemophilia
Link  NICE CG172: Myocardial infarction: cardiac rehabilitation and prevention of further cardiovascular disease
Link  NICE CG94: Unstable angina and NSTEMI: early management
   
Dipyridamole 200mg MR (Persantin® Retard)
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Formulary
Green
 
Link  NICE TA210: Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events
   
Prasugrel (Efient®)
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Formulary
Amber
 
Link  Drug Safety Update December 2014: Prasugrel (Efient▼): rare but serious hypersensitivity reactions
Link  Drug Safety Update December 2014: Prasugrel (Efient): increased risk of bleeding
Link  NICE TA317 (replaces TA182): Acute coronary syndrome - prasugrel
   
Ticagrelor (Brilique®)
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Formulary
Amber
 
Link  NICE TA236: Ticagrelor for the treatment of acute coronary syndromes
Link  NICE TA420: Ticagrelor for preventing atherothrombotic events after myocardial infarction
   
Tirofiban (Aggrastat®)
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Red
 
   
02.10  Stable angina, acute coronary syndromes, and fibrinolysis
02.10.01  Management of stable angina and acute coronary syndromes
02.10.02  Fibrinolytic drugs to top
Alteplase (Actilyse®)
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Formulary
Red
 
Link  NICE TA264: Ischaemic stroke (acute) - alteplase
Link  NICE TA52: Thrombolysis in MI
   
Alteplase 2mg (Actilyse Cathflo®)
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Formulary
Red
 
   
Streptokinase
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Formulary
Red
 
   
Tenecteplase (Metalyse®)
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Formulary
Red
 
   
Urokinase
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Red
 
   
02.11  Antifibrinolytic drugs and haemostatics
Tranexamic Acid
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Formulary
Green

Oral

 
   
Tranexamic Acid
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Formulary
Red
Injection 
   
02.11  Blood-related products
Drotrecogin Alfa (Activated) (Xigris®)
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Formulary
Red
 
   
02.12  Lipid-regulating drugs
Alirocumab (Praluent®)
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Formulary
Red
BlueTeq
 
Link  NICE TA393: Alirocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia
   
Evolocumab (Repatha® )
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Formulary
Red
BlueTeq
 
Link  NICE TA394: Evolocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia
   
02.12  Bile acid sequestrants
Colestyramine
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Formulary
Green
 
   
02.12  Ezetimibe to top
Ezetimibe (Ezetrol®)
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Formulary
Green
 
Link  NICE TA385: Ezetimibe for treating primary heterozygous-familial and non-familial hypercholesterolaemia
   
02.12  Fibrates
Bezafibrate
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Formulary
Green
 
   
Fenofibrate
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Formulary
Green
 
   
02.12  Statins
Atorvastatin
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Formulary
Green
 
Link  Drug Safety Update December 2014: Statins: interactions, and updated advice for atorvastatin
   
Rosuvastatin
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Formulary
Green
 
   
Simvastatin
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Formulary
Green
 
Link  Drug Safety Update December 2014: Simvastatin: dose limitations with concomitant amlodipine or diltiazem
Link  Drug Safety Update December 2014: Simvastatin: increased risk of myopathy at high dose (80 mg)
Link  Drug Safety Update December 2014: Statins: risk of hyperglycaemia and diabetes
Link  Drug Safety Update December 2014: Systemic fusidic acid and interaction with statins
   
02.12  Nicotinic acid group
02.12  Omega-3 fatty acid compounds
02.12  PCSK9 inhibitors to top
02.12  Other lipid modifying agents
02.13  Local sclerosants
Sodium Tetradecyl Sulphate (Fibro-Vein®)
 Track Changes
Formulary
Red
 
   
02.14  New Sub Section
 ....
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
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
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

Amber

Suitable for prescribing in primary care following recommendation or initiation by a specialist. Little or no specific monitoring required. Patient may need a regular review, but this would not exceed that required for other medicines routinely prescribed in primary care. Brief prescribing document or information sheet may be required.  

Amber 1

Suitable for prescribing in primary care following recommendation or initiation by a specialist. Minimal monitoring required. Patient may need a regular review, but this would not exceed that required for other medicines routinely prescribed in primary care. Full prior agreement about patient’s on-going care must be reached under the shared care agreement.  

Amber 2

Initiated by specialist and transferred to primary care following a successful initiation period. Significant monitoring required on an on-going basis. Full prior agreement about patient’s on-going care must be reached under the shared care agreement. Suitable for enhanced service.  

Black

NOT recommended for use by the NHS in Lancashire. Includes medicines that NICE has not recommended for use and terminated technology appraisals, unless there is a local need.  

Blue

Products shown as blue have different Traffic Light List classifications dependent on indication. See the accompanying text next to the product for further information  

Green

Appropriate for initiation and ongoing prescribing in both primary and secondary care. Generally, little or no routine drug monitoring is required.  

Purple

Low Priority for Prescribing - see Low Priority for Prescribing Policy  

Red

Medicine is supplied by the hospital for the duration of the treatment course. Primary care initiation or continuation of treatment is not recommended unless exceptional circumstances such as specialist GP.  

Red Specialist Centre

Prescribing restricted to Specialist Centres only  

netFormulary