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 Formulary Chapter 6: Endocrine system - Full Chapter
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06.04.01.01  Expand sub section  Oestrogens and Hormone Replacement Therapy HRT
Oestrogen conjugated tablets 625microgram and 1.2mg (Premarin®)
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Formulary
Green
 
 
Estradiol patches/gel/spray
(Oestrogen only patches/gel)
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Formulary
Green
  • Twice weekly matrix patches releasing approximately 25, 37.5 (Estradot® only), 50, 75 & 100 microgram/24 hours (Estradot®,Evorel®, Estraderm® MX);
  • Weekly matrix patches releasing approximately 25, 50, 75 & 100 microgram/24 hours (Femseven®);
  • Once weekly matrix patches releasing approx. 50 & 100 microgram estradiol/24 hours (Progynova TS®)
  • Estradiol 0.1% gel (Sandrena®)
  • Estradiol 0.06% gel (Oestrogel®) 
    • Approved for use in gender dysphoria therapy Green plus
    • Approved for use as hormone replacement therapy
  • Estradiol 1.53mg/spray transdermal spray (Lenzetto®)
    • Approved as an alternative to patches and gels for patients who have issues with absorption, find patch adhesive irritating or the gel messy

 

 
 
Estradiol tablets
(Oestrogen only tablets)
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Formulary
Green
  • 1mg and 2mg tablets
 
 
Ethinylestradiol
(Oestrogen only tablets)
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Green plus
  • Note: ethinylestradiol 2microgram tablets are unlicensedunlicensed.
 
 
Continuous combined HRT patch (Evorel® Conti)
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Formulary
Green
 
 
Combined cyclical HRT tablet (Elleste Duet®)
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Formulary
Green
  • Pack of 16 x 1mg estradiol tablets + 12 x 1mg estradiol and 1mg norethisterone tablets
 
 
Combined cyclical HRT tablet (Femoston®)
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Formulary
Green
  • Femoston® 1/10 Tablets:
    • Pack of 14 x 1mg estradiol tablets + 14 tablets containing estradiol 1mg and dydrogesterone 10mg

 

  • Femoston® 2/10 Tablets:
    • Pack of 14 x 2mg estradiol tablets + 14 tablets containing estradiol 2mg and dydrogesterone 10mg
 
 
Continuous combined HRT tablets (Elleste-duet Conti, Kliofem, Kliovance, Femosten Conti, Premique-low dose)
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Formulary
Green
 
 
Estradiol vaginal tablet
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Formulary
Green
  • 10mg vaginal tablet
    • Vagifem® 10mg vaginal tablets
    • Vagirux® 10mg vaginal tablets (alternative)


 
 
Sequential combined cyclical HRT patch (Evorel® Sequi)
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Formulary
Green
 
 
Tibolone
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Formulary
Green
 
 
06.04.01.01  Expand sub section  Hormone replacement therapy
06.04.01.01  Expand sub section  Ethinylestradiol
06.04.01.01  Expand sub section  Raloxifene
Raloxifene Hydrochloride
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Formulary
Green plus
  • For use on the advice of specialists in the prevention and treatment of osteoporosis where alternative treatments are inappropriate.
 
Link  NICE TA160: Raloxifene for the primary prevention of osteoporotic fragility fractures in postmenopausal women (Not Approved)
Link  NICE TA161: Raloxifene and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women
 
06.04.01.01  Expand sub section  Oestrogen only tablets to top
06.04.01.01  Expand sub section  Oestrogens and progestogen sequential combined therapy
06.04.01.01  Expand sub section  Continuous combined therapy
06.04.01.01  Expand sub section  Gonadomimetic
06.04.01.01  Expand sub section  Selective oestrogen modulator
 ....
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
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Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red

Drugs for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician and the drug should be supplied through the hospital throughout the duration of treatment. In some very exceptional circumstances (e.g. due to distance from the hospital, storage, supply or mobility/transport problems) it may be appropriate for the GP to be asked to prescribe a Red drug. This should be negotiated on an individual patient basis and should only be done with the GP’s prior informed agreement where the roles of the GP and hospital services are clearly defined and agreed. The GP should not feel under pressure to prescribe in these circumstances. For all RED drugs automatically added to the formulary in response to a positive NICE TA: Prescribers need to ensure that local Trust new drug governance procedures and pharmacy processes are followed before any prescribing.  

Amber

Drugs initiated by hospital specialist, but where continuing treatment by GPs may be appropriate under a shared care arrangement. The specialist should send the GP a copy of the shared care agreement to sign. The GP should sign the shared care agreement, or indicate they do not want to be part of such an agreement, and return a copy back to the specialist. Shared care guidelines are available or are being developed for most of the drugs listed as Amber. If no shared care guideline is available, the hospital specialist should provide the patient’s GP with sufficient information and support to allow treatment to be continued and managed safely in primary care.  

Green plus

Drugs normally recommended or initiated by a specialist (hospital or GP with an extended role https://www.rcgp.org.uk/gpwer), but can be safely maintained in primary care with very little or no monitoring required. In some cases there may be a further restriction for use outlined - these will be defined in each case. Provision of additional information, or an information leaflet, may be appropriate in some cases to facilitate continuing treatment by GPs.  

Green

Drugs where prescribing by GPs is appropriate. Can be initiated and prescribed in all care settings, and if appropriate, discontinued without recourse to secondary care.  

Black

NOT APPROVED: Drugs that have been considered by NTAG or the NENC ICB Medicines Subcommittee (or other approved body) and are not approved for prescribing within the North East and North Cumbria.   

Brown

UNDER REVIEW: drugs whose current formulary status or RAG status is currently under review.  

Not Recomended

NOT REVIEWED: Drugs that haven not been reviewed yet. This usually means that an application is in progress. These drugs are not normally considered appropriate for prescribing in the North East and North Cumbria until such time that a decision is taken on their formulary status.  

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