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NHS Sunderland Clinical Commissioning Group
City Hospitals Sunderland NHS Foundation Trust
 
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 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.09  Expand sub section  Antiplatelet drugs
Aspirin
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Formulary

Dispersible tablets: 75mg, 300mg (loading dose)

 
   
Aspirin
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Formulary
Green +

Suppository: 150mg, 300mg
For use in patients following stroke

 
   
Clopidogrel
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Formulary Tablets: 75mg, 300mg (loading dose) 
Link  NICE TA210: Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events
   
Dipyridamole
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Formulary
Green +
SR capsules: 200mg
Sugar-free suspension: 50mg/5ml 
   
Prasugrel
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Formulary
Green +
Tablets: 5mg, 10mg 
Link  NICE TA317: Prasugrel with percutaneous coronary intervention for treating acute coronary syndromes (review of technology appraisal guidance 182)
   
Ticagrelor
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Formulary
Green +

Tablets: 60mg, 90mg
Ticagrelor in combination with low-dose aspirin is recommended for up to 12 months as a treatment option in adults with acute coronary syndromes. However, selected patients at high risk may be offered ticagrelor 60mg bd for up to a maximum of three years by the initiating specialist in secondary care. This will be communicated to practices in the patients discharge letter.

 
Link  NICE TA236: Ticagrelor for the treatment of acute coronary syndromes
Link  NICE TA420: Ticagrelor for preventing atherothrombotic events after myocardial infarction
   
Tirofiban
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Formulary
Red
Infusion: 12.5mg/250ml 
   
Abciximab
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Formulary
Red
Vial: 10mg/5ml 
   
 ....
 Non Formulary Items
Cangrelor

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Non Formulary
 
Dipyridamole and Aspirin

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Non Formulary
 
Eptifibatide  (Integrilin)

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Non Formulary
 
Vorapaxar  (Zontivity)

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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
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Link to adult BNF
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Link to SPCs
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

Drugs for hospital use or use by a specialist within specialist centre only. Initiation and monitoring of treatment should remain under the total responsibility of the appropriate hospital clinician or specialist. These drugs should only be prescribed under the direct supervision of that clinician or specialist and are not suitable for shared care arrangements. The drug should be supplied via the hospital or specialist centre for the duration of treatment.   

Amber

These are specialist drugs which must be initiated by secondary care specialist prescribers, but with the potential to transfer prescribing to primary care within written and agreed shared care protocols and according to the agreed process for transfer of care. For these drugs, in order to ensure patient safety, some aspects of care must remain with the specialist due to their complexity e.g. monitoring of disease or drug response. Other more routine aspects can be transferred to the GP e.g. monitoring of adverse effects and supply of the medicine. The specific responsibilities of the specialist and GP are defined in the shared care agreement for each drug. Shared care agreements are still under development for some amber drugs. Until these are available, it would be expected that any shared care request from secondary care to a GP would be accompanied by written information which defines prescribing and monitoring responsibilities. The hospital specialist should also provide the GP with enough information and support to allow the safe transfer and ongoing management of prescribing into primary care.   

Green +

Drugs which should usually be initiated in secondary care, or by a specialist clinician, but can be safely maintained in primary care with very little or no monitoring required. An information leaflet may be provided in order to facilitate ongoing prescribing in primary care.   

Green

These are defined as new and established drugs, which may be prescribed, initiated, changed or maintained on FP10 by the GP and, if appropriate, discontinued without recourse to secondary care. N.B. DRUGS NOT IDENTIFIED IN THE FORMULARY BY A RED, AMBER OR GREEN+ SYMBOL ARE CLASSIFIED AS GREEN.   

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