Report generated from BNF provided by FormularyComplete ( Accessed TA Number. Title Formulary Status Section

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1 Report generated from BNF provided by FormularyComplete ( Accessed Title Formulary Status Section TA Number TA Link Annotation ABCIXIMAB 2.9 Antiplatelet drugs This drug is not used by this Trust as we use an alternative medicine positively appraised by NICE Actilyse Adalat Retard Adenocor ADENOSINE ADRENALINE/EPINEPHRINE Aldomet Aldosterone antagonists 2.10 Stable angina, acute coronary syndromes, and fibrinolysis-> Fibrinolytic drugs->alteplase blockers->nifedipine->modified release arrhythmias->supraventricular arrhythmias->adenosine arrhythmias->supraventricular arrhythmias 2.7 Sympathomimetics->2.7.3 Cardiopulmonary resuscitation 2.5 Hypertension and heart failure->2.5.2 Centrally acting antihypertensive drugs->methyldopa 2.2 Diuretics->2.2.3 Potassium-sparing diuretics and aldosterone antagonists Alpha-adrenoceptor blocking drugs 2.5 Hypertension and heart failure ALTEPLASE 2.10 Stable angina, acute coronary syndromes, and fibrinolysis-> Fibrinolytic drugs TA264 Amias affecting the renin-angiotensin system-> Angiotensin-II receptor antagonists->candesartan CILEXETIL First line Angiotensin 2 receptor antagonist for the treatment of Congestive Cardiac Failure. Amiloride 2.2 Diuretics->2.2.3 Potassium-sparing diuretics and aldosterone antagonists->amiloride HYDROCHLORIDE

2 AMILORIDE HYDROCHLORIDE 2.2 Diuretics->2.2.3 Potassium-sparing diuretics and aldosterone antagonists Amiodarone arrhythmias->supraventricular and ventricular arrhythmias->amiodarone HYDROCHLORIDE AMIODARONE HYDROCHLORIDE arrhythmias->supraventricular and ventricular arrhythmias AMLODIPINE blockers Amlodipine blockers->amlodipine Angiotensin-converting enzyme inhibitors affecting the renin-angiotensin system Angiotensin-II receptor antagonists affecting the renin-angiotensin system Angiox Parenteral anticoagulants->hirudins->bivalirudin This drug is not used by this Trust as we use an alternative medicine positively appraised by NICE. Anti-arrhythmic drugs Anticoagulants and protamine Antifibrinolytic drugs and haemostatics Antiplatelet drugs Apixaban anticoagulants NICE TA275 recommends apixaban as a possible treatment to prevent stroke and systemic embolism in some people with atrial fibrillation without underlying heart valve disease. APIXABAN anticoagulants->apixaban TA245 NICE TA275 recommends apixaban as a possible treatment to prevent stroke and systemic embolism in some people with atrial fibrillation without underlying heart valve disease. APIXABAN anticoagulants->apixaban TA341 NICE TA275 recommends apixaban as a possible treatment to prevent stroke and systemic embolism in some people with atrial fibrillation without underlying heart valve disease. APIXABAN anticoagulants->apixaban TA275 NICE TA275 recommends apixaban as a possible treatment to prevent stroke and systemic embolism in some people with atrial fibrillation without underlying heart valve disease.

3 Apresoline 2.5 Hypertension and heart failure->2.5.1 Vasodilator antihypertensive drugs->hydralazine HYDROCHLORIDE Aprovel affecting the renin-angiotensin system-> Angiotensin-II receptor antagonists->irbesartan Alternative to losartan in hypertension (particularly in hypertensive microalbuminuria/nephropathy). First line treatment for Microalbuminuria/Proteinuria (early and late nephropathy/diabetic and non-diabetic). Asasantin Retard 2.9 Antiplatelet drugs->dipyridamole->with aspirin Aspirin 2.9 Antiplatelet drugs->aspirin (antiplatelet) Aspirin EC tablets are non-formulary ASPIRIN (antiplatelet) 2.9 Antiplatelet drugs ATENOLOL drugs Atenolol BENDROFLUMETHIAZIDE Beta-adrenoceptor blocking drugs Beta-Cardone Betaloc drugs->atenolol 2.2 Diuretics->2.2.1 Thiazides and related diuretics drugs->sotalol HYDROCHLORIDE drugs->metoprolol TARTRATE BEZAFIBRATE drugs->fibrates Bezafibrate Bezalip drugs->fibrates->bezafibrate drugs->fibrates->bezafibrate Bile acid sequestrants drugs BISOPROLOL FUMARATE drugs For use in heart failure BIVALIRUDIN Parenteral anticoagulants->hirudins TA230 This drug is not used by this Trust as we use an alternative medicine positively appraised by NICE. Blood-related products 2.11 Antifibrinolytic drugs and haemostatics

4 Brilique 2.9 Antiplatelet drugs->ticagrelor Approved for use in ACS patients with a Tropinin Positive event undergoing an invasive strategy with a consultant cardiologist only as prescriber NICE TA236 Acute Coronary Syndromes - Recommended combined with low-dose aspirin for up to a year for treatment for specified people with ACS. BUMETANIDE 2.2 Diuretics->2.2.2 Loop diuretics Bumetanide 2.2 Diuretics->2.2.2 Loop diuretics->bumetanide Calcium-channel blockers other antianginal drugs CANDESARTAN CILEXETIL affecting the renin-angiotensin system-> Angiotensin-II receptor antagonists First line Angiotensin 2 receptor antagonist for the treatment of Congestive Cardiac Failure. Capoten affecting the renin-angiotensin system-> Angiotensin-converting enzyme inhibitors->captopril CAPTOPRIL affecting the renin-angiotensin system-> Angiotensin-converting enzyme inhibitors Captopril affecting the renin-angiotensin system-> Angiotensin-converting enzyme inhibitors->captopril Cardiac glycosides 2.1 Positive inotropic drugs Cardicor drugs->bisoprolol FUMARATE For use in heart failure Cardiopulmonary resuscitation 2.7 Sympathomimetics Cardura 2.5 Hypertension and heart failure->2.5.4 Alpha-adrenoceptor blocking drugs->doxazosin CARVEDILOL drugs For use in heart failure Carvedilol drugs->carvedilol For use in heart failure Centrally acting antihypertensive drugs 2.5 Hypertension and heart failure

5 CHLORTALIDONE 2.2 Diuretics->2.2.1 Thiazides and related diuretics To be used in accordance with NICE guidelines Clexane Parenteral anticoagulants->low molecular weight heparins->enoxaparin SODIUM CLOPIDOGREL 2.9 Antiplatelet drugs TA210 Avoid concomitant use of Omeprazole and esomeprazole. COLESTYRAMINE drugs->bile acid sequestrants Coracten XL blockers->nifedipine->modified release The D&T committee has agreed that Coracten XL should be used in place of Adalat LA Cozaar affecting the renin-angiotensin system-> Angiotensin-II receptor antagonists->losartan POTASSIUM First line Angiotensin 2 receptor antagonist for the treatment of hypertension (especially in LVH). Alternative to Irbesartan in Microalbuminuria /Proteinuria (established nephropathy in hypertensive diabetics +/- LVH). Cyklokapron 2.11 Antifibrinolytic drugs and haemostatics->tranexamic ACID Dabigatran etexilate anticoagulants Approved for Haematology use only to be used in Secondary Care for a target group of patients reacting to warfarin. NICE TA249 Atrial Fibrillation - a recommended option for AF patients with risk factors to prevent stroke and embolism DABIGATRAN ETEXILATE anticoagulants->dabigatran etexilate TA249 Approved for Haematology use only to be used in Secondary Care for a target group of patients reacting to warfarin. NICE TA249 Atrial Fibrillation - a recommended option for AF patients with risk factors to prevent stroke and embolism DABIGATRAN ETEXILATE anticoagulants->dabigatran etexilate TA157 Approved for Haematology use only to be used in Secondary Care for a target group of patients reacting to warfarin. NICE TA249 Atrial Fibrillation - a recommended option for AF patients with risk factors to prevent stroke and embolism DABIGATRAN ETEXILATE anticoagulants->dabigatran etexilate TA327 Approved for Haematology use only to be used in Secondary Care for a target group of patients reacting to warfarin. NICE TA249 Atrial Fibrillation - a recommended option for AF patients with risk factors to prevent stroke and embolism DANAPAROID SODIUM Parenteral anticoagulants->heparinoids Approved as an alternative anticoagulant in patients with Heparin-Induced Thrombocytopenia (HIT). DIGOXIN 2.1 Positive inotropic drugs->2.1.1 Cardiac glycosides Digoxin 2.1 Positive inotropic drugs->2.1.1 Cardiac glycosides->digoxin

6 Digoxin-specific antibody DILTIAZEM HYDROCHLORIDE 2.1 Positive inotropic drugs->2.1.1 Cardiac glycosides blockers DIPYRIDAMOLE 2.9 Antiplatelet drugs TA210 Dipyridamole 2.9 Antiplatelet drugs->dipyridamole DISOPYRAMIDE Disopyramide Diuretics arrhythmias->supraventricular and ventricular arrhythmias arrhythmias->supraventricular and ventricular arrhythmias->disopyramide Diuretics with potassium 2.2 Diuretics DOBUTAMINE 2.7 Sympathomimetics->2.7.1 Inotropic sympathomimetics Dopamine 2.7 Sympathomimetics->2.7.1 Inotropic sympathomimetics->dopamine HYDROCHLORIDE DOPAMINE HYDROCHLORIDE 2.7 Sympathomimetics->2.7.1 Inotropic sympathomimetics Doralese 2.5 Hypertension and heart failure->2.5.4 Alpha-adrenoceptor blocking drugs->indoramin DOXAZOSIN 2.5 Hypertension and heart failure->2.5.4 Alpha-adrenoceptor blocking drugs DRONEDARONE arrhythmias->supraventricular arrhythmias TA197 NICE TA197 Atrial Fibrillation - A recommended option for some people with non-permanent atrial fibrillation. Drugs affecting the renin-angiotensin system 2.5 Hypertension and heart failure Drugs for arrhythmias 2.3 Anti-arrhythmic drugs

7 Efient 2.9 Antiplatelet drugs->prasugrel NICE TA182 Acute Coronary Syndrome - A recommended option with aspirin for patients undergoing PCI in specific circumstances. Hertfordshire Medicines Mangement Committee (HMMC) Sept Green Status - Recommended for restricted use in specific subgoups in secondary and primary care for ACS (in combination with aspirin for the prevention of atherosclerotic events). Elantan LA other antianginal drugs->2.6.1 Nitrates->ISOSORBIDE MONONITRATE->Modified release Eliquis anticoagulants->apixaban->apixaban Included on Anticoagulant Prescription approved at APC 15/05/12 ENOXAPARIN SODIUM Parenteral anticoagulants->low molecular weight heparins EPHEDRINE HYDROCHLORIDE 2.7 Sympathomimetics->2.7.2 Vasoconstrictor sympathomimetics Ephedrine Hydrochloride 2.7 Sympathomimetics->2.7.2 Vasoconstrictor sympathomimetics->ephedrine HYDROCHLORIDE EPLERENONE 2.2 Diuretics->2.2.3 Potassium-sparing diuretics and aldosterone antagonists->aldosterone antagonists Consultant cardiologists initiation Epoprostenol Parenteral anticoagulants EPOPROSTENOL Parenteral anticoagulants->epoprostenol EPTIFIBATIDE 2.9 Antiplatelet drugs Ezetimibe drugs NICE TA132 Hypercholesterolaemia - A recommended option for heterozygous-familial and non-familial hypercholesterolaemia with a statin if cholesterol not low enough, or as monotherapy if a statin is unsuitable. EZETIMIBE drugs->ezetimibe TA132 NICE TA132 Hypercholesterolaemia - A recommended option for heterozygous-familial and non-familial hypercholesterolaemia with a statin if cholesterol not low enough, or as monotherapy if a statin is unsuitable.

8 Ezetrol drugs->ezetimibe->ezetimibe NICE TA132 Hypercholesterolaemia - A recommended option for heterozygous-familial and non-familial hypercholesterolaemia with a statin if cholesterol not low enough, or as monotherapy if a statin is unsuitable. Fibrates drugs Fibrinolytic drugs Flolan 2.10 Stable angina, acute coronary syndromes, and fibrinolysis Parenteral anticoagulants->epoprostenol->epoprostenol FUROSEMIDE 2.2 Diuretics->2.2.2 Loop diuretics Furosemide 2.2 Diuretics->2.2.2 Loop diuretics->furosemide GLYCERYL TRINITRATE other antianginal drugs->2.6.1 Nitrates Glyceryl Trinitrate other antianginal drugs->2.6.1 Nitrates->GLYCERYL TRINITRATE->Short-acting tablets and sprays Heparin Parenteral anticoagulants Heparin flushes Parenteral anticoagulants Heparinoids Parenteral anticoagulants Hirudins Parenteral anticoagulants Hydralazine 2.5 Hypertension and heart failure->2.5.1 Vasodilator antihypertensive drugs->hydralazine HYDROCHLORIDE HYDRALAZINE HYDROCHLORIDE 2.5 Hypertension and heart failure->2.5.1 Vasodilator antihypertensive drugs Hygroton 2.2 Diuretics->2.2.1 Thiazides and related diuretics->chlortalidone To be used in accordance with NICE guidelines Hypertension and heart failure

9 Ikorel INDORAMIN Innohep other antianginal drugs->2.6.3 Other antianginal drugs->nicorandil 2.5 Hypertension and heart failure->2.5.4 Alpha-adrenoceptor blocking drugs Parenteral anticoagulants->low molecular weight heparins->tinzaparin SODIUM Inotropic sympathomimetics 2.7 Sympathomimetics Inspra 2.2 Diuretics->2.2.3 Potassium-sparing diuretics and aldosterone antagonists->aldosterone antagonists->eplerenone Consultant Cardiologist initiation Integrilin 2.9 Antiplatelet drugs->eptifibatide IRBESARTAN affecting the renin-angiotensin system-> Angiotensin-II receptor antagonists Alternative to losartan in hypertension (particularly in hypertensive microalbuminuria/nephropathy). First line treatment for Microalbuminuria/Proteinuria (early and late nephropathy/diabetic and non-diabetic). ISOSORBIDE MONONITRATE other antianginal drugs->2.6.1 Nitrates Isosorbide Mononitrate other antianginal drugs->2.6.1 Nitrates->ISOSORBIDE MONONITRATE Istin blockers->amlodipine IVABRADINE other antianginal drugs->2.6.3 Other antianginal drugs TA267 ' LABETALOL HYDROCHLORIDE drugs Lanoxin-PG Lanoxin Lasix 2.1 Positive inotropic drugs->2.1.1 Cardiac glycosides->digoxin 2.1 Positive inotropic drugs->2.1.1 Cardiac glycosides->digoxin 2.2 Diuretics->2.2.2 Loop diuretics->furosemide

10 Lidocaine arrhythmias->ventricular arrhythmias->lidocaine HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE arrhythmias->ventricular arrhythmias Lipid-regulating drugs Lipostat drugs->statins->pravastatin SODIUM The D&T committee (13/03/06) agreed that patients on simvastatin prone to chest infections, in the view of the Respiratory Physician, and in need of macrolide antibiotics, should have their simvastatin changed to pravastatin. LISINOPRIL affecting the renin-angiotensin system-> Angiotensin-converting enzyme inhibitors Local sclerosants Longer-acting formulations blockers->diltiazem HYDROCHLORIDE Loniten 2.5 Hypertension and heart failure->2.5.1 Vasodilator antihypertensive drugs->minoxidil Loop diuretics 2.2 Diuretics Lopresor drugs->metoprolol TARTRATE LOSARTAN POTASSIUM affecting the renin-angiotensin system-> Angiotensin-II receptor antagonists First line Angiotensin 2 receptor antagonist for the treatment of hypertension (especially in LVH). Alternative to Irbesartan in Microalbuminuria /Proteinuria (established nephropathy in hypertensive diabetics +/- LVH). Low molecular weight heparins Parenteral anticoagulants MANNITOL 2.2 Diuretics->2.2.5 Osmotic diuretics Mannitol Metalyse METARAMINOL 2.2 Diuretics->2.2.5 Osmotic diuretics->mannitol 2.10 Stable angina, acute coronary syndromes, and fibrinolysis-> Fibrinolytic drugs->tenecteplase 2.7 Sympathomimetics->2.7.2 Vasoconstrictor sympathomimetics

11 Metaraminol METHYLDOPA Methyldopa METOLAZONE 2.7 Sympathomimetics->2.7.2 Vasoconstrictor sympathomimetics->metaraminol 2.5 Hypertension and heart failure->2.5.2 Centrally acting antihypertensive drugs 2.5 Hypertension and heart failure->2.5.2 Centrally acting antihypertensive drugs->methyldopa 2.2 Diuretics->2.2.1 Thiazides and related diuretics METOPROLOL TARTRATE drugs Metoprolol Tartrate drugs->metoprolol TARTRATE Minijet Lignocaine arrhythmias->ventricular arrhythmias->lidocaine HYDROCHLORIDE MINOXIDIL 2.5 Hypertension and heart failure->2.5.1 Vasodilator antihypertensive drugs Modified release drugs->propranolol HYDROCHLORIDE Modified release other antianginal drugs->2.6.1 Nitrates->ISOSORBIDE MONONITRATE Modified release blockers->nifedipine Unlicensed use of nifedipine as a tocolyic agent currently under review. Unlicensed use needs to be aknowledged by the Trust Board. Modified release blockers->verapamil HYDROCHLORIDE Modified release 2.9 Antiplatelet drugs->dipyridamole Modified release drugs->fibrates->bezafibrate Multaq arrhythmias->supraventricular arrhythmias->dronedarone NICE TA197 Atrial Fibrillation - A recommended option for some people with non-permanent atrial fibrillation.

12 Naftidrofuryl other antianginal drugs->2.6.4 Peripheral vasodilators and related drugs->naftidrofuryl OXALATE NAFTIDROFURYL OXALATE other antianginal drugs->2.6.4 Peripheral vasodilators and related drugs TA223 NICORANDIL other antianginal drugs->2.6.3 Other antianginal drugs Nicorandil other antianginal drugs->2.6.3 Other antianginal drugs->nicorandil NIFEDIPINE blockers The unlicensed use of Nifedipine as a tocolytic agent is currently under review. (D&T Minutes 14/07/03) NIMODIPINE blockers Nimotop blockers->nimodipine Nitrates other antianginal drugs Nitrates, calcium-channel blockers, and other antianginal drugs Nitrocine other antianginal drugs->2.6.1 Nitrates->GLYCERYL TRINITRATE->Parenteral preparations NORADRENALINE/NOREPINEPHRINE 2.7 Sympathomimetics->2.7.2 Vasoconstrictor sympathomimetics Oral anticoagulants 2.8 Anticoagulants and protamine

13 Orgaran Parenteral anticoagulants->heparinoids->danaparoid SODIUM Approved as an alternative anticoagulant in patients with Heparin-Induced Thrombocytopenia (HIT). Osmotic diuretics 2.2 Diuretics Other antianginal drugs other antianginal drugs Parenteral anticoagulants 2.8 Anticoagulants and protamine Parenteral preparations Peripheral vasodilators and related drugs other antianginal drugs->2.6.1 Nitrates->GLYCERYL TRINITRATE other antianginal drugs Persantin 2.9 Antiplatelet drugs->dipyridamole Persantin Retard 2.9 Antiplatelet drugs->dipyridamole->modified release Phaeochromocytoma 2.5 Hypertension and heart failure->2.5.4 Alpha-adrenoceptor blocking drugs PHENTOLAMINE MESILATE 2.5 Hypertension and heart failure->2.5.4 Alpha-adrenoceptor blocking drugs->phaeochromocytoma Phenylephrine 2.7 Sympathomimetics->2.7.2 Vasoconstrictor sympathomimetics->phenylephrine HYDROCHLORIDE Used for treating hypotension during caesarean section. Ephedrine injection used for treating hypotension with bradycardia during caesarean section. PHENYLEPHRINE HYDROCHLORIDE 2.7 Sympathomimetics->2.7.2 Vasoconstrictor sympathomimetics Used for treating hypotension during caesarean section. Ephedrine injection used for treating hypotension with bradycardia during caesarean section. Plavix 2.9 Antiplatelet drugs->clopidogrel Positive inotropic drugs Potassium-sparing diuretics and aldosterone antagonists Potassium-sparing diuretics with other diuretics 2.2 Diuretics 2.2 Diuretics

14 Pradaxa anticoagulants->dabigatran etexilate->dabigatran ETEXILATE PRASUGREL 2.9 Antiplatelet drugs TA317 NICE TA182 Acute Coronary Syndrome - A recommended option with aspirin for patients undergoing PCI in specific circumstances. Hertfordshire Medicines Mangement Committee (HMMC) Sept Green Status - Recommended for restricted use in specific subgoups in secondary and primary care for ACS (in combination with aspirin for the prevention of atherosclerotic events). Pravastatin drugs->statins->pravastatin SODIUM The D&T committee (13/03/06) agreed that patients on simvastatin prone to chest infections, in the view of the Respiratory Physician, and in need of macrolide antibiotics, should have their simvastatin changed to pravastatin. PRAVASTATIN SODIUM drugs->statins The D&T committee (13/03/06) agreed that patients on simvastatin prone to chest infections, in the view of the Respiratory Physician, and in need of macrolide antibiotics, should have their simvastatin changed to pravastatin. Praxilene other antianginal drugs->2.6.4 Peripheral vasodilators and related drugs->naftidrofuryl OXALATE Procoralan other antianginal drugs->2.6.3 Other antianginal drugs->ivabradine ' Propranolol drugs->propranolol HYDROCHLORIDE PROPRANOLOL HYDROCHLORIDE drugs Protamine sulfate 2.8 Anticoagulants and protamine RAMIPRIL affecting the renin-angiotensin system-> Angiotensin-converting enzyme inhibitors Ramipril affecting the renin-angiotensin system-> Angiotensin-converting enzyme inhibitors->ramipril Ranexa other antianginal drugs->2.6.3 Other antianginal drugs->ranolazine Consultant initiation only. Hospital only initiation.. Review by consultant in 4-6 weeks for further treatment and/or dose titration. Refer to GP only if patient stable and not requiring dose titration

15 Rapilysin 2.10 Stable angina, acute coronary syndromes, and fibrinolysis-> Fibrinolytic drugs->reteplase This drug is not used by the Trust as we use an alternative medicine positively appraised by NICE. ReoPro 2.9 Antiplatelet drugs->abciximab This drug is not used by this Trust as we use an alternative medicine positively appraised by NICE RETEPLASE 2.10 Stable angina, acute coronary syndromes, and fibrinolysis-> Fibrinolytic drugs This drug is not used by the Trust as we use an alternative medicine positively appraised by NICE. Rivaroxaban anticoagulants RIVAROXABAN anticoagulants->rivaroxaban TA256 RIVAROXABAN anticoagulants->rivaroxaban TA170 RIVAROXABAN anticoagulants->rivaroxaban TA261 RIVAROXABAN anticoagulants->rivaroxaban TA287 RIVAROXABAN anticoagulants->rivaroxaban TA335 Rythmodan arrhythmias->supraventricular and ventricular arrhythmias->disopyramide Short-acting tablets and sprays other antianginal drugs->2.6.1 Nitrates->GLYCERYL TRINITRATE SIMVASTATIN drugs->statins First line statin Simvastatin drugs->statins->simvastatin First line statin SODIUM NITROPRUSSIDE 2.5 Hypertension and heart failure->2.5.1 Vasodilator antihypertensive drugs Sodium Nitroprusside 2.5 Hypertension and heart failure->2.5.1 Vasodilator antihypertensive drugs->sodium NITROPRUSSIDE SODIUM TETRADECYL SULFATE 2.13 Local sclerosants

16 Sotacor Sotalol drugs->sotalol HYDROCHLORIDE drugs->sotalol HYDROCHLORIDE SOTALOL HYDROCHLORIDE drugs Stable angina, acute coronary syndromes, and fibrinolysis Standard formulations blockers->diltiazem HYDROCHLORIDE Statins drugs Streptase 2.10 Stable angina, acute coronary syndromes, and fibrinolysis-> Fibrinolytic drugs->streptokinase This drug is not used by the Trust as we use an alternative medicine positively appraised by NICE STREPTOKINASE 2.10 Stable angina, acute coronary syndromes, and fibrinolysis-> Fibrinolytic drugs This drug is not used by the Trust as we use an alternative medicine positively appraised by NICE Supraventricular and ventricular arrhythmias arrhythmias Supraventricular arrhythmias arrhythmias Sympathomimetics TENECTEPLASE 2.10 Stable angina, acute coronary syndromes, and fibrinolysis-> Fibrinolytic drugs Tenormin drugs->atenolol Thiazides and related diuretics 2.2 Diuretics TICAGRELOR 2.9 Antiplatelet drugs TA236 Approved for use in ACS patients with a Tropinin Positive event undergoing an invasive strategy with a consultant cardiologist only as prescriber. NICE TA236 Acute Coronary Syndromes - Recommended combined with low-dose aspirin for up to a year for treatment for specified people with ACS. Tildiem LA blockers->diltiazem HYDROCHLORIDE->Longer-acting formulations

17 Tildiem Retard TINZAPARIN SODIUM blockers->diltiazem HYDROCHLORIDE->Longer-acting formulations Parenteral anticoagulants->low molecular weight heparins TIROFIBAN 2.9 Antiplatelet drugs This drug is not used by the Trust as we use an alternative medicine positively appraised by NICE. TRANEXAMIC ACID 2.11 Antifibrinolytic drugs and haemostatics Transdermal preparations Transiderm-Nitro Tritace other antianginal drugs->2.6.1 Nitrates->GLYCERYL TRINITRATE other antianginal drugs->2.6.1 Nitrates->GLYCERYL TRINITRATE->Transdermal preparations affecting the renin-angiotensin system-> Angiotensin-converting enzyme inhibitors->ramipril Vasoconstrictor sympathomimetics 2.7 Sympathomimetics Vasodilator antihypertensive drugs 2.5 Hypertension and heart failure Ventricular arrhythmias Verapamil VERAPAMIL HYDROCHLORIDE Warfarin WARFARIN SODIUM arrhythmias blockers->verapamil HYDROCHLORIDE blockers anticoagulants->coumarins and phenindione->warfarin SODIUM anticoagulants->coumarins and phenindione

18 With aspirin 2.9 Antiplatelet drugs->dipyridamole Xarelto anticoagulants->rivaroxaban->rivaroxaban Zestril affecting the renin-angiotensin system-> Angiotensin-converting enzyme inhibitors->lisinopril Zocor drugs->statins->simvastatin First line statin Aldactone 2.2 Diuretics->2.2.3 Potassium-sparing diuretics and aldosterone antagonists->aldosterone antagonists->spironolactone use - see BNF indications ALISKIREN affecting the renin-angiotensin system-> Renin inhibitors To be prescribed by a consultant cardiologist only and used as a 4th line treatment in patients whose blood pressure was still above target and taking an ACEI/ARB, Calcium Channel Blocker and a diuretic (ACD NICE Guidelines in Hypertension 2006). Patients should be actively followed up ATORVASTATIN drugs->statins Second choice - Alternative to simvastatin or pravastatin. In appropriate circumstances, atorvastatin doses of 10 and 20 mg daily to be changed to Simvastatin 40 mg daily (See separate Statin switch Guidelines). Crestor drugs->statins->rosuvastatin Prescribed by consultant cardiologist only FACTOR VIIa (RECOMBINANT) 2.11 Antifibrinolytic drugs and haemostatics->blood-related products Consultant haematologist use only. Funding should be agreed. Flecainide arrhythmias->supraventricular and ventricular arrhythmias->flecainide ACETATE Flecainide available on a prescription signed by a consultant cardiologist only. FLECAINIDE ACETATE arrhythmias->supraventricular and ventricular arrhythmias Flecainide available on a prescription signed by a consultant cardiologist only. Lipitor drugs->statins->atorvastatin Second choice - Alternative to simvastatin or pravastatin. In appropriate circumstances, atorvastatin doses of 10 and 20 mg daily to be changed to Simvastatin 40 mg daily (See separate Statin switch Guidelines). Micardis affecting the renin-angiotensin system-> Angiotensin-II receptor antagonists->telmisartan Approved as first line ARB in treating hypertension in the elderly.

19 Pletal other antianginal drugs->2.6.4 Peripheral vasodilators and related drugs->cilostazol Available on a consultant signature only. Patients are to be reviewed in clinic after four months. RANOLAZINE other antianginal drugs->2.6.3 Other antianginal drugs Consultant initiation only. Review by consultant in 4-6 weeks for further treatment and/or dose titration. Refer to GP only if patient stable and not requiring dose titration Rasilez affecting the renin-angiotensin system-> Renin inhibitors->aliskiren Renin inhibitors affecting the renin-angiotensin system To be prescribed by a consultant cardiologist only and used as a 4th line treatment in patients whose blood pressure was still above target and taking an ACEI/ARB, Calcium Channel Blocker and a diuretic (ACD NICE Guidelines in Hypertension 2006). Patients should be actively followed up ROSUVASTATIN drugs->statins Prescribed by consultant cardiologist only SPIRONOLACTONE 2.2 Diuretics->2.2.3 Potassium-sparing diuretics and aldosterone antagonists->aldosterone antagonists use - See BNF indications Spironolactone 2.2 Diuretics->2.2.3 Potassium-sparing diuretics and aldosterone antagonists->aldosterone antagonists->spironolactone Use - See BNF indications Tambocor arrhythmias->supraventricular and ventricular arrhythmias->flecainide ACETATE Flecainide available on a prescription signed by a consultant cardiologist only. TELMISARTAN affecting the renin-angiotensin system-> Angiotensin-II receptor antagonists Approved as first line ARB in treating hypertension in the elderly.