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NHS Bath and North East Somerset, Swindon and Wiltshire CCG
Royal United Hospitals Bath NHS Foundation Trust
Great Western Hospitals NHS Foundation Trust
Salisbury NHS Foundation Trust
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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...
02.08.01  Expand sub section  Parenteral anticoagulants
Argatroban 
(Infusion)
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Formulary
Red
  • 1mg/ml soultion for infusion vials
  • Restricted for use on the advice of a Haematologist for the treatment/prophylaxis of thromboembolic disease in patients with a history of heparin-induced thrombocytopenia
  • Used in preference to danaparoid in patients with moderate renal impairment
 
   
02.08.01  Expand sub section  Heparin
Heparin 
(Injection)
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Formulary
  • Note - variation in TLS across trusts. See individual prescribing policies
  • 1000iu/ml 5ml amps, 5ml vials (contains preservative), 10ml amps, 20ml amps
  • 25000iu/ml – 5000iu/0.2ml amps, 125000iu/5ml vials (contains preservative)

 

 

 

 
   
02.08.01  Expand sub section  Low molecular weight heparins
Dalteparin 
(Injection)
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Formulary
  • Note - variation in TLS across trusts and also according to indication. See individual prescribing policies.
  • Pre filled syringes 2,500iu/0.2ml, 5000iu/0.2ml, 7,500iu/0.3ml, 10,000iu/0.4ml, 12,500iu/0.5ml, 15,000iu/0.6ml, 18,000iu/0.72ml for subcutaneous injection

 

 

 
Link  BCAP SCA Dalteparin for the extended treatment of DVT / PE in patients with an underlying malignancy
Link  RUH (BaNES) Guideliness for prophylaxis and treatment of VTE
Link  SFT (Salisbury Foundation Trust) Guidelines and SCA for prescribing of dalteparin
   
02.08.01  Expand sub section  Heparinoids
Danaparoid 
(Injection)
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Formulary
Red
  • SFT and GWH only and restricted for use on the advice of a haematologist for the treatment/prophylaxis of thromboembolic disease in patients with a history of heparin-induced thrombocytopenia
  • Non formulary at RUH
  • 750 units/0.6ml solution for injection ampoules
 
   
02.08.01  Expand sub section  Hirudins to top
Bivalirudin 
(Injection)
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Formulary
Red
  • Injection, powder for reconstitution 250mg vial
  • Anticoagulation during PCI

 

 
Link  NICE TA230 : Bivalirudin for the treatment of STEMI, 2011
   
02.08.01  Expand sub section  Heparin flushes
Heparin Sodium 
(IV Flushing Solution)
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Formulary
  • 50units/5ml and 200units/2ml IV Flushing Solution for maintenance of patency of IV devices 

Red  Prescribing of Heparin Sodium IV flushing solutions should be retained by secondary care except in the instances below.

Amber In BaNES - Heparin Sodium IV flushing solution 200units/2mL is AMBER TLS when recommended by IV nurse specialist and when prescribed in line with BCAP Safe Prescribing Guidance  LINK BELOW 

Also AMBER TLS in Swindon when used as per GWH Line Insertion Service.

 
Link  BaNES Heparin Sodium IV flushing solution - Safe Prescribing Guidance
   
Taurolidine, heparin and citrate
(Taurolock Hep-500)
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Formulary
Red
  • GWH - ONLY for use ITU to lock vascaths.
  • SFT - May occasionally be used for dialysis portacaths. This should be prescribed on the prescription chart. It is supplied by the dialysis unit. No other preparations will be routinely stocked. Any remaining stock ordered for individual patients should be returned to pharmacy when no longer needed.

 

 
   
02.08.01  Expand sub section  Epoprostenol
Epoprostenol 
(Infusion)
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Formulary
Red
High Cost Medicine
  •  Powder for reconstitution 500 micrograms
 
   
02.08.01  Expand sub section  Fondaparinux
Fondaparinux 
(Injection)
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Formulary

Red RUH and SFT (and GWH for acute coronary syndrome)

Amber at GWH/Swindon for VTE if dalteparin unsuitable

  • See individual trust prescribing guidelines
 
   
 ....
 Non Formulary Items
Bemiparin 

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Non Formulary
 
Canusal


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Non Formulary
 
Enoxaparin 

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Non Formulary
 
Hepsal


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Non Formulary
 
Lepirudin 
(Injection)

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Non Formulary
 
Tinzaparin 

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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

Red

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

Amber

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

Amber 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.  

Green

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

Self

Suitable for patient to be directed to buy themselves  

Grey

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

Black

Not currently used. We intend to include this TLS in future to highlight where a decision has been made by either or both the local or national NHS not to routinely commission this preparation for its licensed indications. Do not prescribe.  

Red 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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