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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...
02.09  Expand sub section  Antiplatelet drugs
Aspirin (antiplatelet)

(Tablet)
View adult BNF View SPC online
First Choice
Green
  • Dispersible tablets 75mg
  • Dispersible tablets 300mg
  • Suppositories 300mg 

 

 

 
Abciximab 
(Injection)
View adult BNF View SPC online
Formulary
Red
  • GWH and SFT only
  • Non formulary at RUH
  • 10mg in 5ml
  • Adjunct in percutaneous coronary intervention
 
   
Clopidogrel 
(Tablet )
View adult BNF View SPC online
Formulary
Green
  • 75mg
 
Link  MHRA DSU Dec 2014: Clopidogrel and proton pump inhibitors: interaction—updated advice
   
Dipyridamole 
View adult BNF View SPC online
Formulary
Green
  • 100mg tablet
  • 200mg MR capsule
 
   
Prasugrel 
(Tablet)
View adult BNF View SPC online
Formulary
Amber
  •  5mg, 10mg
  • Initiated by a cardiologist in line with NICE and also for patients who otherwise would be treated with clopidogrel but who are intolerant/allergic to clopidogrel.
  • The treatment period for prasugrel should not exceed 12 months.
  • Prasugrel should not be used in patients at increased risk of bleeding, in patients who are 75 years or older or body weight less than 60kg
  • Prasugrel in combination with aspirin is recommended as an option for preventing blockages in the arteries of people with ACS who are having a PCI only when:
    • immediate PCI is necessary to treat an STEMI or
    • a blood clot has blocked a stent during treatment with clopidogrel or
    • the patient has diabetes mellitus.
 
Link  NICE TA317 (replaces TA182): Acute coronary syndrome - prasugrel
   
Ticagrelor 
(Tablet)
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Formulary
Amber
  • 90mg tablets
  • Consultant cardiologist initiated in line with NICE TA below. 
  • Treatment with ticagrelor will continue for 12 months
  • Ticagrelor in combination with aspirin is available as an alternative to prasugrel or clopidogrel for:
  • Patients allergic to clopidogrel and prasugrel
  • Patients that have had a stent thrombosis on prasugrel
  • Patients with resistance to treatment with clopidogrel and prasugreL
  • Patients with STEMI– defined as ST elevation or new left bundle branch block on electrocardiogram – that cardiologists intend to treat with primary percutaneous coronary intervention (PCI)
  • 60mg tablets
  • Consultant cardiologist initiated in line with NICE TA below.
  • Used in combination with aspirin, it is recommended within its marketing authorisation as an option for preventing atherothrombotic events in adults who had a myocardial infarction and who are at high risk of a further event.
  • Treatment should be stopped when clinically indicated or at a maximum of 3 years
 
Link  NICE TA236: Ticagrelor for the treatment of acute coronary syndromes
Link  NICE TA420: Ticagrelor for preventing atherothrombotic events after myocardial infarction
   
Tirofiban 
(Infusion )
View adult BNF View SPC online
Formulary
Red
  • 50mg/2ml 250ml bag
 
   
 ....
 Non Formulary Items
Cangrelor 

View adult BNF View SPC online
Non Formulary
Link  NICE TA351: Reducing Artherothrombotic Events
 
Clopidogrel (Grepid®)

View adult BNF View SPC online
Non Formulary
 
Clopidogrel 300mg (Plavix®)

View adult BNF View SPC online
Non Formulary
 
Dipyridamole and Aspirin

(Capsule)

View adult BNF View SPC online
Non Formulary
 
Eptifibatide (Integrilin®)

View adult BNF View SPC online
Non Formulary
 
Vorapaxar (Zontivity®)

View adult BNF View SPC online
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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