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 Formulary Chapter 2: Cardiovascular system - Full Chapter
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02.05.05  Expand sub section  Drugs affecting the renin-angiotensin system
02.05.05.01  Expand sub section  Angiotensin-converting enzyme inhibitors (ACE inhibitors)
Lisinopril
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First Choice
Green
 
Ramipril
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First Choice
Green

 

  • Primary Care: prescribe as capsules. 

 

 
Enalapril
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Formulary
Green

 

  • NWAFT: Restricted to existing patients and paediatric use.
  • Formulary at all other Trusts where 1st line choices are unsuitable.

October 2020 - Supply Difficulties with Enalapril 20mg tablets

  • Supplies are currently available from Aurobindo.
  • Dexcel and Noumed are currently out of stock with resupply expected by w/c 9 November 2020 and early 2021, respectively.
  • There will be ongoing constraints with supplies of enalapril 20mg tablets until November 2020 when more manufacturers are back in stock.
  • Specialist importers can source unlicensed products. Lead times may vary.
  • See Medicine Supply Notification below (issued 24/07/2020) for further actions to be taken in relation to this shortage. 

 

 
Link  Medicine Supply Notification July 2020: Enalapril 20mg tablets (published 24/07/2020)
   
Perindopril erbumine
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Formulary
Green

  • Please prescribe generic.

  • NWAFT: non formulary


Perindopril arginine is non formulary in all Trust and Primary Care 

 
Link  Items which should not routinely be prescribed in primary care: Perindopril Arginine
Link  PrescQIPP: Switching from Coversyl® Arginine products (perindopril arginine) to perindopril erbumine tablets
   
Captopril
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Restricted Drug Restricted
Amber No SCG

  • CUHFT: Accepted on Formulary for use by cardiologists for ACEI test dose; not for treatment. (Hospital only)

  • RPH: Restricted to the treatment of refractory autonomic dysreflexia

  • NWAFT: formulary

 
   
02.05.05.02  Expand sub section  Angiotensin-II receptor antagonists
Losartan
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First Choice
Green
 
Candesartan
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Second Choice
Green
 
   
Sacubitril / valsartan ( Entresto ®)
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Restricted Drug Restricted
Amber No SCG

  • Specialist initiation by Heart Failure Specialist with access to MDT as per NICE TA388

 
Link  NICE TA388: Sacubitril valsartan for treating symptomatic chronic heart failure with reduced ejection fraction
Link  Prescribing Support: Sacubitril/valsartan (Entresto)
   
Valsartan
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Restricted Drug Restricted
Advice

 

  • NWAFT: Formulary (capsules).
  • RPH: Formulary (capsules).
  • Non formulary at all other Trusts.
  • Prescribe as capsules in Primary Care.

 

 
   
Irbesartan
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Restricted Drug Restricted
Advice

  • CUHFT: Formulary

  • Non formulary at all other Trusts

 
   
02.05.05.03  Expand sub section  Renin inhibitors
 ....
 Non Formulary Items
Aliskiren

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Non Formulary
Black

 

  • Not included in NICE hypertension guideline as insufficient evidence of its effectiveness.
  • See also safety concerns (see links below).
  • Prescribers in Primary Care should not initiate aliskiren for any new patient.

  • Patients currently prescribed aliskiren should be reviewed by their specialist/initiating trust and aliskiren deprescribed.

  • CUHFT have withdrawn their current shared care guideline.

     

 

 

Link  EMA advise clinicians to review Aliskiren prescribing following termination of ALTITUDE study
Link  MHRA: Aliskiren (Rasilez): risk of angioedema and renal dysfunction
Link  MHRA: Aliskiren (Rasilez): risk of cardiovascular and renal adverse reactions—new contraindications and warnings
 
Azilsartan

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Non Formulary
Grey
 
Captopril and Hydrochlorothiazide  (Capozide®)

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Non Formulary
Grey
Link  MHRA Drug Safety Update: Hydrochlorothiazide- risk of non-melanoma skin cancer, particularly in long-term use
 
Captopril and Hydrochlorothiazide  (Co-zidocapt®)

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Non Formulary
Grey
Link  MHRA Drug Safety Update: Hydrochlorothiazide: risk of non-melanoma skin cancer, particularly in long-term use
 
Cozaar- Comp®
(Losartan & hydrochlorothiazide)

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Non Formulary
Grey
 
Enalapril and Hydrochlorothiazide  (Innozide®)

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Non Formulary
Grey
Link  MHRA Drug Safety Update: Hydrochlorothiazide: risk of non-melanoma skin cancer, particularly in long-term use
 
Eprosartan

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Non Formulary
Grey
 
Fosinopril

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Non Formulary
Grey
 
Imidapril  (Tanatril®)

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Non Formulary
Grey
 
Lisinopril and Hydrochlorothiazide  (Carace® Plus)

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Non Formulary
Grey
Link  MHRA Drug Safety Update: Hydrochlorothiazide - risk of non-melanoma skin cancer, particularly in long-term use
 
Lisinopril and Hydrochlorothiazide  (Lisicostad®)

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Non Formulary
Grey
Link  MHRA Drug Safety Update: Hydrochlorothiazide: risk of non-melanoma skin cancer, particularly in long-term use
 
Lisinopril and Hydrochlorothiazide  (Zestoretic®)

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Non Formulary
Grey
Link  MHRA Drug Safety Update: Hydrochlorothiazide: risk of non-melanoma skin cancer, particularly in long-term use
 
Moexipril

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Non Formulary
Grey
 
Olmesartan

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Non Formulary
Grey
 
Perindopril Arginine

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Non Formulary
Grey
 
Quinapril

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Non Formulary
Grey
 
Quinapril and Hydrochlorothiazide

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Non Formulary
Grey
Link  MHRA Drug Safety Update: Hydrochlorothiazide - risk of non-melanoma skin cancer, particularly in long-term use
 
Ramipril and Felodipine  (Triapin®)

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Non Formulary
Grey
 
Rasitro®
(Aliskeren / amlodipine / hydrochlorothiazide )

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Non Formulary
Grey
Link  MHRA Drug Safety Update: Hydrochlorothiazide- risk of non-melanoma skin cancer, particularly in long-term use
 
Sevikar HCT®
(Olmesartan / amlodipine / hydrochlorothiazide )

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Non Formulary
Grey
Link  MHRA Drug Safety update: Hydrochlorothiazide - risk of non-melanoma skin cancer, particularly in long-term use
 
Telmisartan

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Non Formulary
Grey
 
Trandolapril

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Non Formulary
Grey
 
Trandolapril and Verapamil  (Tarka®)

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Non Formulary
Grey
 
  
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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