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 3: Respiratory system - Full Chapter
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03.04.03  Expand sub section  Allergic emergencies
03.04.03  Expand sub section  Anaphylaxis
03.04.03  Expand sub section  Angioedema
C1 esterase inhibitor injection

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High Cost Medicine
Red
Acute attacks of hereditary angioedema, and prophylaxis of attacks as per NHSE Policy 16045/P

Blueteq prior approval required

Link  NHSE 16045/P: C1 - esterase inhibitor for prophylactic treatment of hereditary angioedema (HAE) types I and II    
Icatibant injection

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Restricted Drug Restricted
High Cost Medicine
Red
Initiation by consultants specialising in hereditary angioedema only
Symptomatic treatment of acute attacks of hereditary angioedema (HAE) in adults with C1-esterase inhibitor deficiency.
Conditional on the there being a clear rationale for prescribing icatibant instead of C1-esterase inhibitor.
Use in accordance with local guidelines
   
Adrenaline inhaler  (Primatene Mist)

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Restricted Drug Unlicensed
Red
For angioedema
Dose: 2-4 sprays to be applied topically, up to hourly as required
Note: this product is currently not available
   
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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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