Search by individual drug

*The Area Prescribing Committee may accept shared care guidelines that have been produced by other organisations.

DrugIndicationsDrug class
3,4-diaminopyridineLambert-Eaton myasthenic syndrome (LEMS)Red
5-methoxypsoralenPUVA treatment of psoriasisRed
AbacavirHIV infectionRed
Abacavir/dolutegravir/lamivudineHIV infectionRed
Abacavir/lamivudineHIV infectionRed
Abaloparatide

Male and juvenile osteoporosisRed
AbataceptAll indications Red
AbirateroneTreatment of cancer Red
AcamprosateMaintain abstinence in alcohol-dependent patientsAmber
Acetylcysteine sachetsIntestinal obstructionGreen Specialist Initiation
AcetylcysteineInterstitial lung diseaseGreen Specialist Initiation
AcetylcysteineRed for newly diagnosed patients with cystic fibrosis (CF)Red
AcitretinOral retinoid for psoriasisRed
Aclidinium bromide powder inhaler Chronic obstructive pulmonary disease (COPD)Green
AdalimumabAll indications Red
AdefovirHepatitis BRed
AfatinibTreatment of cancersRed
Agalsidase alfaFabry's diseaseRed
AfliberceptAll indicationsRed
Agalsidase beta
Fabry's disease
Red
AgomelatineAntidepressant (amber for existing patients)Red for new patients.

Amber
Albumin-bound paclitaxelTreatment of cancer Red
Albutrepenonacog alfa
Haemophilia B
Red
Albutropin
Adult onset growth hormone deficiency
Red
Aldesleukin
Treatment of cancers
Red
AlemtuzumabAll indications
Red
Alglucosidase alfa
Pompe disease
Red
Alipogene tiparvovecLipoprotein lipase deficiencyRed
AliskirenStage 4 hypertensionGreen Specialist Initiation
Alisporivir
Hepatitis C
Red
AlitretinoinSevere chronic hand eczema refractory to potent topical corticosteroidsRed
Alogliptin Type 2 diabetes (T2DM) Green
Alpha-1 antitrypsin
Alpha-1 antitrypsin deficiency
Red
Alpha mannosidase recombinant human
Alpha mannosidase deficiency
Red
AlteplaseThrombolyticRed
AmbrisentanPulmonary arterial hypertensionRed
AmiodaroneArrhythmiasGreen Specialist Initiation
Amifampridine
Lambert-Eaton myasthenic syndrome (LEMS)
Red
Amikacin inhalation
Cystic fibrosis (CF)
Red
Amikacin liposomal
Cystic fibrosis (CF)
Red
Amphotericin liposomal
Fungal infections
Red
AmisulprideAtypical antipsychotic for schizophreniaGreen Specialist Initiation
AnagrelideEssential thrombocythaemiaRed
AnakinraRheumatoid arthritis (RA)Red
AnastrozoleBreast Cancer - long term therapyGreen Specialist Initiation
AnidulafunginIV antifungal agentRed
Anoro Ellipta 55/22®Chronic obstructive pulmonary disease (COPD)Green
Anti-epileptic drugs (AED) in childrenSee LTHT guidance for information Green Specialist Initiation
Antihistamines for hay fever (OTC or prescription)See separate grey list (DROP-List)Grey (DROP-List)
Antihaemophilic factor/Von Willebrand factor complex
As per BCSH guidelines for specialised indications
Red
Antilymphocyte globulin
Aplastic anaemia organ transplant
Red
Antipseudomonas aeruginosa IgY
Cystic fibrosis (CF)
Red
Antithrombin III
As per BCSH guidelines for specialised indications
Red
Antithymocyte immunoglobulin
Aplastic anaemia organ transplant
Red
Anti-retroviralsHIV infectionRed
Antox®Anti-oxidant therapy for pancreatitisGreen Specialist Initiation
Apixaban See DOACsSee DOACs
ApomorphineParkinson's disease Amber
Apremilast
According to NICE (TA433) for the treatment of active psoriatic arthritis & (TA419) for treating moderate to severe plaque psoriasis
Red
AprepitantNausea/vomiting with highly emetogenic chemotherapyRed
AripiprazoleSchizophreniaGreen Specialist Initiation
AsenapineTreatment of bipolar disordersRed
Asfotase alfaHypophosphatasiaRed
Asunaprevir with daclatasvir
Hepatitis C
Red
Atacicept
Systemic lupus erythematosus (SLE)
Red
Ataluren
Duchenne muscular dystrophy
Red
AtazanavirHIV infectionRed
Atazanavir/cobicistatHIV infectionRed
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.
Red
AtomoxetineFor attention deficit hyperactivity disorder (ADHD) in school-age children, adolescents and adultsAmber
AvanafilPenile rehabilitation post radical prostatectomy or radiotherapyBlack
Avanafil Erectile dysfunction in adult males Green
AvastinFor Neovascular Glaucoma and Neovascularization of the RetinaRed
Avoralstat
Hereditary angioedema
Red
Axitinib
Treatment of cancersRed
AzacitidineTreatment of cancersRed
AzathioprineLicensed indications - rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis and polymyositis, auto-immune hepatitis
Off-label indications - systemic vasculitis, inflammatory bowel diseases (Crohn’s disease, ulcerative colitis, microscopic colitis)
Amber
AzathioprineDermatological conditions. Off-label: bullous pemphigoid, eczema, vasculitis & Behcets syndromeAmber
AzathioprineTransplant immunosuppressionRed
Azathioprine Paediatric Inflammatory Bowel Disease (IBD) / Rheumatology Amber
Azithromycin Long term treatment bronchiectasis & COPDGreen Specialist Initiation
Aztreonam lysineRed for newly diagnosed cystic fibrosis (CF) PatientsRed
Baricitinib
Paediatric indications (where adult NICE TA available)
Red
Basiliximab
Renal transplant
Red
BCG vaccine For travel use Black
NHSE items that should not be routinely prescribed in Primary Care
BecaplerminTreatment of diabetic ulcersRed
Beclabuvir
Hepatitis C
Red
BedaquilineTBRed
Begelomab
Graft versus host disease
Red
Belatacept
Renal transplant
Red
BelimumabSystemic lupus erythematosus (SLE)Red
BendamustineCancer treatmentRed
Benralizumab
Asthma
Red
BenzbromaroneUnlicensed medicine - Gout Red
Beractant
Respiratory distress syndrome
Red
Betaine
Homocystinuria
Red
Bevacizumab All indicationsRed
BexaroteneTreatment of cancersRed
BicalutamideLocally advanced prostate cancer at high risk of disease progression.
Locally advanced non-metastatic prostate cancer when surgical castration or other medical intervention inappropriate.
Ongoing monotherapy for prostate cancer in patients wishing to preserve sexual function.
Maximum androgen blockade – use continuously in conjunction with LHRH analogue for three months
Amber
Bimagrumab
Inclusion body myositis
Red
Bimatoprost/timolol eye drops (Ganfort®)GlaucomaGreen Specialist Initiation
Biopatch®Prevention of catheter site infectionRed
BiotinVitamin induced hair loss. Multiple sclerosis (MS)Red
BivalirudinUse in perctaneous coronary intervention proceduresRed
BlinatumomabRecommended as an option for treating Philadelphia-chromosome-negative relapsed or refractory precursor B-cell acute lymphoblastic leukaemia in adults.Red
Blisibimod
Systemic lupus erythematosus (SLE)
Red
BoceprevirHepatitis CRed
Bone morphogenic protein (dibotermin, eptotermin)Bone fractures. See bone morphogenic protein commissioning statementRed
Bone morphogenic protein (dibotermin, eptotermin)Complex spinal surgeryRed
Bortezomib
All indications
Red
BosentanAll indicationsRed
Bosutinib
Cancer
Red
Botulinum toxinAll indicationsRed
Brentuximab
Treatment of cancerRed
Brimonidine gelTreatment of facial erythema of rosacea in adultsBlack
Brincidofovir
Cytomegalovirus
Red
BrivaracetamAs an adjunctive third line treatment option for the management of partial-onset seizures with or without secondary generalisation in adults. Brivaracetam may be considered if there is:
• failure of one or more first line drugs (carbamazepine, lamotrigine or levetiracetam) AND
• failure of one or more 2nd line drugs (topiramate, pregabalin, lacosamide, zonisamide or perampanel)
Green Specialist Initiation
BrodalumabPaediatric indications (where adult NICE TA available)
Red
BulkamidPeriurethral injection for the management of female stress incontinenceRed
BuserelinGonadorelin analogue - IVFRed
BusulfanTreatment of cancerRed
C1 esterase inhibitorsHereditary angioedema
Red
CabazitaxelTreatment of cancersRed
CabozantinibTreatment of cancersRed
Canakinumab
Cryopyrin associated periodic syndrome and juvenile arthritis - paediatric
Red
CabergolineParkinson's diseaseGreen Specialist Initiation
Calcipotriol /
betamethasone scalp gel
Psoriasis Green
Canagliflozin Type 2 diabetes (T2DM) Green
CapecitabineAll indicationsRed
Caphosol® oral rinse For the prevention and treatment of mucositis caused by high dose chemotherapyRed
Capsaicin patches 8%Neuropathic painRed
Carglumic acid
Urea cycle disorders
Red
Carnitine
Carnitine deficiency
Red
Caspofungin
Fungal infections
Red
Catridecacog
Congenital factor XIIIa-subunit deficiency
Red
Ceralifimod
Multiple sclerosis (MS)
Red
CeritinibAll indicationsRed
Cerliponase alfa
Neuronal ceroid lipofuscinosis
Red
Certolizumab pegolAll indicationsRed
CetrorelixIVFRed
CetuximabTreatment of cancersRed
Chenodeoxycholic acid
Cerebrotendinous xanthomatosis and primary biliary cirrhosis
Red
Chloral Hydrate Insomnia (Short term use)Red
ChlorambucilTreatment of cancersRed
ChlordiazepoxideAcute alcohol withdrawalRed
Cholic acidInborn errors in primary bile acid synthesisRed
ChondroitinAll indications Black
NHSE items that should not be routinely prescribed in Primary Care
Chondriotin sulphateBladder instillation for Patients with damaged or glycosaminoglycan deficient bladder epitheliumRed
Chorionic gonadotrophinGonadorelin analogue - IVFRed
CiclosporinInflammatory bowel diseaseAmber - SCG not available for this indication. Please see Amber classification definition for further information and seek advice from requesting consultant for monitoring requirements.
CiclosporinLicensed indications: rheumatoid arthritis, psoriasis.
Off-label indication: psoriatric arthritis
Amber
CiclosporinDermatological conditions. Licensed: atopic dermatitis. Off-label: bullous pemphigoid, pyoderma gangrenosum, hidradenitis suppurativa, pemphigus & lupusAmber
CiclosporinBone marrow transplantAmber - SCG not available for this indication. Please see Amber classification definition for further information and seek advice from requesting consultant for monitoring requirements.
Ciclosporin Paediatric RheumatologyAmber
Ciclosporin Post-transplantAmber
Ciclosporin eye drops 1mg/ml (Ikervis®)Persistent dry eye (NICE TA369)Green Specialist Initiation (Indications other than NICE TA369 are Red)
CidofovirCytomegalovirus Red
CinacalcetHypercalcaemia of primary hyperparathyroidism or parathyroid carcinoma Amber
CinacalcetSecondary hyper-parathyroidism in patients with end-stage renal disease on maintenance dialysis therapyAmber
CinacalcetHyperparathyrodism in dialysis patientsRed
Ciprofloxacin inhalation
Cystic fibrosis (CF)
Red
Ciprofloxacin liposomal (inhaled)
Cystic fibrosis (CF)Red
Cladribine
Multiple sclerosis (MS) and pulmonary Langerhans histiocytosis
Red
Clinical trials materialAll trialsRed
ClofarabineTreatment of cancersRed
ClomifeneIVF treatmentRed
Clopidogrel Green
ClozapineAtypical Antipsychotic - SchizophreniaRed
CobicistatHIV infectionRed
Cobitolimod
Paediatric indications (where adult NICE TA available)
Red
Co-careldopa intestinal gelSevere Parkinson's diseaseRed
Co-Enzyme Q10Enzyme deficiency in childrenRed
Colief® dropsSee separate grey list (DROP-List)Grey (DROP-List)
Colesevelam Hyperlipidaemia Green
ColestilanRenal dialysis - adultsRed
Colistimethate sodiumRed for newly diagnosed cystic fibrosis (CF) patientsRed
Colistimethate sodium - (Colomycin®)Cystic fibrosis (CF) managementAmber - SCG not available for this indication. Please see Amber classification definition for further information and seek advice from requesting consultant for monitoring requirements.
Colistimethate sodium - (Promixin®)Cystic fibrosis (CF) managementAmber
Colistimethate sodium - (Colomycin®)Pseudomonas infection in the lungs Amber
Conestat alfaHereditary angioedemaRed
Co-proxamolAll indications
NHSE items that should not be routinely prescribed in Primary Care
Black
Cough and cold remediesSee separate grey list (DROP-List)Grey (DROP-List)
Crizotinib
Treatment of cancers
Red
Cyclophosphamide All Indications Red
CyproteroneProstate cancerRed for new patients
Amber for existing patients only
Amber
Cyproterone (off-label indications)Off-label indicationsRed
Cytotoxic injectable drugsAll indicationsRed
DabigatranSee DOACsSee DOACs
Dabrafenib Treatment of cancerRed
DaclatasvirHepatitis CRed
Daclizumab
Multiple sclerosis (MS)
Red
DalteparinUrgent bridging of patients on warfarin (for VTE or heart valve), with significantly sub-therapeutic INR, in accordance with Trust dosing guidance (taking account of patient weight and renal function)Green Specialist Initiation
DalteparinPre-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.
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)

Red
Dapagliflozin Type 2 diabetes (T2DM)Green
DapoxetinePremature ejaculationBlack
DapsoneLicensed indication- Dermatitis herpetiformis, and off-label indications - dermatoses (leucocytoclastic vasculitis, Sweet's syndrome, pyoderma gangrenosum)Amber
DaratumunabFor 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
Red
Darbepoetin alfaAll indications Red
DarunavirHIV treatmentRed
Darunavir/cobicistatHIV treatmentRed
Dasabuvir
Hepatitis C
Red
DasatinibTreatment of cancersRed
DaunorubicinTreatment of cancersRed
Decitabine
Treatment of cancers
Red
DeferasiroxIron chelation in thalassaemia and sickle cellRed
DeferiproneIron chelation in thalassaemia and sickle cellRed
Defibrotide
Hepatic veno-occlusive disease
Red
DegarelixProstate cancer Red
DelamanidExtensively drug-resistant TB and multi drug-resistant TBRed
DenosumabPrevention of osteoporosisAmber SWYAPC (please note this shared care guideline has not been adopted by Bradford CCGs)
DenosumabPrevention of skeletal events from breast cancerRed
Dental products on FP10
Black 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.
DesferrioxamineIron chelation in thalassaemia and sickle cellRed
DesferrioxamineTreatment of iron overloadAmber
Dexamethasone intravitreal implant Macular oedemaRed
DexamfetamineFor attention deficit hyperactivity disorder (ADHD) in school-age children, adolescents and adultsAmber
DexmedetomideMaintenance of sedation during intensive careRed
Dexrazoxane
Anthracycline extravasation and cardiotoxicity
Red
Dibotermin alfa Bone fracturesRed - see bone morphogenic protein commissioning statement
Dibotermin alfa Complex spinal surgeryRed
DidanosineHIV infectionRed
Dihydrotestosterone (Androstanolone®)Unlicensed - recommendation from Leeds paediatric surgeonsRed
Dimethyl fumarateMultiple sclerosis (MS)/psoriasis

Red
Dinoprostone vaginal delivery systemCervical ripening/induction of labourRed
Disodium pamidronate (IV)Bisphosphonate - all licensed indicationsRed
DisulfiramManagement of patients with drinking problemsAmber
DOACsRed for prevention of venous thromboembolic events (VTE) in adults who have undergone elective hip or knee replacement surgery. Red for acute coronary syndrome (ACS). Full courses supplied through Acute Trust. GSI for treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrent DVT and PE in adults, subject to local policy. Green 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 drugsRed for prevention of venous thromboembolic events (VTE) in adults who have undergone elective hip or knee replacement surgery. Red for acute coronary syndrome (ACS). Full courses supplied through Acute Trust. GSI for treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrent DVT and PE in adults, subject to local policy. Green 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
DocetaxelAdvanced/metastatic breast cancer, prostate cancerRed
DolutegravirHIV InfectionRed
DonepezilMild to moderate dementia in Alzheimer's diseaseGreen Specialist Initiation
Dornase alfaRed for newly diagnosed CF PatientsRed
Dornase alfaCystic fibrosis (CF) managementAmber
Dornase alfaPrimary ciliary dyskinesia
Red
DosulepinAll indications Black for new patients for all indications
NHSE items that should not be routinely prescribed in Primary Care
Doxazosin MRAll indications Black
NHSE items that should not be routinely prescribed in Primary Care
Drisapersen
Duchenne muscular dystrophy
Red
DronedaroneCardiac arrhythmiaGreen Specialist Initiation
Droperidol injectionPost operative nausea and vomitingRed
Duloxetine Green
Dupilumab
Asthma
Red
Ecallantide
Hereditary angioedema
Red
Eculizumab
All indicationsRed
EdoxabanSee DOACsSee DOACs
Edratide
Systemic lupus erythematosus (SLE)
Red
EfavirenzHIV infectionRed
Eflornithine cream
See separate grey list (DROP-List)
Grey (DROP-List)
Efraloctocog alfa/efmoroctocog alfa/factor VIII FC fusion protein
Haemophilia A
Red
Efmoroctocog alfa HaemophiliaRed
Elbasvir

Hepatitis CRed
Eliglustat
Gaucher's disease
Red
Elosulfase alfaLysosomal storage disordersRed
EltrombopagIdiopathic thrombocytopenic purpuraRed
ElvitegravirHIV infectionRed
Emricasan
Non-alcoholic steatohepatitis fibrosis
Red
EmtricitabineHIV infectionRed
Emtricitabine/elvitegravir/cobicistat/tenofovir alafenamide fumarateHIV infectionRed
Emtricitabine/rilpivirine/tenofovir alafenamide fumarateHIV infectionRed
Emtricitabine/tenofovir alafenamide fumarateHIV InfectionRed
Enfuvirtide HIV InfectionRed
Enstilar® (calcipotriol and betamethasone) Green if failed on individual components
EntecavirChronic Hepatitis B infectionRed
Enzalutamide
Treatment of cancers
Red
EpoetinDialysis-induced anaemia - red.
All other indications- amber
Dialysis-induced anaemia - red.
All other indications amber - SCG not available Please see amber classification definition for further information and seek advice from requesting consultant for monitoring requirements.
EpoprostenolOff-label indications and pulmonary arterial hypertensionRed
Epratuzumab
Systemic lupus erythematosus (SLE)
Red
Eprodisate
Amyloidosis
Red
Eptotermin alfaBone fracturesRed - see bone morphogenic protein commissioning statement
Eptotermin alfaComplex spinal surgeryRed
EribulinTreatment of cancersRed
ErlotinibTreatment of cancersRed
EstramustineTreatment of cancersRed
EtanerceptAll indicationsRed
Eteplirsen
Duchenne muscular dystrophy
Red
EthambutolTreatment of TBRed
EtoposideTreatment of cancersRed
EtravirineHIV treatmentRed
Etrolizumab
Paediatric indications (where adult NICE TA available)
Red
Everolimus (Afinitor®)
Treatment of cancers
Red
Everolimus (Certican®)
Preventing transplant rejection
Red
Everolimus (Votubia®)
Tubular sclerosis
Red
Evicel®Tissue adhesive - for use in patients undergoing pelvic surgery or laparoscopic partial nephrectomiesRed
EvolocumabHomozygous familial hypercholesterolaemiaRed
ExemestaneBreast CancerGreen Specialist Initiation
Exenatide Type 2 diabetes (T2DM)Green
Exenatide weekly Type 2 diabetes (T2DM) Green
Ex-vivo expanded autologous human corneal epithelial cells containing stem cells
Limbal stem cell deficiency
Red
Factor IX
As per BCSH guidelines for specialised indications
Red
Factor VII
As per BCSH guidelines for specialised indications
Red
Factor VIIa (Recombinant)
(NovoSeven®)
Bleeding episodes in surgery in specific patientsRed
Factor VIIa
As per BCSH guidelines for specialised indications
Red
Factor VIII
As per BCSH guidelines for specialised indications
Red
Factor VIII inhibitor bypassing factorAs per BCSH guidelines for specialised indications
Red
Factor XIII
As per BCSH guidelines for specialised indications
Red
Fampridine
Multiple sclerosis (MS)
Red
Febuxostat In line with NICE for patients intolerant of allorpurinol Green
Fentanyl nasal sprayPain relief - use should be restricted to palliative care consultantsGreen Specialist Initiation
Fentanyl IR For non palliative care indications Black
NHSE items that should not be routinely prescribed in Primary Care
Ferric carboxymaltoseIron-deficiency anaemiaRed
Ferric carboxymaltoseHeart failure patients with or without decreased haemoglobin levelsRed
Fesoterodine Overactive bladder syndrome Green
Fiasp® (insulin aspart)Treatment of diabetes in adult patients with Type 1 diabetes who are likely to benefit directly from a more rapid onset of action, including:
1.Pregnancy
2.Use of insulin pump
3.Young adults unable to manage with Novorapid because of poor post-prandial glucose control, despite adequate therapeutic trial
Green Specialist Initiation
Fibrinogen
As per BCSH guidelines for specialised indications
Red
Fibroblast growth factor 1 gene therapy
Somatostatin analogue
Red
FidaxomicinTreatment of Clostridium difficile infection only when it prevents admission to hospital or severe illnessGreen Specialist Initiation
Filgotinib
Paediatric indications (where adult NICE TA available)
Red
FilgrastimNeutropenia and Barth syndrome
Red
Filibuvir
Hepatitis C
Red
FingolimodManagement of multiple sclerosisRed
Fitusiran
Haemophilia A And B
Red
FlecainideGreen Specialist Initiation
FludarabineTreatment of cancersRed
Fluocinolone acetonide intravitreal implant Treatment of chronic diabetic macular oedemaRed
Fluorouracil/salicylic acid (Actikerall®) Management of actinic keratosis Green
Flupentixol depot injectionDepot antipsychotic for schizophreniaGreen Specialist Initiation
Fluphenazine depot injectionDepot antipsychotic for schizophrenia (to be discontinued at the end of 2018 - no new patients should be started on this if treatment is expected to continue beyond 2018) Green Specialist Initiation
FlutamideAdvanced prostate cancer patients for:
Long term palliative therapy when LHRH analogues or orchidectomy is contraindicated, not tolerated or oral therapy preferred.
Hot flushes with LHRH analogue therapy or after orchidectomy
Amber
Fluticasone furoate nasal spray Green
Follitropin alfa/betaIVF - GonadotrophinRed
FondaparinuxParenteral anticoagulantRed
Forigerimod acetate
Systemic lupus erythematosus (SLE)
Red
FosamprenavirHIV InfectionRed
Fosaprepitant injectionChemotherapy induced nausea and vomitingRed
Foscarnet
Cytomegalovirus
Red
Fosfomycin IV2nd line antibiotic for patients with carbapenemase resistant infections or with confirmed anaphylactoid reaction to penicillins presenting with suspected meningitisRed
FosfomycinUrinary tract infections (UTIs) (sensitivities reported by Microbiology)Green Specialist Initiation
Fostemsavir
HIV infection
Red
FulvestrantBreast cancerRed
GalantamineMild to moderate dementia in Alzheimer's diseaseGreen Specialist Initiation
Galsulfase
Mucopolysaccharidosis
Red
Ganetespib
Treatment of cancers
Red
GanciclovirMaintenance of cytomegalovirus (CMV) retinitis in patients with AIDS. CMV disease in immunocompromised patients & patients with AIDS. Use in liver transplant patientsRed
GefitinibOral treatment for cancerRed
Gender dysphoria or reassignment drugsGuidance available from Leeds Health Pathways (search 'gender')See information from Leeds
Gevokizumab
Uveitis
Red
GlatiramerMultiple sclerosis (MS)Red
Glecaprevir
Hepatitis C
Red
GlucosamineAll indications Black
NHSE items that should not be routinely prescribed in Primary Care
Glucarpidase
Methotrexate-induced renal dysfunction
Red
Glycerol phenylbutyrate
Urea cycle disorders
Red
Glycopegylated factor IX
Haemophilia A
Red
Glycopyrronium (oral)Hypersalivation Amber
Glycopyrronium SCG LTHT*
Glycopyrronium (topical)HyperhidrosisRed
GnRH analogues (Leuprorelin or Triptorelin) Endometriosis or uterine fibroidsAmber
GnRH analogues (Goserelin, Leuproelin, Triptorelin) Management of prostate cancer Amber
GolimumabAll indicationsRed
GonadorelinIVF - hypothalmic hormoneRed
GoserelinManagement of prostate cancer Amber - see GnRH analogues
GoserelinIVF - gonadorelin analogueRed
GoserelinEndometriosisAmber - SCG not available for this indication. Please see Amber classification definition for further information and seek advice from requesting consultant for monitoring requirements.
Granulocyte-macrophage colony-stimulating factor
Antibody-positive pulmonary alveolar proteinosis
Red
Grazoprevir
Hepatitis C
Red
Grazax®
Seasonal allergic hayfeverRed
GuanfacineAttention deficit hyperactivity disorder (ADHD) in school age children, adolescents and adultsAmber
Haloperidol depot injectionDepot antipsychotic for schizophreniaGreen Specialist Initiation
Haemorrhoid preparations available over-the-counterSee separate grey list (DROP-List)Grey (DROP-List)
Herbal All indications Black
NHSE items that should not be routinely prescribed in Primary Care
Hepatitis B vaccine For travel use Black
NHSE items that should not be routinely prescribed in Primary Care
HIV-fusion inhibitorsHIV infectionRed
HIV-integrase inhibitorsHIV infectionRed
HIV vaccine
HIV infection prophylaxis
Red
Homeopathic medicinesAll indications Black
NHSE items that should not be routinely prescribed in Primary Care
Human (haem) arginate
Hepatic porphyria
Red
Human menopausal
gonadotrophins
IVF - GonadotrophinRed
Human heterologous liver cells
Urea cycle disorders
Red
Human parathyroid hormone-related protein analogue
Male and juvenile osteoporosis hypoparathyroidism
Red
Hyaluronic acid derivatives (injectables)Osteoarthritis and other joint conditionsBlack
Hydrocortisone MRReplacement in adrenocortical insufficiencyBlack
HydroxycarbamideTreatment of solid tumoursRed
HydroxycarbamideHaematological conditions
Amber
HydroxycarbamidePsoriasis (off-label)Amber
Hydroxychloroquine Interstitial Pneumonitis in children Green Specialist Initiation
see LTHT guidance for information
Hydroxychloroquine Paediatric RheumatologyGreen Specialist Initiation
See LTHT guidance for information
HydroxychloroquineRheumatoid arthritis, systemic and discoid lupus erythematosus (and related connective tissue diseases – off-label)Amber
Hydroxyprogesterone caproatePrevention of recurrent miscarriagesRed
Ibalizumab
HIV infectionRed
Ibandronic acid tablets 50mgPost-menopausal women with breast cancerPending Green Specialist Initiation
Ibandronic acid injectionBisphosphonate - all licensed indicationsRed
IbrutinibTreatment of cancersRed
Icatibant
Hereditary angioedema
Red
IdarubicinTreatment of cancersRed
Idebenone
Duchenne muscular dystrophy
Red
IdelalisibTreatment of cancersRed
Idursulfase
Mucopolysaccharidosis
Red
Iloprost
Pulmonary arterial hypertension
Red
Imatinib mesilateAll indicationsRed
ImigluceraseEnzyme replacement - Gaucher's diseaseRed
ImiquimodAnogenital wartsGreen Specialist Initiation
ImiquimodBasal cell carcinomaRed
Immunoglobulin - Intravenous (IVIg)All indicationsRed
IndinavirHIV InfectionRed
Indocyanine dyeOphthalmologyRed
InfliximabCrohn’s disease. Rheumatoid arthritis (RA)Red
Influenza intra-nasal vaccine Green
Ingenol mebotate Management of actinic keratosis Green
Insulin degludecDiabetes mellitus (DM)Green Specialist Initiation
Insulin glargine (Abasaglar®) Diabetes mellitus (DM)Green
Insulin glargine (Toujeo®)Diabetes mellitus (DM)Green
Insulin - Humulin R® - U500500 unit/mL insulin for use in severely insulin resistant patientsRed
Interferon alfaAll licensed indicationsRed
Interferon betaMultiple sclerosisRed
Ipilimumab
Treatment of cancersRed
IrinotecanMetastatic colorectal cancer used with 5-FU and folinic acidRed
Iron sucroseIron deficiency anaemia requiring intravenous therapyRed
Isavuconazole
Fungal infection (licensed indications)
Red
IsoniazidTreatment of TBRed
IsotretinoinOral retinoid - acneRed
IvabradineAngina in sinus rhythmGreen Specialist Initiation
IvacaftorRed for newly diagnosed cystic fibrosis (CF) patientsRed
Ivermectin cream RosaceaGreen
IVF TreatmentAll drugsRed
Ixazomib
For the treatment of adult patients with multiple myeloma who have received at least one prior therapy.Red
Japanese encephalitis For travel use Black
NHSE items that should not be routinely prescribed in Primary Care
KetamineAll indicationsRed
Ketogenic Dietary ProductsFor paediatric patients with epilepsy on a ketogenic diet and under the care of the regional service.
See link to LTHT for additional information on ketogenic prescribable products
Green Specialist Initiation
LacosamideResistant partial seizuresGreen Specialist Initiation
LamivudineHepatitis B treatmentRed
LamivudineHIV infectionRed
Lamivudine/abacavir/dolutegravirHIV infectionRed
Lamivudine/zidovudineHIV infectionRed
Lamivudine/zidovudine/abacavir HIV infectionRed
LanreotideNeuroendocrine tumours, acromegalyAmber - SCG not available for this indication. Please see Amber classification definition for further information and seek advice from requesting consultant for monitoring requirements.
LanreotideRed for NHS England indicationsRed
LanthanumControl of hyperphosphataemia in patients with chronic renal failureAmber
LanthanumAdult renal dialysisRed
LapatinibBreast cancerRed
Laquinimod
Multiple sclerosis (MS)
Red
Laronidase
Mucopolysaccharidosis
Red
Lebrikizumab
Asthma
Red
Ledipasvir/sofosbuvir
Hepatitis CRed
LeflunomideRheumatoid arthritis and psoriatic arthritis*Please note: awaiting regional update of guidelines* Amber
LenalidomideAll indicationsRed
LenograstimRecombinant human granulocyte - colony stimulating factor - neutropeniaRed
Letermovir
Cytomegalovirus
Red
LetrozoleAdvanced breast cancer - long term therapyGreen Specialist Initiation
LeuprorelinEndometriosis or uterine fibroidsAmber - see GnRH analogues
LeuprorelinManagement of prostate cancer Amber - see GnRH analogues
Levofloxacin (inhaled)
Cystic fibrosis (CF)
Red
Lidocaine plastersPost-herpetic neuralgia Green Specialist Initiation
Lidocaine plasters For all unlicensed use Black
NHSE items that should not be routinely prescribed in Primary Care
LinezolidAntibiotic - Microbiologist initiation onlyRed
Liothyronine and
liothyronine with levothyroxine
Hypothyroidism Black - not to be initiated in Primary Care for new patients
NHSE items that should not be routinely prescribed in Primary Care
Lipegfilgrastim
Neutropenia
Red
LiraglutideManagement of obesity Black
Liraglutide Type 2 diabetes (T2DM)Green
LisdexamfetamineFor attention deficit hyperactivity disorder (ADHD) in school-age children, adolescents and adultsAmber
LithiumTreatment and prophylaxis of mania, bipolar disorder and recurrent depressionAmber
To refer patients back into the service who have been discharged - please see the link to the SWYPFT Service directory
Lithium carbonateMotor neurone disease (MND)Red
Lixisenatide Type 2 diabetes (T2DM)Green
Lixivaptan
Hyponatraemia; other endocrine uses
Red
LomustineTreatment of cancersRed
Lomitapide

Homozygous familial hypercholesterolemia
Red
Lonafarnib
Treatment of cancers
Red
Lopinavir/ritonavirHIV infectionRed
Loteprednol Peri-operative useRed
Loteprednol GlaucomaGreen Specialist Initiation
Low molecular weight heparin (LMWH) - this includes: dalteparin, enoxaparin and tinzaparinTreatment of adult patients with venous thromboembolism (VTE) presenting clinically as deep vein thrombosis (DVT), pulmonary embolism (PE) or both.

LMWH under this guideline may be used in: -
•Patients unable to take warfarin and in whom a direct oral anticoagulant (DOAC) is not appropriate or contraindicated.
•Patients in whom it has not been possible to stabilise on oral anticoagulant therapy and in whom a DOAC is not appropriate or contraindicated (for example: a patient with a replacement metal mitral heart valve and a sub-therapeutic INR and ‘bridging’ therapy is required).
•IV drug users (where warfarin is generally considered inappropriate) and in whom a DOAC is not appropriate or contraindicated.

Extended treatment & prophylaxis of VTE in adult patients with solid tumours.
Amber
LubiprostoneTreatment of chronic idiopathic constipationGreen Specialist Initiation
Lumacaftor/ivacaftorCystic fibrosis (CF)Red
LurasidoneSchizophrenia (adults)Green Specialist Initiation
Lutein and antioxidants All indications Black
NHSE items that should not be routinely prescribed in Primary Care
Macimorelin
Growth failure
Red
MacitentanPulmonary arterial hypertensionRed
Mannitol dry powder inhalerTreatment of cystic fibrosis in adultsRed
MaravirocHIV infectionRed
Masitinib
Pancreatic cancer.
Gastrointestinal stoma tumour (GIST)
Red
Mavrilimumab
Paediatric indications (where adult NICE TA available)
Red
Mecasermin Growth failureRed
Melatonin MR Treatment of sleep disorders in children and young people under 18 yearsAmber. Leaflet for patients Crushing Circadin tablets leaflet
Melatonin MR Cerebral palsy - these patients will require longer term treatment – there are no drug monitoring/blood monitoring requirementsGreen Specialist Initiation
MelphalanTreatment of cancersRed
MemantineModerately severe to severe Alzheimers disease.Green Specialist Initiation
Meningitis ACWY vaccine For travel use Black
NHSE items that should not be routinely prescribed in Primary Care
Mepolizumab
AsthmaRed
Mercaptamine (cysteamine)Nephropathic cystinosisRed
MercaptopurineGastroenterologyAmber
MercaptopurineFor the treatment of Inflammatory Bowel Disease in ChildrenAmber
MercaptopurineTreatment of cancersRed
Mesalazine MR (Mezavant®)For the induction of clinical and endoscopic remission in patients with mild to moderate, active ulcerative colitis. For maintenance of remission Green
Mesenchymal stem cellsAll indicationsRed
Methotrexate
(oral, IM & SC)
Cancer indicationsRed
Methotrexate
(IM and SC)
Non-cancer indicationsRed
Methotrexate (oral)Licensed indications – Rheumatoid arthritis, Psoriatic arthritis
Off-label indication - Other inflammatory arthritides, connective tissue disease (not for cancer or dermatological conditions)
Amber
Methotrexate (oral)Licensed indication: severe uncontrolled psoriasis.
Off-label conditions: e.g pemphigoid, pemphigus, sarcoidosis, scleroderma, dermatomyositis, eczema. See shared care guideline for further indications
Amber
Methotrexate (oral)Non cancer indications in paediatrics Amber
Methylnaltrexone subcutaneous injectionSevere opioid induced constipationBlack
MethylphenidateFor ADHD in school-age children, adolescents and adultsAmber
MetyraponeManagement of patients with Cushing’s SyndromeRed for new patients
Green Specialist Initiation for existing patients
Metreleptin
Dyslipidaemia
Red
MexiletineTreatment of life-threatening ventricular arrhythmiasRed
Micafungin
Fungal infections
Red
Miconazole buccalOropharyngeal candidiasisGreen Specialist Initiation
Midazolam oromucosal
solution
Convulsive seizuresGreen Specialist Initiation
MidodrineIn adults for the treatment of severe orthostatic hypotension due to autonomic dysfunction when corrective factors have been ruled out and other forms of treatment are inadequate.Green Specialist Initiation
Migalastat
Fabry's disease
Red
Miglustat
Gaucher's disease/Niemann-Pick disease
Red
Minocycline for acneSee separate grey list (DROP-List)Grey (DROP-List)
Mirabegron Overactive bladder syndrome Green
MitotaneTreatment of cancersRed
ModafinilTreatment of adults with excessive sleepiness associated with chronic pathological conditions, including narcolepsy. Multiple sclerosis (MS) and Parkinson's disease are to be included as they are chronic pathological conditionsAmber
Momelotinib
Treatment of cancers
Red
Mycophenolate Off-label indications –systemic lupus erythematosus (SLE), particularly lupus nephritis, other connective tissue diseases and systemic vasculitis. Treatment of myasthenia gravis in patients intolerant or non-responding to azathioprine*Please note: awaiting regional update of guidelines* Amber
Mycophenolate Cytotoxic immunosuppressant - prophylaxis of acute transplant rejectionAmber
Mycophenolate Indications not classified as amberRed
Mycophenolate Paediatric rheumatologyAmber
MycophenolateFor the prevention of relapse in frequently relapsing nephrotic syndrome in paediatricsAmber
Mysimba® (naltrexone plus bupropion) For the treatment of overweight and obesity Black
NabiloneAntiemetic; Multiple sclerosis treatmentRed
NafarelinIVF - gonadorelin analogueRed
Nalmefene
(only for patients under the care of alcohol services including shared care)
Alcohol dependenceRed
NaloxegolFor opioid-induced constipation according to NICE TA345Green Specialist Initiation
NaltrexoneMaintain abstinence in alcohol-dependent patientsAmber
Nasal sprays available over-the-counter for symptomatic relief of hay fever and congestion See separate grey list (DROP-List)Grey (DROP-List)
Natalizumab
Multiple sclerosis (MS)
Red
NelarabineTreatment of cancersRed
Neomycin oral tablet Surgical prophylaxis alongside oral metronidazole, plus standard intravenous surgical prophylaxis for colorectal – with mechanical bowel preparationRed
Nephro-vite®Vitamin supplementation in renal impairmentGreen Specialist Initiation
Netupitant and palonosetronAnti-emetic for use with cancer chemotherapyRed
NevirapineHIV infectionRed
NilotinibTreatment of cancersRed
Nintedanib
Treatment of cancers; idiopathic pulmonary fibrosis
Red
NitazoxanideUnlicensed in UK - for treatment of Cryptosporidiosis and GiardiasisRed
Nitazoxanide
Hepatitis CRed
NitisinoneAlkaptonuria; tyrosinaemia
Red
Nitric oxide
Pulmonary arterial hypertension
Red
NivolumabTreatment of cancersRed
NOACsSee DOACsSee DOACs
Nonacog alpha
Haemophilia B
Red
Nonacog beta pegol
Haemophilia B
Red
Non-nucleoside reverse transcriptase inhibitorsHIV infectionRed
Nucleoside reverse transcriptase inhibitors (nucleoside analogues)HIV infectionRed
Obeticholic acid
Primary biliary cirrhosis
Red
Obinutuzumab Treatment of cancersRed
Ocrelizumab
Multiple sclerosis (MS)
Red
OcriplasminRetinal disordersRed
Octocog alfa
Haemophilia A
Red
Octreolin
Acromegaly
Red
OctreotideFor palliative care indicationsGreen Specialist Initiation
OctreotideAmber for licensed CCG funded indications (symptoms associated with carcinoid tumours with features of carcinoid syndrome, VIPomas, glucagonomas, acromegaly, prevention of complications after pancreatic surgery). Red for NHS England indicationsAmber - SCG not available. Please see Amber classification definition for further information and seek advice from requesting consultant for monitoring requirements.
Red for NHS England indications
Octreotide (off-label indications)Off-label indicationsRed
Ofatumumab
Cancer and pemphigus vulgaris
Red
Olanzapine (IM injection)Atypical antipsychotic - schizophrenia and bipolar disordersRed
Olanzapine (oral)Atypical antipsychotic - schizophrenia and bipolar disordersGreen Specialist Initiation
OlaparibTreatment of cancersRed
Olesoxime
Spinal muscular atrophy
Red
OmalizumabProphylaxis of allergic asthmaRed
Ombitasvir/paritaprevir/ritonavir Hepatitis CRed
Omega 3 and other fish oilsAll indications Black
NHSE items that should not be routinely prescribed in Primary Care
Oraldine® gel and mouthwashOral hygeineRed
Osilodrostat
Cushing's disease
Red
OsimertinibTreatment of cancersRed
OxaliplatinMetastatic colorectal cancer used with 5-FU and folinic acidRed
Oxycodone and naloxone MR All indications Black
NHSE items that should not be routinely prescribed in Primary Care
Ozanimod
Multiple sclerosis (MS)
Red
Pacritinib
Myelofibrosis
Red
PaliperidoneAntipsychoticRed
PalivizumabProphylaxis of respiratory syncytial virus (RSV) for childrenRed
Pancreatin preparationsPancreatic insufficiencyGreen Specialist Initiation
PanitumumabTreatment of cancersRed
PanobinostatTreatment of cancersRed
Para-aminosalicylic acid

TB
Red
Paracetamol and tramadolAll indications Black
NHSE items that should not be routinely prescribed in Primary Care
Parathyroid hormone
Specialist endocrinology conditions
Red
ParomomycinTreatment of cryptosporidium in immunocompromised patientsRed
Paritaprevir
Hepatitis C
Red
Pasireotide
Acromegaly; Cushing's disease
Red
Pazopanib
Treatment of cancers
Red
PegaspargaseTreatment of cancersRed
Pegylated liposomal doxorubicinTreatment of cancersRed
Peg-filgrastim Reduction in neutropenia with cytotoxic chemotherapyRed
Peg-interferon alfaTreatment of hepatitis B and C, patients not tolerating conventional terferonsRed
Peginterferon beta-1aMultiple sclerosis (MS)Red
Peginterferon lambda-1A
Hepatitis C
Red
Pegvisomant
Acromegaly
Red
PembrolizumabFor locally advanced or metastatic urothelial cancer previously treated with platinum-based chemotherapy only if the agreed criteria is met. Red
PembrolizumabMelanomaRed
PemetrexedTreatment of cancersRed
Pentosan polysulphateInterstitial Cystitis (Unlicensed)Red
PenicillamineRheumatoid arthritis (RA)Amber
Peptide receptor radionucelotide therapyTreatment of cancers
PergolideParkinson's diseaseGreen Specialist Initiation
Perindopril arginine All indications Black
NHSE items that should not be routinely prescribed in Primary Care
PertuzumabTreatment of cancersRed
PhenelzineTreatment resistant depressionAmber
Phenol 2% in Zinc paste Intractable pruritus aniRed
PhenylbutazoneNSAID - ankylosing spondylitisRed
Phenylephrine/tropicamide ophthalmic insert (Mydriasert®)Surgical mydriasisRed
Phytomenadione capsulesNot licensed in UKGreen Specialist Initiation
Pipotiazine depot injectionDepot antipsychotic for schizophreniaGreen Specialist Initiation
PirfenidoneAntifibrotic for idiopathic pulmonary fibrosisRed
Pivmecillinam Green
PixantroneTreatment of cancersRed
PlerixaforStem cell mobilisationRed
Pomalidomide
Treatment of cancers
Red
Ponatinib
Treatment of cancersRed
Ponesimod
Multiple sclerosis (MS)
Red
Poractant alfa
Respiratory distress syndrome
Red
PosaconazoleAll indicationsRed
Potassium iodideFor treatment of erythema nodosumRed
Pramipexole Restless legs syndrome Green
PramipexoleParkinson's diseaseGreen Specialist Initiation
Pramipexole MRParkinson's diseaseGreen Specialist Initiation
PrasugrelCobination with aspirin for the prevention of atherothrombotic events in patients with acute coronory syndrome undergoing percutaneous coronary interventionGreen Specialist Initiation
Prednisone MRRheumatoid arthritis (RA)Black
Pre-exposure prophylaxis (PrEP)For prevention of HIV in adults. Only as part of a clinical trial. Further details from NHS EnglandBlack
Pretomanid
Multi-drug resitant TB
Red
ProbioticsManagement of gastro-intestinal symptomsBlack (except VSL#3® which is 'green with specialist initiation' for ACBS criteria i.e. for the maintenance of remission of ileo-anal pouchitis).

See NHSE Guidance on the conditions for which over the counter items should not routinely be prescribed in primary care.
ProcarbazineTreatment of cancersRed
PropranololPaediatric Migraine Green Specialist Initiation
See LTHT guidance for information
Protease inhibitorsHIV infectionRed
Protein C
As per BCSH guidelines for specialised indications
Red
Protein kinase inhibitorsEndocrinology; non-malignant conditionsRed
Prothrombin complexAs per BCSH guidelines for specialised indicationsRed
PrucaloprideChronic constipation in women when other laxatives fail to provide an adequate response - NICE TA211Green Specialist Initiation
PyrazinamideTreatment of TBRed
QuetiapineAtypical antipsychotic - schizophreniaGreen Specialist Initiation
QuinidineShort QT syndrome, Brugada syndrome, and idiopathic ventricular fibrillation (VF)Red
Rabies vaccine For travel use Black
NHSE items that should not be routinely prescribed in Primary Care
Radium-223 dichlorideTreatment of cancersRed
RaltegravirHIV infectionRed
RaltitrexedAdvanced colorectal cancerRed
RamucirumabTreatment of cancersRed
Ranibizumab All indicationsRed
RanolazineOnly in accordance with NICE CG126Green Specialist Initiation
RasagilineParkinson's diseaseGreen Specialist Initiation
Rasburicase
Hyperuricaemia
Red
Regorafenib
Treatment of cancers
Red
Renavit®Vitamin supplementation in renal impairmentGreen Specialist Initiation
Reslizumab
As an add-on therapy, recommended as an option for the treatment of severe eosinophilic asthma that is inadequately controlled in adults despite maintenance therapy with high-dose inhaled corticosteroids plus another drug, only if the agreed criteria is met. Red
Reveglucosidase alfa
Pompe disease
Red
RibavirinChronic hepatitis C treatmentRed
RifampicinTreatment of TBRed
Rifater® (rifampicin/isoniazid/pyrazinamide )
Treatment of TBRed
RifaximinTreatment of small intestinal bacterial overgrowth and for the treatment of chronic refractory pouchitis
Red
RifaximinPrevention of hepatic encephalopathy in adult patientsGreen Specialist Initiation
Rifinah® (rifampicin/isoniazid)Treatment of TBRed
Rigosertib
Myelodysplastic syndromes (MDS); pancreatic cancer
Red
Rilonacept
Cryopyrin-associated periodic syndromes
Red
RilpivirineHIV infectionRed
RiluzoleTo extend life or time to mechanical ventilation for patients with amyotrophic lateral sclerosisAmber
Rimexolone ophthalmic
suspension
Local ocular steroid anti-inflammatoryGreen Specialist Initiation
Riociguat
Pulmonary arterial hypertension
Red
Risperidone injection Schizophrenia and other psychoses in patients tolerant to risperidone by mouthRed
Risperidone oralAtypical antipsychotic - schizophreniaGreen Specialist Initiation
RitonavirHIV infectionRed
Ritonavir/lopinavirHIV infectionRed
RituximabAll usesRed
Rivaroxaban See DOACsSee DOACs
RivastigmineMild to moderate dementia in Alzheimer's diseaseGreen Specialist Initiation
Rivastigmine patchesMild to moderate dementai in patients with swallowing difficultiesGreen Specialist Initiation
Roflumilast As per TA461: Roflumilast, as an add-on to bronchodilator therapy, is recommended as an option for treating severe chronic obstructive pulmonary disease in adults with chronic bronchitis, only if:
•the disease is severe, defined as a forced expiratory volume in 1 second (FEV1) after a bronchodilator of less than 50% of predicted normal, and
•the person has had 2 or more exacerbations in the previous 12 months despite triple inhaled therapy with a long-acting muscarinic antagonist, a long-acting beta-2 agonist and an inhaled corticosteroid
Green Specialist Initiation
RomiplostimThrombocyclopenic purpuraRed
Ropeginterferon alfa-2bHepatitis CRed
Ropinirole & ropinirole MR Parkinson's diseaseGreen Specialist Initiation
Rotigotine transdermal
patches
Parkinson's disease, either used alone or as an adjunct to levodopa with dopa-decarboxylase inhibitor Green Specialist Initiation
RoxadustatDialysis-induced anaemiaRed
Rubefacients (excluding topical NSAIDs)All indications Black
NHSE items that should not be routinely prescribed in Primary Care
RuxolitinibTreatment of cancersRed
Sacubitril valsartanAccording to NICE TA388 for treating symptomatic chronic heart failure with reduced ejection fractionGreen Specialist Initiation
SafinamideParkinson's disease, as an adjunct to levodopa alone or in combination with other antiparkinsonian drugs, for mid- to late-stage fluctuationsGreen Specialist Initiation
SapropterinManagement of patients with phenylketonuria and tetrahydrobiopterin deficiency
Red
SaquinavirHIV InfectionRed
SarilumabPaediatric indications (where adult NICE TAs are available)Red
Sativex® Oromucosal Spray (cannabis-based product. Delta-9-tetrahydrocannabinol/
cannabidiol )
Spasticity and neuropathic pain in multiple sclerosis (MS)Black. Also see information on the DROP-List
Saxagliptin Type 2 diabetes (T2DM)Green
Sebelipase alfaLysosomal acid lipase deficiencyRed
SecukinumabAll indicationsRed
SelexipagPulmonary arterial hypertensionRed
SetrobuvirHepatitis CRed
SevelamerHyperphosphataemia in dialysis patientsAmber
SevelamerAdult renal dialysisRed
Sialic acidMyopathyRed
SildenafilPost prostatectomy or radiotherapyGreen Specialist Initiation
SildenafilOff-label use for Raynaud's Disease. Pulmonary hypertensionRed
Silicone scar gels and sheetsWhen the specialist service recommending the treatment is funded by the NHS and has provided NHS funded care for that patient AND • The treatment is for hypertrophic or keloid scars that result from burns, trauma, keloid formation, or surgery and only when one or more of the following clinical criteria are met: a). Scar is functionally disabling b). Scar results in facial disfigurementGreen Specialist Initiation
Silk garmentsSevere eczema and allergic skin conditionsGreen Specialist Initiation
SimeprevirHepatitis CRed
SirolimusProphylaxis of organ rejection in transplant patientsAmber
SirukumabPaediatric indications (where adult NICE TAs are available)Red
Sitagliptin Type 2 diabetes (T2DM)Green
Sodium aurothiomalate
(IM gold)
Rheumatoid ArthritisAmber
Sodium benzoateUrea cycle disordersRed
Sodium chloride 5% nebuliser solutionUnlicensedRed
Sodium chloride 7% nebuliser solution (Nebusal®)For patients with retained bronchopulmonary secretions and where usual treatment is not sufficiently effectiveGreen Specialist Initiation
Sodium clodronate (IV)Bisphosphonate – osteolytic lesions, hypercalcaemia and bone pain associated with skeletal masses in breast cancer or multiple myelomaRed
Sodium hyaluronate (Cystistat®)Interstitial cystitisRed
Sodium oxybateNarcolepsy with cataplexyRed
Sodium phenylbutyrateUrea cycle disordersRed
SofosbuvirHepatitis CRed
Sofosbuvir/ledipasvirHepatitis CRed
Sofosbuvir/velpatasvir Hepatitis CRed
Somatropin for adultsAcquired adult-onset post-surgery growth hormone deficiency
*Please note that Omnitrope® is what we commission in adults as growth hormone product of choice*
Amber
Somatropin for paediatricsFor the treatment of Growth
Hormone Insufficiency in Paediatrics
Green Specialist Initiation (see LTHT guidance)
SorafenibTreatment of cancersRed
StavudineHIV infectionRed
StiripentolRare forms of epilepsyRed
StreptomycinTreatment of TBRed
Sucraid®Treatment of sucrase-isomaltase deficiencyRed
Sucroferric oxyhydroxideControl of serum phosphorus levels in dialysis patientsRed
SugammadexReversal of neuromuscular blockade induced by rocuronium or vecuroniumRed
SucralfateAll indications Red
SulfasalazineLicensed indication - rheumatoid arthritis (RA).
Off-label - other inflammatory arthritides
Amber
SulfasalazinePaediatric rheumatologyAmber
SunitinibTreatment of cancersRed
Susoctocog alfaHaemophilia A
Red
TabalumabSystemic lupus erythematosus (SLE)Red
Tacrolimus (oral)Immunosuppressant for transplant patients Amber
Tacrolimus Post paediatric renal transplant Amber
Tacrolimus (Adaport®)Treatment of Crohns Disease unresponsive to other immunosuppressants (off-label use) Amber
Tacrolimus Nephrotic Syndrome in children Amber
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 Green
TadalafilPenile rehabilitation post radical prostatectomy or radiotherapyBlack
Tadalafil once daily Erectile dysfunction Black
NHSE items that should not be routinely prescribed in Primary Care
TadalafilPulmonary arterial hypertensionRed
TafluprostGlaucomaGreen Specialist Initiation
Taliglucerase alfa Gaucher's disease Red
Talimogene laherparepvec
Treatment of cancersRed
Taribavirin Hepatitis CRed
Tapentadol modified-release tabletsChronic non-malignant painGreen Specialist Initiation
TaurineCystic fibrosis (CF) managementAmber - SCG not available. Please see Amber classification definition for further information and seek advice from requesting consultant for monitoring requirements.
TB drugsRed when used for TBRed
TeduglutideShort bowel syndromeRed
Tegafur with uracilTreatment of cancersRed
TelaprevirHepatitis CRed
TelbivudineHepatitis BRed
TemozolomideTreatment of cancers; endocrinology; non-malignant conditionsRed
TemsirolimusTreatment of cancersRed
Tenofovir alafenamide fumarate Hepatitis BRed
Tenofovir disoproxil fumarateHIV infectionRed
Tenofovir/cobicistat/elvitegravir/emtricitabineHIV infectionRed
Tenofovir/efavirenz/emtricitabineHIV infectionRed
Tenofovir disoproxil fumarate/emtricitabineHIV infectionRed
Tenofovir/emtricitabine/elvitegravir/cobicistatHIV infectionRed
Tenofovor/emtricitabine/rilpiverineHIV infectionRed
TeriflunomideMultiple sclerosis (MS)Red
TeriparatideAll indicationsRed
Testosterone gelsHypogonadism due to testosterone deficiency inn menGreen Specialist Initiation
Testosterone injections (all brands)Use in line with licensed indicationsGreen Specialist Initiation
TetrahydrobiopterinPhenylketonuriaRed
ThalidomideAll indicationsRed
ThrombinPseudoaneurysmRed
TicagrelorAntiplatelet drug - use in line with NICE TA236 and TA420Green Specialist Initiation
Tick-bourne encephalitis vaccine For travel use Black
NHSE items not to be routinely prescribed in Primary Care
Timolol/brinzolamide eye erops (Azarga®)GlaucomaGreen Specialist Initiation
TioguanineTreatment of cancersRed
TipranavirHIV infectionRed
TizanidineSpasticityGreen Specialist Initiation
TizanidineCerebral Palsy Spasticity in ChildrenGreen Specialist Initiation
See LTHT guidance for information
TobramycinRed for newly diagnosed CF PatientsRed
Tobramycin (Tobi®) nebuliser solutionCystic fibrosis (CF) managementAmber
Tobramycin dry powder inhalerSuppression of chronic pulmonary infections in cystic fibrosisRed
TocilizumabAll indicationsRed
TofacitinibPaediatric indications (where adult NICE TA available)
Red
TofacitinibXELJANZ® in combination with methotrexate (MTX) is indicated for the treatment of moderate to severe active rheumatoid arthritis (RA) in adult patients who have inadequately responded to, or who are intolerant to, one or more disease-modifying antirheumatic drugs (DMARDs).
XELJANZ® can be given as monotherapy in case of intolerance to MTX or when treatment with MTX is inappropriate.
Red
TolvaptanHyponatraemia secondary to secretion of inappropriate antidiuretic hormone secretion (SIADH)Red
TopiramatePaediatric MigraineGreen Specialist Initiation
See LTHT guidance for information
TopotecanCancer chemotherapyRed
ToremifineMetastatic breast cancerGreen Specialist Initiation
Total parenteral nutrition (TPN)Intravenous nutrition - various indicationsRed
TrabectedinTreatment of cancersRed
TraLife® oral sprayOral hygeineRed
TralokinumabAsthmaRed
TrametinibTreatment of cancersRed
TrastuzumabTreatment of cancers
Red
Trastuzumab emtansineTreatment of cancersRed
Travoprost/timolol
(Duotrav®)
Rasied intra-ocular pressureGreen Specialist Initiation
Trenonacog alphaHaemophilia BRed
TreosulfanTreatment of cancersRed
Treprostinil Pulmonary arterial hypertensionRed
Tretinoin (oral)Antineoplastic; induction of remission in acute promyelocytic leukaemiaRed
Triamcinolone hexacetonide (Lederspan®)Unlicensed - depot steroid injection for use in childrenRed
TrientineWilson's diseaseRed
Trifluridine/tipiracilTreatment of cancersRed
Trimipramine vaccine For travel use Black
NHSE items not to be routinely prescribed in Primary Care
TriptorelinEndometriosis or uterine fibroidsAmber - see GnRH analogues
TriptorelinIVF treatment;
male hypersexuality
Red
TriptorelinPrecocious pubertyAmber - SCG not available. Please see Amber classification definition for further information and seek advice from requesting consultant for monitoring requirements.
Triptorelin Management of prostate cancerAmber - see GnRH analogues
Trospium MR Urinary incontinence Green
Trospium XL Urinary incontinence Green
TryptophanSevere disabling depression. Unlicensed product - named patient use onlyRed
Turotocog alfaAs per BCSH guidelinesRed
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
Red
Ultibro Breezhaler®Chronic obstructive pulmonary disease (COPD) Green
UrofollitrophinIVF treatmentRed
UstekinumabAll indicationsRed
VadadustatDialysis-induced anaemiaRed
ValaciclovirFor the treatment of Herpes Simplex Virus (HSV) Encephalitis in PaediatricsGreen Specialist Initiation
See LTHT guidance for information
ValganciclovirAll indicationsRed
Valproate All indications Green Specialist Initiation
VandetanibThyroid cancerRed
VardenafilPenile rehabilitation post radical prostatectomy or radiotherapyBlack
VedolizumabAll indicationsRed
Velaglucerase alfaGaucher's diseaseRed
VelcalcetideHyperparathyrodismRed
VemurafenibMelanomaRed
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
Green
VerteporfinAge related macular degenerationRed
Viekirax®Hepatitis CRed
Vildagliptin Type 2 diabetes (T2DM)Green
Vildagliptin with metformin Type 2 diabetes (T2DM) Green
VinblastineTreatment of cancersRed
VincristineTreatment of cancersRed
VindesineTreatment of cancersRed
VinorelbineTreatment of cancersRed
VismodegibTreatment of cancersRed
Vitamin ARetinosa pigmentosaRed
Voluvyte® injectionPlasma expanderRed
Von Willebrand factor, recombinant
Von Willebrand deficiencyRed
VoriconazoleAnti-fungal agentRed
VortioxetineFor treating major depressive episodesGreen Specialist Initiation
VSL#3® in paediatricsFor Pouchitis, Hirschsprungs disease or Ulcerative Colitis (UC) post Ileal Pouch Anal AnastomosisGreen Specialist Initiation
See LTHT guidance for information
VSL#3® Management of GI symptomsGreen Specialist Initiation
(for ACBS criteria i.e. for the maintenance of remission of ileo-anal pouchitis).
Yellow fever vaccine For travel use Black
Items that should not be routinely prescribed in Primary Care
ZiconotideNon-opioid analgesic administered by intrathecal infusionRed
ZidovudineHIV infectionRed
Zoledronic acidPrevention of skeletal related events (pathological, spinal compression, radiation/surgery to bone, or tumour-induced hypercalcaemia) in patients with advanced malignancies involving bone; treatment of tomour-induced hypercalcaemiaRed
Zuclopenthixol depot injectionDepot antipsychotic for schizophreniaGreen Specialist Initiation