Search by drug classification

  • Red Drug Classification

    Prescribing responsibility should remain with the consultant or specialist clinician. Medicines with one or more of the following criteria should be categorised as RED. These are drugs that:

    1. are unlicensed medicines unsuitable for use in primary care or are being used ‘off-label’ for an indication with no established evidence base;
    2. require long-term on-going specialist monitoring of efficacy or require long-term on-going specialist monitoring of toxicity (either because of difficulty in recognising side effects or high cost/availability of investigations to identify toxicity);
    3. are specifically designated as hospital only by nature of the product;
    4. are being used as part of a hospital based clinical trial;
    5. are not listed in the current BNF or BNFc;
    6. are part of a defined commissioning arrangement

    Always check the latest Summary of Product Characteristics for the licensed indications

    DrugIndications
    3,4-diaminopyridineLambert-Eaton myasthenic syndrome (LEMS)
    5-methoxypsoralenPUVA treatment of psoriasis
    Abacavir HIV infection
    Abacavir/lamivudine HIV infection
    Abacavir/dolutegravir/lamivudineHIV infection
    Abaloparatide
    Male and juvenile osteoporosis
    Abatacept All indications
    AbirateroneTreatment of cancer
    AcetylcysteineRed for newly diagnosed patients with cystic fibrosis (CF)
    Acitretin Psoriasis
    Adalimumab All indications
    Adefovir Hepatitis B
    Afatinib
    Treatment of cancers
    Aflibercept All indications
    Agalsidase alfa
    Fabry's disease
    Agalsidase beta
    Fabry's disease
    AgomelatineAntidepressant. Red for new patients
    Albumin-bound paclitaxelTreatment of cancers
    Albutrepenonacog alfaHaemophilia B
    AlbutropinAdult onset growth hormone deficiency
    AlectinibUntreated anaplastic ALK-positive, advanced non-small-cell, lung cancer in adults
    Aldesleukin
    Treatment of cancers
    Alemtuzumab All indications
    Alglucosidase alfa
    Pompe disease
    Alipogene tiparvovecLipoprotein lipase deficiency
    Alpha mannosidase recombinant human
    Alpha mannosidase deficiency
    Alpha-1 antitrypsin
    Alpha-1 antitrypsin deficiency
    Alisporivir
    Hepatitis C
    Alitretinoin Severe chronic hand eczema refractory to potent topical corticosteroids
    Alteplase Thrombolytic
    AmbrisentanPulmonary arterial hypertension
    Amifampridine
    Lambert-Eaton myasthenic syndrome (LEMS)
    Amikacin inhalation
    Cystic fibrosis (CF)
    Amikacin liposomal
    Cystic fibrosis (CF)
    Amphotericin liposomal
    Fungal infections
    Anagrelide Essential thrombocythaemia
    Anakinra Gout for patients who have contra-indications to standard treatment
    Anakinra Rheumatoid arthritis (RA). Juvenile arthritis in paediatrics. Specialist autoinflammatory disease. Paediatric indications. Cryopyrin associated periodic syndrome
    Anidulafungin IV antifungal agent
    Antihaemophilic factor/Von Willebrand factor complexAs per BCSH guidelines for specialised indications
    Antilymphocyte globulin
    Aplastic anaemia organ transplant
    Antipseudomonas aeruginosa IgY
    Cystic fibrosis (CF)
    Antithrombin III
    As per BCSH guidelines for specialised indications

    Antithymocyte immunoglobulin
    Aplastic anaemia organ transplant
    Anti-retroviralsHIV Infection
    ApixabanSee DOACs
    ApremilastAccording to NICE (TA433) for the treatment of active psoriatic arthritis & (TA419) for treating moderate to severe plaque psoriasis

    ApremilastPaediatric indications
    Aprepitant Nausea/vomiting with highly emetogenic chemotherapy
    Aragam®All indications
    Asenapine Treatment of bipolar disorders
    Asfotase alfaHypophosphatasia
    Asunaprevir with daclatasvir
    Hepatitis C
    Atacicept
    Systemic lupus erythematosus (SLE)
    Ataluren
    Duchenne muscular dystrophy
    Atazanavir HIV Infection
    Atazanavir/cobicistatHIV infection
    Atezolizumab1. For treating previously platinum-treated locally advanced/ metastatic non squamos or squamos non-small cell lung cancer
    2. For locally advanced or metastatic urothelial cancer previously treated with platinum-based chemotherapy only if the agreed criteria is met.
    Autologous chrondocyte implantationArticular cartilage defect
    AvastinFor Neovascular Glaucoma and Neovascularization of the Retina
    Avoralstat
    Hereditary angioedema
    Axitinib
    Cancer
    Azacitidine Treatment of cancers
    Aztreonam lysine Red for newly diagnosed cystic fibrosis (CF) patients
    Baricitinib
    Moderate to severe active rheumatoid arthritis in adults who have responded inadequately to, or are intolerant to one or more DMARDs
    BaricitinibPaediatric indications (where adult NICE TA available)

    Basiliximab
    Renal transplant
    Becaplermin Treatment of diabetic ulcers
    Beclabuvir
    Hepatitis C
    Bedaquiline
    TB
    Begelomab
    Graft versus host disease
    Belatacept
    Renal transplant
    BelimumabSystemic lupus erythematosus (SLE)
    Bendamustine Treatment of cancer
    Benralizumab
    Asthma
    BenzbromaroneUnlicensed medicine - Gout
    Beractant
    Respiratory distress syndrome
    Betaine
    Homocystinuria
    Bevacizumab All indications
    Bexarotene Treatment of cancers
    Bimagrumab
    Inclusion body myositis
    BiopatchPrevention of catheter site infection
    Biotin Vitamin induced hair loss. Multiple sclerosis (MS)
    Bivalirudin Use in perctaneous coronary intervention procedures
    BlinatumomabRecommended as an option for treating Philadelphia-chromosome-negative relapsed or refractory precursor B-cell acute lymphoblastic leukaemia in adults.
    Blisibimod
    Systemic lupus erythematosus (SLE)
    Boceprevir Hepatitis C
    Bone morphogenic protein (dibotermin, eptotermin)Bone fractures - see bone morphogenic protein commissioning statement
    Bone morphogenic protein (dibotermin, eptotermin)Complex spinal surgery
    BortezomibAll indications
    Bosentan All indications
    Bosutinib
    Cancer
    Botulinum toxin All indications
    BrentuximabTreatment of cancers
    BrincidofovirCytomegalovirus
    Brodalumab
    Paediatric indications (where adult NICE TA available)
    Brodalumab
    For moderate to severe plaque psoriasis in adults according to NICE TA511
    Bulkamid Periurethral injection for the management of female stress incontinence
    Buserelin Gonadorelin analogue for IVF
    Busulfan Treatment of cancers
    C1 esterase inhibitorsHereditary angioedema
    CabazitaxelTreatment of cancers
    CabozantinibTreatment of cancers
    Canakinumab
    Cryopyrin associated periodic syndrome and juvenile arthritis - paediatric
    Capecitabine All indications
    Caphosol® oral rinse For the prevention and treatment of mucositis caused by high dose chemotherapy
    CaplacizumabAcquired thrombotic thrombocytopenic purpura (aTTP)
    Capsaicin patches 8%Neuropathic pain
    Carfilzomib
    Cancer
    Carglumic acidUrea cycle disorders
    Carnitine
    Carnitine deficiency
    CaspofunginFungal infections
    Catridecacog
    Congenital factor XIIIa-subunit deficiency
    CeralifimodMultiple sclerosis (MS)
    CeritinibAll indications
    Cerliponase alfa
    Neuronal ceroid lipofuscinosis
    Certolizumab pegol All indications
    Cetrorelix IVF
    CetuximabTreatment of cancers
    Chenodeoxycholic acid
    Cerebrotendinous xanthomatosis and primary biliary cirrhosis
    Chloral hydrate Insomnia (short term use)
    Chlorambucil Treatment of cancers
    ChlordiazepoxideAcute alcohol withdrawal
    Cholic acidInborn errors in primary bile acid synthesis
    Chondriotin sulphateBladder instillation for patiients with damaged or glycosaminoglycan deficient bladder epithelium
    Chorionic gonadotrophinGonadorelin analogue for IVF
    Ciclosporin eye drops 1mg/ml (Ikervis®)Red for indications other than persistent dry eye (NICE TA369)
    Cidofovir Cytomegalovirus retinitis in AIDS (acquired immune deficiency syndrome)
    Ciprofloxacin inhalation
    Cystic fibrosis (CF)
    Ciprofloxacin liposomal (inhaled)
    Cystic fibrosis (CF)
    Cladribine
    Multiple sclerosis (MS) and pulmonary Langerhans histiocytosis
    Cladribine (oral)Treating highly active multiple sclerosis in adults, only if the person has rapidly evolving severe relapsing-remitting multiple sclerosis.
    Clinical trials material All trials
    ClofarabineTreatment of cancers
    Clomifene IVF treatment
    Clozapine Atypical antipsychotic for schizophrenia
    CobicistatHIV infection
    Cobitolimod
    Paediatric indications (where adult NICE TA available)
    Co careldopa intestinal gelSevere Parkinson's disease
    Co Enzyme Q10Enzyme deficiency in children
    ColestilanRenal dialysis - adults
    Colistimethate sodium Red for newly diagnosed patients with cystic fibrosis (CF)
    Conestat alfa
    Hereditary angioedema
    Crizotinib
    Treatment of cancers
    CyclophosphamideAll indications
    CyproteroneProstate cancer -
    Red for new patients
    Amber for existing patients
    Cyproterone (off-label indications)Off-label indications
    Cysteamine (mercaptamine)Nephropathic cystinosis
    Cytotoxic injectable drugsAll indications
    DabigatranSee DOACs
    Dabrafenib Treatment of cancer
    DaclatasvirHepatitis C
    Daclizumab
    Multiple sclerosis (MS)
    Dalteparin
    Pre-procedural bridging therapy for patients usually on warfarin (as directed by surgeon/clinical haematologist).
    Extended post-operative thromboprophylaxis.
    High risk patients with plaster cast (~6 weeks whilst immobile) – off-label indication.
    Treatment of acute VTE & maintenance during pregnancy.
    Antenatal thromboprophylaxis in women at high risk of VTE in pregnancy.
    Postpartum thromboprophylaxis in high risk women (7 days or 6 weeks)
    Daratumunab•As monotherapy for the treatment of adult patients with relapsed and refractory multiple myeloma, whose prior therapy included a proteasome inhibitor and an immunomodulatory agent and who have demonstrated disease progression on the last therapy.
    •In combination with lenalidomide and dexamethasone, or bortezomib and dexamethasone, for the treatment of adult patients with multiple myeloma who have received at least one prior therapy
    Darunavir HIV infection
    Darunavir/cobicistatHIV infection
    Darbepoetin alfa All indications
    Dasabuvir

    Hepatitis C
    Dasatinib Treatment of cancers
    Daunorubicin Treatment of cancers
    DecitabineTreatment of cancers
    Deferasirox Iron chelation in thalassaemia and sickle cell
    Deferiprone
    Iron chelation in thalassaemia and sickle cell
    Defibrotide
    Hepatic veno-occlusive disease
    DegarelixProstate cancer
    DelamanidExtensively drug-resistant TB and multi drug-resistant TB
    DenosumabPrevention of skeletal events from breast cancer
    Desferrioxamine Iron chelation in thalassaemia and sickle cell
    Dexamethasone intravitreal implant Macular oedema
    Dexrazoxane

    Anthracycline extravasation and cardiotoxicity
    Dexmedetomide Maintenance of sedation during intensive care
    Dibotermin alfa Complex spinal surgery
    Dibotermin alfa Bone fractures. See bone morphogenic protein commissioning statement
    Didanosine HIV Infection
    Dihydrotestosterone(Androstanolone®)Unlicensed - recommendation from Leeds paediatric surgeons
    Dimethyl fumarateTreatment of adult patients with relapsing multiple sclerosis (MS)/
    treatment of psoriasis
    Dinoprostone vaginal delivery systemCervical ripening/induction of labour
    Disodium pamidronate (IV)Bisphosphonate all licensed indications
    DOACsRed for prevention of venous thromboembolic events (VTE) in adults who have undergone elective hip or knee replacement surgery. Acute coronary syndrome (ACS). Full courses supplied through Acute Trust. Check licensed indications and doses of individual drugs
    Docetaxel Advanced/metastatic breast cancer/prostate cancer
    DolutegravirHIV Infection
    DoravirineHIV infection
    Dornase alfa Red for newly diagnosed patients with cystic fibrosis (CF)
    Dornase alfa Primary ciliary dyskinesia
    Drisapersen

    Duchenne muscular dystrophy
    Droperidol injection Post operative nausea and vomiting
    Dupilumab

    Asthma
    DupilumabFor atopic dermatitis in adults according to NICE TA534
    Ecallantide
    Hereditary angioedema
    Eculizumab
    All indications
    EdoxabanSee DOACs
    Edratide
    Systemic lupus erythematosus (SLE)
    Efavirenz HIV Infection
    Eftrenonacog alfa Haemophilia B
    Efraloctocog alfa/efmoroctocog alfa/factor VIII FC fusion protein

    Haemophilia A
    Elbasvir

    Hepatitis C
    Eliglustat

    Gaucher's disease
    Elosulfase alfaMucopolysacchardosis IV type A
    EltrombopagImmune (idiopathic) thrombocytopenic purpura
    ElvitegravirHIV infection
    ElvucitabineHIV infection
    Emricasan
    Non-alcoholic steatohepatitis (NASH) fibrosis
    EmtricitabineHIV infection
    Emtricitabine/tenofovir
    HIV infecion
    Emtricitabine/tenofovir alafenamideHIV infection
    Emtricitabine/rilpivirine/tenofovir alafenamide HIV Infection
    Enfuvirtide HIV Infection
    Entecavir Chronic hepatitis B infection
    Enzalutamide

    Treatment of cancers
    Epoetin (all variants)Dialysis-induced anaemia
    Epoprostenol Off-label indications
    Eprodisate
    Amyloidosis
    Epratuzumab

    Systemic lupus erythematosus (SLE)
    Eptotermin alfa
    Bone fractures - see bone morphogenic protein commissioning statement
    Eptotermin alfaComplex spinal surgery
    EribulinTreatment of cancers
    Erlotinib Treatment of cancers
    Estramustine Treatment of cancers
    Etanercept All indications
    Etelcalcetide
    Hyperparathyroidism -dialysis patients only
    Eteplirsen

    Duchenne muscular dystrophy
    EthambutolTreatment of TB
    Etoposide Treatment of cancers
    Etravirine HIV infection
    Etrolizumab

    Paediatric indications (where adult NICE TA available)
    Everolimus (Afinitor®)

    Treatment of cancer
    Everolimus (Certican®)
    Preventing transplant rejection
    Everolimus (Votubia®)
    Tubular sclerosis
    Evicel®Tissue adhesive - to be used in patients undergoing pelvic surgery or laparoscopic partial nephrectomies
    Evolocumab
    Homozygous familial hypercholesterolaemia
    Ex-vivo expanded autologous human corneal epithelial cells containing stem cells

    Limbal stem cell deficiency
    Factor IX

    As per BCSH guidelines for specialised indications
    Factor VIIa (Recombinant) (NovoSeven®)Bleeding episodes in surgery in specific patients
    Factor VIIa

    As per BCSH guidelines for specialised indications
    Factor VII

    As per BCSH guidelines for specialised indications
    Factor VIII

    As per BCSH guidelines for specialised indications
    Factor VIII inhibitor bypassing factor
    As per BCSH guidelines for specialised indications
    Factor X
    Hereditary factor X deficiency
    Factor XIII
    As per BCSH guidelines for specialised indications
    Fampridine
    Multiple sclerosis (MS)
    Ferric carboxymaltoseIron deficiency anaemia
    Ferric carboxymaltoseHeart failure patients with or without decreased haemoglobin levels
    Fibrinogen



    As per BCSH guidelines for specialised indications
    Fibroblast growth factor 1 gene therapy
    Somatostatin analogue
    Filgrastim Neutropenia and Barth syndrome
    FilgotinibPaediatric indications (where adult NICE TA available)
    Filibuvir

    Hepatitis C
    Fingolimod
    Management of multiple sclerosis (MS)
    FitusiranHaemophilia A and B
    Flash glucose monitoring systemsType 1 diabetes mellitus for patients who fulfil the criteria
    Flebogamma®All indications
    Flebogammadif®All indication
    FludarabineTreatment of cancers
    Fluocinolone acetonide intravitreal implant Treatment of chronic diabetic macular oedema
    Follitropin alfa/beta IVF gonadotrophin
    Fondaparinux Parenteral anticoagulant
    Forigerimod acetate

    Systemic lupus erythematosus (SLE)
    FosamprenavirHIV Infection
    Fosaprepitant injection Chemotherapy induced nausea and vomiting
    Foscarnet

    Cytomegalovirus
    Fosfomycin IV2nd line antibiotic for patients with carbapenemase resistant infections or with confirmed anaphylactoid reaction to penicillins presenting with suspected meningitis
    Fostemsavir
    HIV infection
    Fulvestrant Breast cancer
    Galsulfase

    Mucopolysaccharidosis
    Gammagard®All indications
    Gammanorm®All indications
    Gammaplex®All indications
    Gamuex®All indications
    Ganciclovir Cytomegalovirus (CMV)
    Ganetespib
    Treatment of cancer
    Gefitinib Treatment for cancer
    Gemtuzumab ozogaminFor untreated acute myeloid leukaemia in people aged 15 years and over according to NICE TA545
    Gevokizumab
    Uveitis
    Glatiramer Multiple sclerosis (MS)
    Glecaprevir
    Hepatitis C
    Glucarpidase
    Methotrexate-induced renal dysfunction
    Glycerol phenylbutyrate
    Urea cycle disorders
    Glycopegylated factor IX
    Haemophilia A
    Glycopyrronium (topical)Hyperhidrosis
    Golimumab All indications
    Gonadorelin IVF hypothalmic hormone
    Goserelin IVF gonadorelin analogue
    Granulocyte-macrophage colony-stimulating factor
    Antibody-positive pulmonary alveolar proteinosis
    Grazax®Seasonal allergic hayfever
    Grazoprevir
    Hepatitis C
    GuselkumabFor moderate to severe plaque psoriasis in adults according to NICE TA521
    HIV-fusion inhibitorsHIV infection
    HIV-integrase inhibitorsHIV infection
    HIV vaccine
    HIV infection prophylaxis
    Hizentra®All indications
    Human (haem) arginate
    Hepatic porphyria
    Human heterologous liver cells
    Urea cycle disorders
    Human menopausal gonadotrophinsIVF Gonadotrophin
    Human parathyroid hormone-related protein analogue
    Male and juvenile osteoporosis hypoparathyroidism
    HydroxycarbamideTreatment of solid tumours
    Hydroxyprogesterone Caproate Prevention of recurrent miscarriages
    Hyqvia®All indications
    Ibalizumab
    HIV infection
    Ibandronic acid injectionBisphosphonate - all licensed indications
    IbrutinibTreatment of cancers
    Icatibant
    Hereditary angioedema
    Idarubicin Treatment of cancers
    Idebenone
    Duchenne muscular dystrophy
    IdelalisibTreatment of cancers
    Idursulfase

    Mucopolysaccharidosis
    Iloprost
    Pulmonary arterial hypertension
    Imatinib mesilate All indications
    Imiglucerase Enzyme replacement - Gaucher's disease
    Imiquimod Basal cell carcinoma
    Immunoglobulin Intravenous (IVIg)All indications
    Indinavir HIV Infection
    Indocyanine dye Ophthalmology
    Infliximab All indications
    Insulin Humulin R® U500500unit/mL insulin for use in severely insulin resistant patients
    InotuzumabRelapsed or refactory CD22-positive B cell precursor acute lymphoblastic leukaemia
    Interferon alfa All licensed indications
    Interferon beta Multiple sclerosis (MS)
    Intratect®All indications
    Irinotecan Metastatic colorectal cancer used with 5 FU and folinic acid
    Iron sucrose Iron deficiency anaemia requiring intravenous therapy
    Ipilimumab Treatment of cancer
    Isavuconazole
    Fungal infections (licensed indications)
    IsoniazidTreatment of TB
    Isotretinoin Oral retinoid - acne
    Ivacaftor Red for newly diagnosed cystic fibrosis (CF) patients
    IVF Treatment All drugs
    Ixazomib
    All indications
    Ketamine All indications
    Kiovig®
    All indications
    Lamivudine HIV Infection
    Lamivudine Hepatitis B treatment
    Lamivudine/abacavir/dolutegravirHIV infection
    Lamivudine/zidovudineHIV infection
    Lamivudine/zidovudine/abacavirHIV infection
    LanreotideRed for NHS England indications
    LanthanumAdult renal dialysis patients
    Lapatinib Cancer
    Laquinimod
    Multiple sclerosis (MS)
    Laronidase
    Mucopolysaccharidosis
    Lebrikizumab
    Asthma
    Ledipasvir/sofosbuvir Hepatitis C
    Lenalidomide All indications
    Lenograstim Recombinant human granulocytecolony stimulating factor - neutropenia and Barth syndrome
    Lenvatnib
    Cancer
    Letermovir
    Cytomegalovirus
    Levofloxacin (inhaled)
    Cystic fibrosis (CF)
    Linezolid Antibiotic - Microbiologist initiation only
    Lithium carbonate Motor neurone disease (MND)
    Lipegfilgrastim
    Neutropenia
    Liposomal cytarabine-daunorubicinFor untreated acute myeloid leukaemia
    Lixivaptan
    Hyponatraemia and other endocrine uses
    Lomitapide
    Homozygous familial hypercholesterolemia
    Lomustine Treatment of cancers
    Lonafarnib
    Treatment of cancers
    Lopinavir/ritonavirHIV infection
    Loteprednol Peri-operative use
    Lumacaftor/ivacaftorCystic fibrosis
    Macimorelin
    Growth failure
    MacitentanPulmonary arterial hypertension
    Mannitol dry powder inhalerTreatment of cystic fibrosis
    Maraviroc HIV infection
    Masitinib
    Pancreatic cancer.
    Gastrointestinal stromal tumour (GIST)
    MavrilimumabPaediatric indications (where adult NICE TA available)
    Mecasermin Growth failure
    Melphalan Treatment of cancers
    Mepolizumab
    Asthma
    Mercaptopurine Treatment of cancers
    Mesenchymal stem cellsAll indications
    Methotrexate
    (oral, IM & SC)
    Cancer indications
    Methotrexate
    (IM and SC)
    Non-cancer indications
    Metreleptin
    Dyslipidaemia

    Metyrapone Management of patients with Cushing’s Syndrome
    *(Red for new patients - Green Specialist initiation for existing patients)
    MexiletineTreatment of life-threatening ventricular arrhythmias
    Micafungin
    Fungal infections
    Midodrine Management of hypotension (Red - will be re-classified once Shared Care Guideline is approved)
    MidostraurinAcute FLT 3-mutation-positive myeloid leukaemia
    Migalastat
    Fabry's disease
    Miglustat
    Gaucher's disease; Niemann-Pick disease
    Mitotane Treatment of cancers
    Momelotinib
    Treatment of cancers
    MotavizumabProphylaxis of respiratory syncytial virus (RSV)
    MycophenolateIndications not classified as amber
    Nabilone Antiemetic.
    Multiple sclerosis (MS) treatment
    Nafarelin IVF - gonadorelin analogue
    Nalmefene
    (only for patients under the care of alcohol services including shared care)
    Alcohol dependence
    Natalizumab
    Multiple sclerosis (MS)
    NelarabineTreatment of cancers
    NelfinavirHIV infection
    Neomycin oral tabletSurgical prophylaxis alongside oral metronidazole, plus standard intravenous surgical prophylaxis for colorectal surgery –with mechanical bowel preparation
    Netupitant and palonosetronAnti-emetic for use with cancer chemotherapy
    Nevirapine HIV Infection
    Nilotinib Treatment of cancers
    NintedanibTreatment of cancers; idiopathic pulmonary fibrosis
    NitazoxanideCryptosporidiosis and Giardiasis
    Nitazoxanide
    Hepatitis C
    Nitisinone
    Alkaptonuria; tyrosinaemia
    Nitric oxide

    Pulmonary arterial hypertension

    NivolumabTreatment of cancers
    NOACsSee DOACs
    Nonacog alpha
    Haemophilia B
    Nonacog beta pegol
    Haemophilia B
    Non-nucleoside reverse transcriptase inhibitorsHIV infection
    Normal immunoglobulinAll indications
    Nucleoside reverse transcriptase inhibitors (nucleoside analogues)HIV infection
    Obeticholic acid
    Primary biliary cirrhosis
    Obinutuzumab Treatment of cancers
    Ocrelizumab
    Multiple sclerosis (MS)
    OcrelizumabTreatment of adult patients with relapsing forms of multiple sclerosis (RMS) with active disease defined by clinical or imaging features
    OcriplasminRetinal disorders
    Octagam®All indications
    Octocog alfa
    Haemophilia A
    Octreolin
    Acromegaly
    Octreotide Off-label indications and NHS England indications
    -
    Ofatumumab
    Cancer and pemphigus vulgaris
    Olanzapine (IM injection)Atypical antipsychotic - schizophrenia and bipolar disorders
    OlaparibTreatment of cancers
    Olaratumab
    Cancer
    Olesoxime
    Spinal muscular atrophy
    Omalizumab Asthma
    Ombitasvir/paritaprevir/ritonavir Hepatitis C
    Oraldine® gel and mouthwashOral hygeine
    Osilodrostat
    Cushing's disease
    OsimertinibTreatment of cancers
    Oxaliplatin Metastatic colorectal cancer with 5 FU and folinic acid
    Ozanimod
    Multiple sclerosis (MS)
    Pacritinib

    Myelofibrosis
    PalbociclibCancer
    Paliperidone Antipsychotic
    Palivizumab Prophylaxis of respiratory syncytial virus (RSV)
    PanitumumabTreatment of cancers
    PanobinostatTreatment of cancers
    Para-aminosalicylic acid
    TB
    Parathyroid hormone
    Specialist endocrinology conditions
    Paritaprevir
    Hepatitis C
    Paromomycin Treatment of cryptosporidium in immunocompromised patients
    Pasireotide
    Acromegaly; Cushing's disease
    Pazopanib
    Treatment of cancers
    PegaspargaseTreatment of cancers
    Pegylated liposomal doxorubicinTreatment of cancers
    Peg-filgrastim Reduction in neutropenia with cytotoxic chemotherapy
    Peg-interferon alfaTreatment of hepatitis B and C
    Peg-interferon beta-1aMultiple sclerosis (MS)
    Peginterferon lambda-1A
    Hepatitis C
    Pegvisomant
    Acromegaly
    PembrolizumabCancer
    PembrolizumabTreating relapsed or refractory classical Hodgkin lymphoma advanced melanoma not previously treated with ipilimumab
    Pemetrexed Treatment of cancer
    Pentosan polysulphate Interstitial Cystitis (Unlicensed)
    Peptide receptor radionucelotide therapyTreatment of cancers
    PertuzumabTreatment of cancers
    Phenol 2% in Zinc paste Intractable pruritus ani
    Phenylbutazone NSAID - ankylosing spondylitis
    Phenylephrine/tropicamide ophthalmic insert (Mydriasert®)Surgical mydriasis
    Pirfenidone Antifibrotic for idiopathic pulmonary fibrosis
    PixantroneTreatment of cancers
    Plerixafor Stem cell mobilisation
    Pomalidomide
    Treatment of cancers and myelofibrosis
    Ponesimod
    Multiple sclerosis (MS)
    PonatinibTreatment of cancers
    Poractant alfa
    Respiratory distress syndrome
    Posaconazole All indications
    Potassium iodide For treatment of erythema nodosum
    PrembrolizumabFor adults with relapsed or refractory classical Hodgkin Lymphoma who are stem cell transplant ineligible and failed on brentuximab vedotin
    Pretomanid
    Multi-drug resistant TB
    Privagen®All indications
    Procarbazine Treatment of cancers
    Protease inhibitorsHIV infection
    Protein C
    As per BCSH guidelines for specialised indications
    Prothrombin complexAs per BCSH guidelines for specialised indications
    Protein kinase inhibitorsEndocrinology; non-malignant conditions
    PyrazinamideTreatment of TB
    QuinidineShort QT syndrome, Brugada syndrome, and idiopathic ventricular fibrillation (VF)
    Radium-223 dichlorideTreatment of cancers
    Raltegravir HIV infection
    Raltitrexed Advanced colorectal cancer
    RamucirumabTreatment of cancers
    Ranibizumab All indications
    Rasburicase
    Hyperuricaemia
    Regorafenib
    Treatment of cancers
    Reslizumab
    Asthma
    Reveglucosidase alfa
    Pompe disease
    Ribavirin Chronic hepatitis C treatment
    RibociclibCancer
    RifampicinTreatment of TB
    Rifater® (rifampicin/isoniazid/pyrazinamide)Treatment of TB
    Rifaximin Treatment of small intestinal bacterial overgrowth and for the treatment of chronic refractory pouchitis
    Rifinah® (rifampicin/isoniazid)Treatment of TB
    Rigosertib
    Myelodysplastic syndromes (MDS); pancreatic cancer
    Rilonacept
    Cryopyrin-associated periodic syndromes
    Rilpivirine HIV infection
    Riociguat
    Pulmonary arterial hypertension (CTEPH).
    Pulmonary arterial hypertension
    Risperidone inj Schizophrenia and other psychoses in patients tolerant to risperidone by mouth
    Ritonavir HIV Infection
    Ritonavir/lopinavirHIV infection
    Rituximab All uses
    RivaroxabanSee DOACs
    Romiplostim Immune (idiopathic) thrombocyctopenic purpura
    Ropeginterferon alfa-2bHepatitis C
    RoxadustatDialysis-induced anaemia
    RuxolitinibTreatment of cancers
    Sandoglobulin®All indications
    Sapropterin For children with phenylketonuria. Maternal phenylketonuria
    Saquinavir HIV Infection
    SarilumabPaediatric indications (where adult NICE TAs are available)
    SarilumabFor moderate to severe active rheumatoid arthritis in adults according to NICE TA485
    Sebelipase alfaLysosomal acid lipase deficiency
    Secukinumab All indications
    SelexipagPulmonary arterial hypertension
    SetrobuvirHepatitis C
    Sialic acidMyopathy
    Sildenafil Off-label use for Raynaud's Disease.
    Pulmonary arterial hypertension
    SimeprevirHepatitis C
    SirukumabPaediatric indications (where adult NICE TAs are available)
    Sodium benzoateUrea cycle disorders
    Sodium chloride 5% nebuliser solutionUnlicensed
    Sodium clodronate (IV) Bisphosphonate – osteolytic lesions, hypercalcaemia and bone pain associated with skeletal masses in breast cancer or multiple myeloma
    Sodium hyaluronate (Cystistat®)Interstitial cystitis
    Sodium oxybate Narcolepsy with cataplexy in children
    Sodium phenylbutyrateUrea cycle disorders
    SofosbuvirHepatitis C
    Sofosbuvir/daclatasvirHepatitis C
    Sofosbuvir/ledipasvir Hepatitis C
    Sofosbuvir/velpatasvir Hepatitis C
    Sorafenib Treatment of cancers
    Stavudine HIV Infection
    StiripentolRare forms of epilepsy
    StreptomycinTreatment of TB
    Strimvelis®Adenosine deaminase deficiency-severe combined immundeficiency
    Subcuvia®All indications
    Subgam®All indications
    Sucraid®Treatment of sucrase-isomaltase deficiency
    SucralfateAll indications
    Sucroferric oxyhydroxideControl of serum phosphorus levels in dialysis patients
    Sugammadex Reversal of neuromuscular blockade induced by rocuronium or vecuronium
    Sunitinib Treatment of cancers
    Susoctocog alfaHaemophilia A
    TabalumabSystemic lupus erythromatosus (SLE)
    TadalafilPulmonary arterial hypertension
    Tafamandis
    Amyloidosis
    Taliglucerase alfa
    Gaucher's disease
    Talimogene laherparepvec
    Treatment of cancers
    TaribavirinHepatitis C
    TB drugsTreatment of TB
    TeduglutideShort bowel syndrome
    Tegafur with uracil Treatment of cancers
    Telaprevir Hepatitis C
    TelbivudineHepatitis B
    Temozolomide Treatment of cancers; endocrinology; non-malignant conditions
    TemsirolimusTreatment of cancers
    Tenofovir alafenamideHepatitis B
    Tenofovir alafenamideHIV infection
    Tenofovir disoproxil/cobicistat/elvitegravir/emtricitabineHIV infection
    Tenofovir/efavirenz/emtricitabineHIV infection
    Tenofovir alafenamide/emtricitabine/elvitegravir/cobicistatHIV infection
    Tenofovor/emtricitabine/rilpiverineHIV infection
    Tivozanib
    Cancer
    TeriflunomideMultiple sclerosis (MS)
    Teriparatide All indications
    TetrahydobiopterinPhenylkenuria
    Thalidomide All indications
    ThrombinPseudoaneurysm
    Tioguanine Treatment of cancers
    Tipranavir HIV Infection
    Tezacaftor
    Cystic fibrosis
    TobramycinRed for newly diagnosed patients with cystic fibrosis (CF)
    Tobramycin dry powder InhalerSuppression of chronic pulmonary infections in cystic fibrosis (CF)
    Tocilizumab All indications
    TofacitinibWith or without methotrexate for moderate to severe active rheumatoid arthritis (RA) in adults according to NICE TA480. Also for active psoriatic arthritis in adults according to NICE TA543 in combination with methotrexate
    TofacitinibPaediatric indications (where adult NICE TA available)
    Tolvaptan Hyponatraemia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH) or cancer
    TopotecanCancer chemotherapy
    Total parenteral nutrition (TPN)Intravenous nutrition - various indications
    Trabectedin
    Treatment of cancers
    TraLife® oral spray Oral hygiene
    TralokinumabAsthma
    TrametinibTreatment of cancers
    Trastuzumab Treatment of cancers
    Trastuzumab emtansineTreatment of cancers
    Trenonacog alphaHaemophilia B
    Treprostinil sodiumPulmonary artierial hypertension
    Treosulfan Treatment of cancers
    Treprostinil diethalaminePulmonary arterial hypertension
    Tretinoin (oral) Antineoplastic; induction of remission in acute promyelocytic leukaemia
    Triamcinolone hexacetonide (Lederspan®)Unlicensed - depot steroid injection for use in children
    Trientine Wilson's disease
    Trifluridine/tipiracilTreatment of cancers
    Triptorelin IVF treatment.
    Male hypersexuality
    Tryptophan Severe disabling depression. Unlicensed product - named patient use only
    Turoctocog alfaAs per BCSH guidelines for specialised indications
    Ulipristal 5mg1. Pre-operative management of uterine fibroids. Alternative treatment to hysterectomy, myomectomy, uterine embolization or GnRH agonists in perimenopausal patients with moderate to severe symptoms caused by fibroids. Also considered in younger patients with high surgical/anaesthetic risks.
    2. Intermittent treatment of moderate to severe symptoms of uterine fibroids
    Urofollitropin IVF treatment
    Ustekinumab All indications
    VadadustatDialysis-induced anaemia
    Valganciclovir All indications
    VandetanibThyroid cancer
    VedolizumabAll indications
    Velaglucerase alfaGaucher's disease
    VelcalcetideHyperparathyrodism
    VemurafenibMelanoma
    Venetoclax
    Cancer
    VenetoclaxIn combination with rituximab for the treatment of adult patients with chronic lymphocytic leukaemia who have received at least one prior therapy
    Verteporfin Age related macular degeneration (AMD)
    Viekirax®Hepatitis C
    Vigam®All indications
    Vinblastine Treatment of cancers
    Vincristine Treatment of cancers
    Vindesine Treatment of cancers
    Vinorelbine Treatment of cancers
    VismodegibTreatment of cancers
    Vivaglobin®All indications
    Vitamin A Retinosa pigmentosa
    Voluvyte® Injection Plasma expander
    Von Willebrand factor, recombinantVon Willebrand deficiency
    Voriconazole Fungal infections,
    Chronic pulmonary aspergillosis
    Ziconotide Non-opioid analgesic administered by intrathecal infusion
    Zidovudine HIV Infection
    Zidovudine/lamivudineHIV Infection
    Zidovudine/lamivudine/ababacavirHIV Infection
    Zoledronic acidPrevention of skeletal related events (pathological fractures, spinal compression, radiation/surgery to bone, or tumour-induced hypercalcaemia) in patientts with advanced malignancies involving bone; Treatment of tumour-induced hypercalcaemia

  • Amber Drug Classification

    Responsibility for prescribing may be transferred from secondary care/specialist services to primary care with agreement of an individual primary care prescriber and when locally approved and agreed shared care arrangements have been established (e.g. approved shared care guidelines are available)

    Drugs that do not have written shared care guidelines may be prescribed in primary care at the primary care prescriber’s discretion. The primary care prescriber should be satisfied that he/she has all the information and support needed to prescribe and monitor the patient.

    Medicines with the following criteria should be classified as AMBER:

    require specialist/consultant assessment to enable patient selection and initiation of treatment, plus one or more of the following;

    1. require short or medium term specialist monitoring of efficacy;
    2. require short or medium term specialist monitoring of toxicity;
    3. are very rarely used, such that individual primary care prescribers are unlikely to see sufficient patients and acquire a working knowledge of the drug.
    *The Area Prescribing Committee may accept shared care guidelines that have been produced by other organisations.
    Always check the latest Summary of Product Characteristics for the licensed indications
    Attention: The internal data of table “5” is corrupted!

  • Green with Specialist Initiation Drug Classification

    A medicine only to be initiated by the clinicians specified below, but where there is no requirement for additional monitoring for toxicity over and above the general requirements for all medicines i.e. monitoring of efficacy, annual review etc. The primary care prescriber should be satisfied that he/she has all the information and support needed to continue to prescribe for the patient.

    Health care professionals who can initiate GSI medicines are prescribers:

    •Specialist working in a provider service

    •GPwSI

    •Independent prescribers who undertake further training to demonstrate competence in an area of healthcare.

    Primary care specialists work in a commissioned service.

    Specialists are accountable, expert healthcare professionals who can be consulted because of their in-depth knowledge and skills in a particular specialist field. Their practice is underpinned by approved governance structures and regular demonstration of competency. They must take personal responsibility for their actions and omissions and fully recognise their personal accountability.

    The person initiating prescribing should undertake any necessary pre-prescribing tests (bloods/ECGs/Xray etc) and initial monitoring.

    Medicines with the following criteria should be classified as GREEN SPECIALIST INITIATION:

    1. requires a primary or secondary care clinician with specialist knowledge to enable patient selection;
    2. requires short or medium term specialist monitoring of efficacy;
    3. requires the dose to be titrated by the specialist service;
    4. is initiated following discussion with a specialist.
    Always check the latest summary of product characteristics for the licenced indications.
    Attention: The internal data of table “6” is corrupted!

  • Black Drug Classification

    Drugs that have been classified as “black” are those drugs that commissioning organisations across the SWY APC boundaries have agreed with local trusts and clinicians that they will not commission locally. Medicines with the following criteria should be classified as BLACK:

    1. there is a clear NHSE specialised commissioning group decision to not routinely fund usage of the drug.
    2. There is a CCG local decision not to routinely fund.
    3. There is a NICE recommendation that the drug should not be prescribed on the NHS for the condition specified
    4. A medicine for which the APC considers there is a poor evidence base or lack of cost effectiveness compared to alternative commissioned treatments
    DrugIndications
    AvanafilPenile rehabilitation post-radical prostatectomy or radiotherapy
    BCG vaccine Black for travel use
    NHSE items that should not be routinely prescribed in Primary Care
    Brimonidine gelTreatment of facial erythema of rosacea in adults patients
    Cannabis-based products (not Sativex®)See NHS England's Guidance. Guidance documents
    ChondroitinBlack - for all indications
    NHSE items that should not be routinely prescribed in Primary Care
    Co-proxamolBlack for all indications NHSE items that should not be routinely prescribed in Primary Care
    DapoxetinePremature ejaculation
    Dental Products on FP10Black with the exception of those patients on specialist advice following treatment for head and neck cancers (GSI)
    See NHSE Guidance on the conditions for which over the counter items should not routinely be prescribed in primary care.
    DosulepinBlack for new patients for all indications - NHSE items that should not be routinely prescribed in Primary Care
    Doxazosin MR Black for all indications - NHSE items that should not be routinely prescribed in Primary Care
    Fentanyl IR Black for non palliative care use - NHSE items that should not be routinely prescribed in Primary Care
    Glucosamine Black for all indications - NHSE items that should not be routinely prescribed in Primary Care
    Hepatitis B (single agent vaccine) Black for travel use
    NHSE items that should not be routinely prescribed in Primary Care
    Herbal Black - for all indications
    NHSE items that should not be routinely prescribed in Primary Care
    Homeopathic medicinesBlack - for all indications
    NHSE items that should not be routinely prescribed in Primary Care
    Hyaluronic acid (injectables)Osteoarthritis and other joint conditions
    Hydrocortisone MRReplacement in adrenocortical insufficiency
    Japanese Encephalitis vaccine Black for travel use
    NHSE items that should not be routinely prescribed in Primary Care
    Lidocaine plasters Black - for unlicensed indications
    NHSE items that should not be routinely prescribed in Primary Care
    Liothyronine and
    liothyronine with levothyroxine
    Black - not to be initiated in Primary Care for new patients
    NHSE items that should not be routinely prescribed in Primary Care
    LiraglutideManagement of obesity
    Lutein and antioxidants Black - for all indications
    NHSE items that should not be routinely prescribed in Primary Care
    Meningitis ACWY vaccine Black for travel use
    NHSE items that should not be routinely prescribed in Primary Care NHSE items that should not be routinely prescribed in Primary Care
    Methylnaltrexone subcutaneous injectionSevere opioid induced constipation
    Mysimba® (naltrexone/bupropion) For managing overweight and obesity
    NefopamPain. Black for new patients
    Omega 3 and other fish oils Black for all indications
    NHSE items that should not be routinely prescribed in Primary Care
    Oxycodone and naloxone MR Black for all indications
    NHSE items that should not be routinely prescribed in Primary Care
    Paracetamol and tramadol Black for all indications
    NHSE items that should not be routinely prescribed in Primary Care
    Perindopril arginine Black for all indications
    NHSE items that should not be routinely prescribed in Primary Care
    Pre-exposure prophylaxis (PrEP)For prevention of HIV in adults. Only as part of a clinical trial. Further details from NHS England
    Probiotics Black.
    See NHSE Guidance on the conditions for which over the counter items should not routinely be prescribed in primary care
    Prednisone MRRheumatoid arthritis (RA)
    Rabies vaccine Black for travel use
    NHSE items that should not be routinely prescribed in Primary Care
    RoflumilastClassification pending formal guidance from NICE and Commissioning
    Rubefacients Black for all indications
    NHSE items that should not be routinely prescribed in Primary Care
    Sativex® Oromucosal Spray (cannabis-based product. Delta-9-tetrahydrocannabinol/
    cannabidiol )
    Spasticity and neuropathic pain in multiple sclerosis (MS). Also see information on the DROP-List
    Tadalafil once daily Black for erectile dysfunction
    NHSE items that should not be routinely prescribed in Primary Care
    TadalafilPenile rehabilitation post-radical prostatectomy or radiotherapy
    Tick-borne encephalitis vaccine Black for travel use
    NHSE items that should not be routinely prescribed in Primary Care
    Travel vaccinesBlack
    NHSE items that should not be routinely prescribed in Primary Care
    TrimipramineBlack for new patients for all indications
    NHSE items that should not be routinely prescribed in Primary Care
    VardenafilPenile rehabilitation post-radical prostatectomy or radiotherapy
    Yellow fever vaccine Black for travel use
    NHSE items that should not be routinely prescribed in Primary Care

  • Green Drug Classification

    The drugs in this category have been reviewed and classified as GREEN by the NHS locally as being suitable for initiation, stabilisation and maintenance in a primary, secondary or tertiary care setting.
    This list is not exhaustive. Please contact your medicines management team if you are unsure if you can prescribe a particular drug.

     

    Drug Indication
    Aclidinium bromide powder inhaler Chronic obstructive pulmonary disease (COPD)
    Alogliptin Type 2 diabetes (T2DM)
    Anoro Ellipta 55/22®Chronic obstructive pulmonary disease (COPD)
    Apixaban see DOACs
    Avanafil Erectile Dysfunction in adult males
    Calcipotriol/betamethasone scalp gel Psoriasis
    Canagliflozin Type 2 diabetes (T2DM)
    Clopidogrel Heart disease and stroke
    Colesevelam Hyperlipidaemia
    Dabigatransee DOACs
    Dapagliflozin Type 2 diabetes (T2DM)
    DOACsGreen for prevention of stroke and systemic embolism in adults with non-valvular atrial fibrillation, with one or more risk factors, subject to local policy. Check licensed indications and doses of individual drugs
    Duloxetine Pain - nerve
    Edoxabansee DOACs
    Enstilar® (calcipotriol/betamethasone)Psoriasis
    Exenatide Type 2 diabetes (T2DM)
    Exenatide weekly Type 2 diabetes (T2DM)
    Febuxostat In line with NICE patients intolerant of allorpurinol
    Fesoterodine Overactive bladder syndrome
    Fluorouracil/salicylic acid (Actikerall®) Management of actinic keratosis
    Fluticasone furoate nasal spray
    Influenza intra-nasal vaccine
    Ingenol mebotate Management of actinic keratosis
    Insulin glargine (Abasaglar®)Diabetes mellitus (DM)
    Insulin glargine (Toujeo®)Diabetes mellitus (DM)
    Ivermectin cream Rosacea
    LiraglutideType 2 diabetes (T2DM)
    Lixisenatide Type 2 diabetes (T2DM)
    Mesalazine MR (Mezavant®)For the induction of clinical and endoscopic remission in patients with mild to moderate, active ulcerative colitis. For maintenance of remission
    Mirabegron Overactive bladder syndrome
    NOACsSee DOACs
    Pivmecillinam
    PramipexoleRestless legs syndrome
    Rivaroxabansee DOACs
    Saxagliptin Type 2 diabetes (T2DM)
    Sitagliptin Type 2 diabetes (T2DM)
    Tacrolimus (topical) Treatment of moderate to severe atopic dermatitis in adults who are not adequately responsive to or are intolerant of conventional therapies such as topical corticosteroids
    Trospium MR Urinary incontinence
    Trospium XL Urinary incontinence
    Ultibro Breezhaler®Chronic obstructive pulmonary disease (COPD)
    Venlafaxine (at doses over 300mg daily)Treatment of major depressive episodes.
    For prevention of recurrence of major depressive episodes.
    Treatment of generalised anxiety disorder.
    Treatment of social anxiety disorder.
    Treatment of panic disorder, with or without agoraphobia
    Vildagliptin Type 2 diabetes (T2DM)
    Vildagliptin with metformin Type 2 diabetes (T2DM)

  • Black not yet classified

    The drugs and devices in this category have reached the market but have not yet been classified by the NHS locally.
    This list is not exhaustive. Please contact your medicines management team if you are unsure if you can prescribe a particular drug.
    Drugs/deviceIndication   
    ActiPatch®Pain
    Xoneva®Nausea and vomiting in pregnancy