netFormulary South East London Joint Medicines Formulary NHS
Guy's and St Thomas' NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Lewisham and Greenwich NHS Trust
 
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 Formulary Chapter 2: Cardiovascular system - Full Chapter
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02.06.02  Expand sub section  Calcium-channel blockers
 note  For the use of calcium-channel blockers in the management of stable angina, please refer to NICE clinical guideline 126. Calciumchannel blockers and beta-blockers should be considered as first line treatment options for stable angina.
Amlodipine tabs

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First Choice First-line dihydropyridine calcium channel blocker
Nifedipine caps, m/r tabs, m/r caps

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Diltiazem tabs, m/r tabs, m/r caps

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Verapamil tabs, m/r tabs

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Nimodipine tabs, injection

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Felodipine m/r tabs

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Formulary Second line dihydropyridine calcium channel blocker at LGT (after amlodipine)
   
Lacidipine tabs

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Nicardipine injection

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Restricted Drug Restricted
Red
  • Second line option for severe hypertension (after labetalol) in critical care settings only
  •    
    Nicardipine tabs

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    Flunarizine caps, tabs

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    Restricted Drug Unlicensed Approved for:
  • Intermittent claudication
  • Raynaudís syndrome
  • Prophylaxis of migraine
  • Vertigo

    Protocol for prophyaxis of migraine:
  • Starting dose of 10 mg at night (5mg for patients ≥65 years). Treatment should be discontinued if no significant improvement observed after 2 months.
  • Maintenance treatment should continue at the same daily dose but interrupted by two successive drug-free days every week, e.g. Saturday and Sunday.
  • All patients should have treatment stopped after 6 months and it should only be re-initiated if the patient relapses.
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     ....
    Key
    note Notes First Choice Item First Choice item
    Section Title Section Title (top level) Non Formulary Item Non Formulary section
    Section Title Section Title (sub level)
    Cytotoxic Drug
    Cytotoxic Drug
    Restricted Drug
    Restricted Drug
    CD
    Controlled Drug
    Unlicensed Drug
    Unlicensed
    High Cost Medicine
    High Cost Medicine
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    Link to SPCs
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    Link to adult BNF
    Track Changes
    Display tracking information
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    Cancer Drugs Fund
    Cancer Drugs Fund
       

     

    Traffic Light Status Information

    Status Description
      Red   Specialist Prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist. In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.   
      Amber 1   Treatment can be initiated in primary care after a recommendation from an appropriate specialist  
      Amber 2   Specialist initiation followed by maintenance prescribing in primary care  
      Amber 3   Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation  
      Green   Specialist and non-specialist initiation  
      Grey   Not recommended for prescribing  

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