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 Formulary Chapter 2: Cardiovascular system - Full Chapter
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02.05.01  Expand sub section  Vasodilator antihypertensive drugs
Hydralazine
(Tablets, injections)
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Formulary
Green

  • Injection: Hospital only

 
   
Minoxidil
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Restricted Drug Restricted
Amber No SCG

  • CUHFT: Must be prescribed in addition to a diuretic and a beta blocker

  • Non formulary at all other Trusts

 
   
Tadalafil (Adcirca)
(Pulmonary hypertension)
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Restricted Drug Restricted
Red Hospital

  • RPH: Restricted to use in pulmonary hypertension only, available via homecare 

  • Non formulary at all other Trusts

 
Link  Clinical Commissioning Policy: National policy for targeted therapies for the treatment of pulmonary hypertension in adults (May 2014)
   
Ambrisentan
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Restricted Drug Restricted
Red Hospital
High Cost Medicine

  • RPH: Restricted to use in pulmonary hypertension only, available via homecare

  • Non formulary at all other Trusts

 
Link  Clinical Commissioning Policy: National policy for targeted therapies for the treatment of pulmonary hypertension in adults (May 2014)
Link  Letters sent to healthcare professionals October 2019: Volibris (ambrisentan) - new patient alert card and removal of the controlled distribution system
   
Iloprost
(Injection)
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Restricted Drug Restricted
Red Hospital
High Cost Medicine

unlicensedunlicensed - Supplied on a named patient basis only



  • RPH: Restricted to Critical Care

  • NWAFT: Formulary.

  • CUHFT: Restricted to:

    • Vasculitis (limb ischaemia)

    • Rheumatology (peripheral vascular disease)



 
Link  Clinical Commissioning Policy: National policy for targeted therapies for the treatment of pulmonary hypertension in adults (May 2014)
Link  Group Prior Approval Forms for CCG Commissioned Indications
Link  NICE Evidence Review ESUOM24: Critical limb ischaemia in peripheral vascular disease (intravenous iloprost)
   
Iloprost nebules (Vantavis)
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Restricted Drug Restricted
Red Hospital
High Cost Medicine

  • RPH: Restricted to use in pulmonary hypertension only, available via homecare 

  • Non Formulary at all other Trusts


 

 
Link  Clinical Commissioning Policy: National policy for targeted therapies for the treatment of pulmonary hypertension in adults (May 2014)
   
Macitentan (Opsumit View adult BNF View SPC online View childrens BNF  Track Changes Restricted Drug Restricted
Red Hospital
High Cost Medicine

  • RPH: Restricted to use in pulmonary hypertension only, available via homecare 

  • Non formulary at all other Trusts

 
Link  Clinical Commissioning Policy: National policy for targeted therapies for the treatment of pulmonary hypertension in adults (May 2014)
   
Riociguat (Adempas)
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Restricted Drug Restricted
Red Hospital
High Cost Medicine

  • RPH: Restricted to use in pulmonary hypertension only, available via homecare

  • Non formulary at all other Trusts

 
Link  NHS England: Targeted Therapies for use in Pulmonary Hypertension in Adults Superseded
   
Sildenafil (Revatio, Granpidam)
(Pulmonary hypertension)
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Restricted Drug Restricted
Red Hospital
High Cost Medicine

  • RPH: Restricted to use in pulmonary hypertension only, available via homecare.



  • CUHFT: Intravenous sildenafil is clinically approved for acute pulmonary hypertension in neonates (off-label use) as second line additional agent when nitrous oxide alone ineffective, and patient is NBM so cannot have oral sildenafil. 



  • Non formulary at all other Trusts. 


 

 
Link  Clinical Commissioning Policy: National policy for targeted therapies for the treatment of pulmonary hypertension in adults (May 2014)
Link  MHRA Drug Safety Update: Sildenafil (Revatio and Viagra): reports of persistent pulmonary hypertension of the newborn (PPHN) following in-utero exposure in a clinical trial on intrauterine growth restriction
   
Sodium Nitroprusside
View adult BNF  Track Changes
Restricted Drug Restricted
Red Hospital

  • CUHFT: Restricted to hypertensive crisis unlicensedunlicensed 

  • Non Formulary at all other Trusts


 


 

 
   
Tolazoline
(Injection)
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Restricted Drug Restricted
Red Hospital

  • CUHFT: Restricted to neonatal use only. Named patient use only. unlicensed unlicensed

  • Non formulary at all other Trusts 

 
   
Bosentan
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Restricted Drug Restricted
Red Hospital
High Cost Medicine

  • RPH: Restricted to use in pulmonary hypertension only, available via homecare 

  • CUHFT: Restricted to the treatment of digit ulceration in systemic sclerosis. Prior approval required (NHSE)

  • Non formulary at all other Trusts and in Primary Care


 

 
Link  Clinical Commissioning Policy: National policy for targeted therapies for the treatment of pulmonary hypertension in adults (May 2014)
Link  Clinical Commissioning Policy: Treatment of Digital Ulceration in Systemic Sclerosis
   
Sildenafil (Generic)
(Digital ulcers)
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Restricted Drug Restricted
Amber No SCG

 



 




    • Prescribe generically as 25mg or 50mg tablets. (DO NOT PRESCRIBE 20mg tablets for this indication)



 




    • Non-formulary at all other Trusts for this indication



 




    • For other indications see seperate entry



 

 
Link  Clinical Commissioning Policy: Sildenafil and bosentan for the treatment of digital ulceration in systemic sclerosis
Link  NICE Evidence summary: Sildenafil for digital ulcers
Link  MHRA Drug Safety update: Sildenafil (Revatio and Viagra): reports of persistent pulmonary hypertension of the newborn (PPHN) following in-utero exposure in a clinical trial on intrauterine growth restriction
   
 ....
 Non Formulary Items
Iloprost  (Colonis)
(100mcg/ml concentrate for solution for infusion)

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Non Formulary
Grey
  • RPH: New Product Assessment taking place by RPH. Existing unlicensed product will continue to be issued in the interim.
  • Iloprost 100 micrograms/ml Concentrate for solution for infusion is NOT ready to use and requires dilution before administration. 

 

 
  
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

OTC

Available Over the Counter. Consider Self Care   

Green

Formulary - Can be prescribed in both secondary and primary care.   

Advice

Formulary - Specialist Advice, secondary care advice provided for primary care initiation.  

Amber No SCG

Formulary - Specialist initiation without shared care guidance.  

Amber SCG

Formulary - Specialist initiation with shared care guidance.  

Red Hospital

Restricted - Hospital only, not to be prescribed in primary care.  

Switch

Not recommended for prescribing. Switch to alternative cost-effective option.   

Black

Not recommended for prescribing in primary or secondary care.  

Grey

Not recommended as no formal application made for addition to the formulary. Contact relevant pharmacy team for further information.   

Non Formulary

Non-Formulary (category under review).  

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