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 Formulary Chapter 2: Cardiovascular system - Full Chapter
Notes:
 

Cardiology-related Prescribing Guidance

Please see our Prescribing Guidelines page for all prescribing guidance relating to this chapter.

Cardiology-related Shared Care Agreements

Please see our Shared Care Agreements page for all shared care agreements (SCAs) relating to this chapter.

 

 Details...
02.05.01  Expand sub section  Vasodilator antihypertensive drugs
Bosentan
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • Formulary at RUH and SFT (under shared care with Southampton)
  • Tablets 62.5mg, 125mg
  • For digitial ischaemia and ulceration in Raynaud's Disease and scleroderma as per NHSE policy below within Specialist Centres
 
Link  NHSE Clinical Commissioning Policy: Sildenafil and bosentan for the treatment of digital ulceration in systemic sclerosis Jan 2015
 
Hydralazine
(Tablet, Injection)
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Formulary
traffic lightAmber
  • Tablets 25mg, 50mg
  • Injection 20mg ampoule
  • Note: Hydralazine may be used in combination with long acting nitrates in moderate to severe chronic congestive cardiac failure when an ACE inhibitor is contra-indicated or not tolerated.
  • Note: Hydralazine injection is Red at RUH

 

 
 
Iloprost injection
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • When used for digitial ischaemia and ulceration in Raynaud's Disease and scleroderma as per NHSE policy below within Specialist Services
 
Link  NHSE Clinical Commissioning Policy: Sildenafil and bosentan for the treatment of digital ulceration in systemic sclerosis Jan 2015
 
Sildenafil
(digital ulcers and connective tissue disorders)
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Formulary
traffic lightAmber with Shared Care
  • 25mg and 50mg tablets (do not prescribe diffferent strengths)
  • Used outside product license for digitial ischaemia and ulceration in Raynaud's Disease and scleroderma as per NHSE policy below and BSW SCA 
  • It is recommended that the indication (Raynaud’s / Digital ulceration) is clarified on the prescribing system to avoid confusion over use.
  • For use in erectile dysfunction see section 7.4.5
 
Link  BSW SCA Sildenafil for Digital Ulceration and Severe Raynaud’s (unlicensed indication)
Link  NHSE Clinical Commissioning Policy: Sildenafil and bosentan for the treatment of digital ulceration in systemic sclerosis Jan 2015
Link  MHRA Drug Safety Update (Nov 2018): Sildenafil (Revatio and Viagra): reports of persistent pulmonary hypertension of the newborn (PPHN)
 
Sodium nitroprusside (Injection)
Unlicensed Drug Unlicensed
traffic lightRed
  • 50mg vial
  • Strictly Consultant Cardiologist use only.
 
 
 ....
 Non Formulary Items
Ambrisentan

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Non Formulary
Red
High Cost Medicine
NHS England
 
Bosentan

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Non Formulary
Red
High Cost Medicine
NHS England
 
Diazoxide
(Eudemine®)

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Non Formulary
 
Iloprost injection

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Non Formulary
Red
High Cost Medicine
NHS England
 
Iloprost nebules
(Vantavis)

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Non Formulary
 
Minioxidil
(Loniten®)

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Non Formulary
 
Minoxidil
(Tablet)

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Non Formulary

 

 

 
Riociguat (Adempas)

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Non Formulary
High Cost Medicine
 
Sildenafil (Revatio )

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Non Formulary
High Cost Medicine
NHS England
 
Sildenafil (Revatio )

View adult BNF View SPC online
Non Formulary
High Cost Medicine
NHS England
 
Sildenafil (Revatio)
(pulmonary hypertension)

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Non Formulary
High Cost Medicine
 
Sitaxentan Sodium
(Thelin)

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Non Formulary
 
Tadalafil (Adcirca)
(Pulmonary hypertension)

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Non Formulary
High Cost Medicine
 
Tolazoline

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Non Formulary
 
  
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 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
Blueteq
High Cost Drug Approval System

Traffic Light Status Information

Status Description

Traffic LightRed

RED - Hospital only to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.  

Traffic LightAmber

Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.  

Traffic LightAmber with Shared Care

Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.  

Traffic LightGreen

These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.  

Traffic LightSelf

Suitable for patient to be directed to buy themselves  

Traffic LightGrey

Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.   

Traffic LightBlack

(In use from Oct 2020) Used where a decision has been made by the BSW APC not to routinely commission this preparation for its licensed indications. Do not prescribe.   

Traffic LightRed Specialist Centre

Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.  

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