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 Formulary Chapter 2: Cardiovascular system - Full Chapter
Notes:

Where a formulary entry does not detail a medicine’s indications for use, the medicine can be assumed to be approved for all licensed indications.

Formulary approved "off-label" use is detailed separately.

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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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Formulary  
   
Diltiazem tabs, m/r tabs, m/r caps
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Formulary  
   
Verapamil tabs, m/r tabs
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Formulary  
   
Nimodipine tabs, injection
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Formulary  
   
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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Formulary  
   
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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    Formulary  
       
    Flunarizine caps, tabs
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    Unlicensed Drug Unlicensed

    Approved for:

    • Intermittent claudication
    • Raynaud’s 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.
     
       
     ....
    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

    Traffic Light Status Information

    Status Description

    Red

    Specialist or hospital prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist or hospital. 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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