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Royal United Hospitals Bath NHS Foundation Trust
Great Western Hospitals 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...
02.12  Expand sub section  Lipid-regulating drugs
 note 

BSW STP PCSK9 inhibitors (evolocumab and alirocumab) Blueteq treatment pathway

02.12  Expand sub section  Bile acid sequestrants
02.12  Expand sub section  Ezetimibe
02.12  Expand sub section  Fibrates
02.12  Expand sub section  Statins to top
Atorvastatin 
(Tablet)
View adult BNF View SPC online
First Choice
Green
  • 10mg, 20mg, 40mg, 80mg
  • Primary Prevention: New patients offer atorvastatin 20 mg for the primary prevention of CVD to people who have a 10% or greater 10 year risk of developing CVD. Estimate the level of risk using the QRISK2 assessment tool as per NICE CG below.
  • Secondary Prevention: New patients start statin treatment in people with CVD with atorvastatin 80 mg. Use a lower dose of atorvastatin if any of the following apply: potential drug interactions, high risk of adverse effects, patient preference as per NICE CG below.
  • Primary prevention for people with type 1 diabetes as per NICE CG below, start treatment for adults with type 1 diabetes with atorvastatin 20 mg.
  • Primary prevention for people with type 2 diabetes as per NICE CG below, Offer atorvastatin 20 mg to people who have a 10% or greater 10?year risk of developing CVD using the QRISK2 assessment tool
 
Pravastatin  
(Tablet)
View adult BNF View SPC online
Formulary
Green
  • 10mg, 20mg, 40mg
 
   
Rosuvastatin 
(Tablet)
View adult BNF View SPC online
Formulary
Green
  • 5mg, 10mg, 20mg, 40mg
  • Not licensed for secondary prevention
 
   
Simvastatin 
(Tablet)
View adult BNF View SPC online
Formulary
Green
  • 10mg, 20mg, 40mg
  • Maximum recommended dose for simvastatin in combination with amlodipine or diltiazem is 20 mg/day
 
Link  MHRA DSU Dec 2014: Simvastatin: updated advice on drug interactions
   
 ....
 Non Formulary Items
Fluvastatin (Lescol®)

View adult BNF View SPC online
Non Formulary
 
Fluvastatin (Lescol® XL)

View adult BNF View SPC online
Non Formulary
 
Simvastatin and Ezetimibe
(Inegy)

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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