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		  
 Search
 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.
Chapter Links...
Link   
Link   NICE NG106: Chronic heart failure in adults: diagnosis and management
Link   SE London APC guidance: optimising therapy in chronic stable angina
Link   SE London APC Guidance: Pharmacological management of Heart Failure
 Details...
02.08.02  Expand sub section  Oral anticoagulants
Acenocoumarol tabs
View adult BNF View SPC online 		Formulary
Amber 2 		 
   
Apixaban tabs
View adult BNF View SPC online 		Formulary

Amber Traffic Light For treatment and secondary prevention of DVT and PE, and thromboprophylaxis in AF.

See links at the end of the section for initiation of treatment and transfer of care documents

Red Traffic Light (hospital only) For prevention of VTE after hip or knee replacement surgery 

 
Link  SE London APC prescribing guidance - Apixaban for AF
Link  SE London APC prescribing guidance - Apixaban for VTE
Link  Jun 19 - MHRA Drug Safety Update: Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome
Link  NICE TA245: Venous thromboembolism - apixaban (hip and knee surgery
Link  NICE TA275: Stroke and systemic embolism (prevention, non-valvular atrial fibrillation) - apixaban
Link  NICE TA341: Apixaban for treatment and secondary prevention of DVT and/or PE
Link  Apixaban for non-valvular AF - manufacturers patient information booklets (several languages)
Link  Apixaban for venous thromboembolism - manufaturers patient information booklets (several languages)
   
Dabigatran caps
View adult BNF View SPC online 		Formulary

Amber Traffic Light For treatment and secondary prevention of DVT and PE, and thromboprophylaxis in AF

See links at the end of the section for initiation of treatment and transfer of care documents

 

Red Traffic Light (hospital only) For prevention of VTE after hip or knee replacement surgery 

 
Link  SE London APC prescribing guidance: Dabigatran for AF
Link  SE London APC prescribing guidance: Dabigatran for VTE
Link  Jun 19 - MHRA Drug Safety Update: Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome
Link  NICE TA157: Venous thromboembolism - dabigatran
Link  NICE TA249: Dabigatran for Stroke prevention in AF
Link  NICE TA327: Dabigatran for treatment and secondary prevention of DVT and/or PE
   
Edoxaban tabs
View adult BNF View SPC online 		Formulary
Amber 3 		See links at the end of the section for initiation of treatment and transfer of care documents 
Link  SE London APC prescribing guidance: Edoxaban for AF
Link  SE London APC prescribing guidance: Edoxaban for VTE
Link  Jun 19 - MHRA Drug Safety Update: Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome
Link  NICE TA354: Edoxaban for treating and for preventing DVT and/or PE
Link  NICE TA355: Edoxaban for thromboprohylaxis in non-valvular AF
Link  Edoxaban - manufacturer’s patient support materials (several languages)
   
Phenindione tabs
View adult BNF View SPC online 		Formulary
Amber 2 		 
   
Rivaroxaban tabs (licensed uses)
View adult BNF View SPC online 		Formulary

Amber Traffic Light For treatment and secondary prevention of DVT and PE, thromboprophylaxis in AF, and preventing adverse outcomes after acute management of ACS.

See links at the end of the section and below for initiation of treatment and transfer of care documents

 

Red Traffic Light (hospital only) For prevention of VTE after elective hip or knee replacement surgery

 
Link  Rivaroxaban for ACS: Notification of initiation to GP
Link  Rivaroxaban in ACS: Transfer of care to GP
Link  SE London prescribing guidance: Rivaroxaban for ACS
Link  SE London prescribing guidance: Rivaroxaban for AF
Link  SE London prescribing guidance: Rivaroxaban for VTE
Link  Jun 19 - MHRA Drug Safety Update: Direct-acting oral anticoagulants (DOACs): increased risk of recurrent thrombotic events in patients with antiphospholipid syndrome
Link  NICE TA256: Rivaroxaban for thromboprophylaxis in AF
Link  NICE TA261: Rivaroxaban for the treatment of DVT and prevention of recurrent DVT and/or PE
Link  NICE TA287: Rivaroxaban for treating PE and preventing recurrent VTE
Link  NICE TA335: Rivaroxaban for preventing adverse outcomes after acute management of ACS
Link  Rivaroxaban - manufacturer’s patient brochures (several languages)
   
Rivaroxaban tabs (superficial vein thrombosis off label use)
View adult BNF View SPC online 		Formulary
Red

Approved off-label indication:

  • Rivaroxaban 10mg for the treatment of superficial vein thrombosis (SVT) in adults
  • If the thrombosis is >5cm in length AND >3cm of a junction with a deep vein, rivaroxaban may be considered at a dose of 10mg daily for 6 weeks
 
Link  SE London APC Recommendation: Rivaroxaban 10mg for the treatment of superficial vein thrombosis (SVT) in adults (off-label use)
   
Warfarin tabs
View adult BNF View SPC online 		Formulary
Amber 2 		 
   
Rivaroxaban tabs (orthopaedic off label use)
View adult BNF View SPC online 		Formulary
Red 		Approved off-label indication:
  • Thromboprophylaxis post pelvic ring/acetabular fracture as an alternative to Low Molecular Weight Heparin Full course of up to 90 days to be prescribed and provided by the hospital. Dose as per thromboprophylaxis post elective orthopaedic surgery (10mg daily)  
    • Link  SE London APC Recommendation: Rivaroxaban for thromboprophylaxis post pelvic ring fracture
       
     link Link    Direct Oral Anticoagulants (DOACs) for VTE: Notification of initiation to GP
     link Link    Direct Oral Anticoagulants (DOACs) for VTE: Transfer of care to GP form
     link Link    Direct Oral Anticoagulants (DOACs) in AF: Notification of initiation to GP
     link Link    Direct Oral Anticoagulants (DOACs) in AF: Transfer of Care to GP
     link Link    Direct Oral Anticoagulants (DOACs): SE London guide for calculating renal function (Creatinine Clearance) for safe and effective dosing
     ....
    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  

    netFormulary