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 Formulary Chapter 6: Endocrine system - Full Chapter
06.01.02.03  Expand sub section  Other antidiabetic drugs
Semaglutide (Ozempic®)
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First Choice
Green
  • First choice glucagon-like peptide-1 receptor agonist in parimary care
 
Acarbose (Glucobay®)
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Formulary
Green
Tablet50mg 100mg
  • Useful in the occasional overweight patient but limited by gastrointestinal intolerance

     
  •    
    Dulaglutide (Trulicity®)
    (Once weekly injection)
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    Restricted Drug Restricted 0.75mg/0.5ml & 1.5mg/0.5ml pre-filled pen/pre-filled syringe

  • Restricted for initiation by diabetes team 
  •    
    Linagliptin (Trajenta®)
    (DPP4-inhibitor)
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    Formulary
    Green
    Tablet 5mg
  • First choice DPP4 inhibitor at BTHFT 
  •    
    Repaglinide
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    Formulary Tablets 0.5mg, 1mg and 2mg 
       
    Sitagliptin (Januvia®)
    (DPP4 Inhibitor)
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    Formulary
    Green
    Tablets 25mg, 50mg and 100mg 
       
    Liraglutide (Victoza®)
    (GLP-1 analogue)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Green
    injection 6mg/ml 
    Link  NICE CG28: Type 2 diabetes in adults: management
       
    Pioglitazone (Actos®)
    (Thiazolidinedione)
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    Formulary
    Green
    Tablets 15mg, 30mg, 45mg 
       
    06.01.02.03  Expand sub section  SGLT2 inhibitors
    Empagliflozin (Jardiance®)
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    Restricted Drug Restricted
  • Restricted for initiation by diabetes team

    Replaced use of canagliflozin and dapagliflozin
     
  • Link  Drug Safety Update (April 2016) - SGLT2 inhibitors: updated risk of diabetic ketoacidosis
    Link  MHRA Drug Safety Update (March 2017)- increased risk of lower-limb amputation (mainly toes)
    Link  NICE TA336- Empagliflozin in combination therapy for treating type 2 diabetes
    Link  NICE TA390- Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes
       
     ....
     Non Formulary Items
    Alogliptin  (Vipidia®)

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    Non Formulary
     
    Canagliflozin
    (SGLT2 inhibitor)

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    Non Formulary Tablet, 100mg, 300mg
     
    Dapagliflozin
    (SGLT2 inhibitor)

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    Non Formulary
    Green
    Tablets 5mg and 10mg
  • As per NICE TA
  • Link  NICE TA288: Dapagliflozin in combination therapy for treating type 2 diabetes
     
    Exenatide  (Bydureon®)

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    Non Formulary
    Link  NICE TA248: MR exenatide
     
    Exenatide  (Byetta®)
    (GLP-1 agonist)

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    Non Formulary
    Green
    Injection 5microgram per dose prefilled pen, 10microgram per dose prefilled pen
  • Byetta® = twice daily formulation.
  •  
    Linagliptin/ metformin  (Jentadueto®)

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    Non Formulary Not stocked within BTHFT - can prescribe as individual drugs, Linagliptin 2.5mg and Metformin 850mg or 1000mg
     
    Lixisenatide  (Lyxumia®)

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    Non Formulary
     
    Nateglinide  (Starlix®)

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    Non Formulary Tablet 60mg, 120mg and 180mg
  • TDS dosing
  •  
    Pioglitazone and Metfomin  (Competact®)

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    Non Formulary Not stocked within BTHFT - can prescribe as individual drugs, Pioglitazone 15mg and and Metformin 850mg
     
    Rosiglitazone  (Avandia®)

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    Non Formulary Suspended in the UK - no longer available
     
    Rosiglitazone and Metformin  (Avandamet®)

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    Non Formulary Suspended in the UK - no longer available
     
    Saxagliptin  (Onglyza®)

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary
    Green
    Tablets 2.5mg and 5mg
  • Linagliptin preferred choice of DPP4 inhibitor at BTHFT. Not recommended for prescribing as initial therapy, but can be continued if patient already stable on treatment
  •  
    Saxagliptin and metformin  (Komboglyze®)

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary Not stocked within BTHFT - can prescribe as individual drugs, Saxagliptin 2.5mg and and Metformin 850mg or 1000mg
     
    Sitagliptin and Metformin  (Janumet®)

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary Not stocked within BTHFT - can prescribe as individual drugs, Sitagliptin 50mg and Metformin 1000mg
     
    Vildagliptin

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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
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    Link to children's 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

    Amber

    Medicines suitable to be prescribed in primary care after Specialist* recommendation or initiation. A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust D&TC(s). *Specialist is defined as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice.   

    Amber 1

    Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (D&TC) * All drugs awaiting the production or approval of a shared care guideline default to RED   

    Cancer Drug Fund

    Cancer Drug Fund   

    Green

    Medicines suitable for routine use and can be prescribed within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.  

    Green Specialist Initiation

    These drugs should be initiated only by a hospital or specialist clinician (GPSi) but there is no requirement for additional monitoring over the general requirements for all medicines. Some may require short or medium specialist monitoring of efficacy or dose titration before transferring in Primary care. The GP should have all the information they require to support continued prescribing.   

    Green Specialist Recomendation

      

    Grey

    Grey - Medicines, which the Drug & therapeutics Committee has actively reviewed and does not recommend for use at present following a review of clinical and/or cost effective data. Grey (assessment in progress) - will be reviewed at a future D&T meeting. Grey (awaiting submission) - The D&T are awaiting a submission from an appropriate practitioner. If you wish to make a submission for this medicine to be added to the formulary please email drug.information@bthft.nhs.uk .   

    Non Formulary

    Not recommended for prescribing as initial therapy, but can be continued if patient already stable on treatment   

    Red

    Medicines which should normally be prescribed by specialists only. ** For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care   

    RED ULM

    Unlicensed Medication  

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