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 Formulary Chapter 2: Cardiovascular system - Full Chapter
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02.08.01  Expand sub section  Parenteral anticoagulants
02.08.01  Expand sub section  Heparin
02.08.01  Expand sub section  Low molecular weight heparins
Dalteparin
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First Choice
Advice

 

  • Dalteparin is the LMWH of choice (excluding RPH where Tinzaparin is 1st line).
  • See Trusts guidelines for further information on dosing and duration of treatment.
  • Traffic light status for initiation and continuation of treatment is indication specific. Please see LMWH Prescribing Guideline (THIS GUIDELINE IS CURRENYLY UNDER REVIEW). 
  • For paediatric patients under the age of 16 years, both the prescribing and monitoring of dalteparin should remain - HOSPITAL ONLY. 
  • Patients, irrespective of age, requiring administration of dalteparin from vials, both the prescribing and monitoring should remain - HOSPITAL ONLY.
  • Dalteparin is indicated for VTE prophylaxis where high risk pregnancy is confirmed:
    • High risk pregnancy may be confirmed either by the hospital or within general practice.
    • Presribing and monitoring to be continued by the patient's GP.
    • Very few women will need prescriptions from the beginning of pregnancy. Women will be risk assessed by the community midwives at booking.
    • More women will have a prescription initiated from their specialist from 28 weeks of gestation. 

 

 
Tinzaparin
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Restricted Drug Restricted
Red Hospital

  • RPH: Tinzaparin is the LMWH of choice

  • CUHFT and NWAFT: for use ONLY in the Dialysis Unit to replace unfractionated heparin. ALL other locations/indications: use dalteparin.

  • Non formulary in Primary Care


 

 
   
Enoxaparin
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Restricted Drug Restricted
Amber SCG

 

  • RPH (HOSPITAL ONLY): VTE prophylaxis in patients with renal impairment when creatinine clearance <20ml/min.
  • RPH and Primary Care Shared Care Guideline: For patients undergoing invasive procedures to establish a diagnosis of pulmonary hypertension, assess treatment response or in preparation for surgery. See link below. 
  • Non formulary at all other Trusts and in Primary Care. 
  • Biosimilars available - brand prescribing recommended. 
  • Patients, irrespective of age, requiring administration of enoxaparin from vials, both the prescribing and monitoring should remain -HOSPITAL ONLY
  • For paediatric patients under the age of 16 years, both the prescribing and monitoring of enoxaparin should remain - HOSPITAL ONLY

 

 
Link  RPH: Shared Care Guideline - Enoxaparin for patients undergoing invasive procedures to establish a diagnosis of pulmonary hypertension, assess treatment response or in preparation for surgery
   
02.08.01  Expand sub section  Heparinoids
02.08.01  Expand sub section  Hirudins to top
02.08.01  Expand sub section  Heparin flushes
02.08.01  Expand sub section  Epoprostenol
02.08.01  Expand sub section  Fondaparinux
 ....
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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