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Royal United Hospitals Bath NHS Foundation Trust
Great Western Hospitals NHS Foundation Trust
Salisbury NHS Foundation Trust
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 Formulary Chapter 6: Endocrine system - Full Chapter
Notes:

Endocrine-related Prescribing Guidance

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

Endocrine-related Shared Care Agreements

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

 

 Details...
06.04.01.01  Expand sub section  Oestrogens and HRT
 note 

BSW HRT Formulary Treatment options

Sep 2019 - Prescribing Advice - New HRT Risk Data

Combined continuous HRT
(Evorel® Conti)
(patch)
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Formulary
traffic lightGreen
  • Patches 50 micrograms estradiol 170 micrograms norethisterone
  • Change Twice a week
 
 
Combined continuous HRT
(Femoston Conti)
( Tablet)
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Formulary
traffic lightGreen
  • 1mg estradiol + 5mg dydrogesterone
  • 0.5mg estradiol + 2.5mg dydrogesterone (low dose)

 

 
 
Combined continuous HRT (Kliofem)
(Tablet)
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Formulary
traffic lightGreen
  • 2mg estradiol and 1mg norethisterone
  • 1 prescription charge. 
 
 
Combined continuous HRT (Kliovance)
( Tablet)
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Formulary
traffic lightGreen
  • estradiol 1mg and norethisterone acetate 500micrograms
 
 
Combined continuous HRT
(Premique low dose)
( Tablet)
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Formulary
traffic lightGreen
  •  300 micrograms conj. oestrogens and 1.5mg medroxyprogesterone acetate
 
 
Combined cyclical HRT
(Elleste-Duet®)
(Tablet)
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Formulary
traffic lightGreen
  • Tablets estradiol (1mg, 2mg) with 1mg norethisterone acetate
  • 2 prescription charges
 
 
Combined cyclical HRT
(Evorel® Sequi)
(Patch)
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Formulary
traffic lightGreen
  • Patches 50 micrograms estradiol and 170 micrograms norethisterone acetate
  • Change patch Twice a week
 
 
Combined cyclical HRT (Femoston®)
(Tablet)
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Formulary
traffic lightGreen
  • Tablets (1mg or 2mg) estradiol with 10mg dydrogesterone 
 
 
Oestrogen only HRT (Elleste-Solo®)
( Tablet)
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Formulary
traffic lightGreen
  • estradiol (1mg, 2mg)
  • 1 prescription charge

 

 
 
Oestrogen only HRT (Estradot)
(Patch)
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Formulary
traffic lightGreen
  • estradiol (25, 37.5, 50, 75, 100 micrograms)
  • Change twice a week.

 

 
 
Oestrogen only HRT (Evorel)
( Patch)
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Formulary
traffic lightGreen
  • estradiol (25 micrograms, 50 micrograms, 75 micrograms, 100 micrograms)
  • Change twice a week.

 

 
 
Oestrogen only HRT (Oestrogel)
( Gel)
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Formulary
traffic lightGreen
  • 0.06% oestradiol gel
  • 0.75mg estradiol per measure, 2 measures=standard regime

 

 
 
Oestrogen only HRT (Premarin)
(Tablet)
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Formulary
traffic lightGreen
  •  conjugated oestrogens (300 micrograms, 625 micrograms, 1.25 milligram)
  • 1 prescription charge
 
 
Oestrogens for HRT
(Elleste-Duet Conti®)
(Tablet)
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Formulary
traffic lightGreen
  •  2mg estradiol and 1mg norethisterone
  • 1 prescription charge. 

 

 
 
Oestrogens for HRT (Indivina)
(Tablet)
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Formulary
traffic lightGreen
  • Estradiol valerate 1mg /Medroxyprogesterone 2.5mg
  • Estradiol valerate 1mg /Medroxyprogesterone 5mg

 

 

 

 
 
Tibolone (Livial®)
(Tablet)
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Formulary
traffic lightGreen
  • 2.5mg
 
 
Oestrogens for HRT
(Progynova®)
(Tablet)
View adult BNF View SPC online
Formulary
traffic lightRed
  • RUH only Specialist use fertility treatment (not HRT)
  • Not on formuary in Salisbury or Swindon.
  • 1mg or 2mg estradiol valerate
 
 
06.04.01.01  Expand sub section  Ethinylestradiol
Ethinylestradiol
(Oral)
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Formulary
  • Green Bath
  • Amber Swindon and Salisbury 
  • Tablets 10 micrograms, 50 micrograms, 1mg.
  • Red 2 microgram strength is an unlicensed unlicensed special.
  • Licensed for short term use for short term treatment of oestrogen deficiency, female hypogonadism and menstrual disorders.
  • Also used for treatment of  gender dysphoria 

Note: Ethinylestradiol tablets are very expensive consider using estradiol where clinically appropriate as a more cost effective option.

 
 
06.04.01.01  Expand sub section  Raloxifene
Raloxifene Hydrochloride
(Tablet)
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Formulary
traffic lightGreen
  • 60mg       
  • Raloxifene is licensed for the treatment and prevention of postmenopausal osteoporosis; unlike HRT therapy, raloxifene does not reduce menopausal vasomotor symptoms.
  • NICE Guidance (TA161) recommends Raloxifene as an alternative treatment option in osteoporosis, under the certain circumstances.    

 

 
Link  Raloxifene and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women
 
06.04.01.01  Expand sub section  Oestrogen only tablets
 ....
 Non Formulary Items
Oestrogens for HRT
(Cyclo-Progynova®)
(Tablet)

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

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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