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Current Adult Red Amber Green (RAG) List

On this page you will find our RED AMBER GREEN DNP/GREY list for adults (scroll down to see the list).

Please check the paediatric RAG list for those drugs/indications which are used only in children.

RAG list entries may be subject to a lag period to allow for commissioning approval and implementation by Trusts/CCGs. Please check with your individual Trust or CCG.

Pre-meds for procedures/services commissioned by NHS England where GPs are not expected to be involved in the patients care must be provided by secondary or tertiary care provider.

If an indication is not stated then designated status relates to licensed indications only.

Drugs without a UK marketing authorisation [“product licence”] are automatically classified as red unless designated otherwise on the list below. Please note that while some drugs are not listed in the BNF or the Electronic Medicines Compendium, a Summary of Product Characteristics is available from the MHRA. For off-label use of licensed medicines, the following advice is offered:

Where there is body of evidence or support from a recognised professional body such as NICE, NHS Clinical Knowledge Summaries, Scottish Medicines Consortium [SMC], Scottish Intercollegiate Guidelines Network [SIGN] or a Royal College, then the RAG status of a drug when used at licensed doses in off-licence indications should default to the same RAG status as when used within licensed indications, providing little or no extra monitoring is required and little or no increase in risk to patient safety can be identified.

Exceptions may arise and it is to be remembered that the RAG list is advisory and cannot be expected to include every possible use of every drug. GPs and Consultants are encouraged to discuss individual patient circumstances and consider where prescribing is best managed taking into account monitoring requirements, drug interactions, frequency of routine patient visits to the Consultant and the specialist nature of the condition being treated.  Clinical judgement should be used to arrive at the most reasonable outcome. However, if it is not possible to reach a consensus or a specific issue has arisen, please submit an application to the Formulary & Managed Entry Subgroup to assess or re-assess the RAG status.

Please read the Guidelines on Defining Red, Amber, Green, DNP, Grey Status for further detail on assigning a RAG status prior to submitting any queries or applications to GMMMG.

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Red Amber Green Classifications

Red

Drugs considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs should not be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy, this may include arranging for supply via a home care company.

Amber

Drugs suitable for shared care arrangements under a shared care protocol.
Prescribing may be transferred from secondary to primary care once the patient is stabilised and agreed shared care arrangements have been established. Alternatively primary care may initiate under the supervision of secondary care if this option is given in the shared care document. It is recommended that shared care arrangements should be drawn up following local discussion and agreement by prescribing parties.

Green
specialist initiation

Drugs designated green with specialist initiation are suitable for on-going prescribing within primary care. Little or no monitoring is required. Transfer of prescribing should occur after initiation and an initial review (unless specified) in secondary care.

Green
following specialist
recommendation

For drugs that can be initiated by primary care following written or verbal advice from a specialist and can then subsequently be safely prescribed in primary care with little or no monitoring required.

Green

Drugs designated green are suitable for initiation (unless specified otherwise) and ongoing prescribing within primary care.

DNP

Products which have been reviewed by the GM Formulary & Managed Entry Subgroup and have been deemed not suitable for prescribing for adults and children in primary or secondary care within Greater Manchester (in addition to all medicines with a “not NHS” or “DLCV” classification in the BNF, those agents with a NICE “Do not do” recommendation, and those agents included in the NHS England: “Items which should not routinely be prescribed in primary care” guidance).

Grey

Items which are listed as Grey are deemed not suitable for routine prescribing but may be suitable for a defined patient population. Whilst prescribers should think very carefully before prescribing or recommending any of the products on the grey list, there may be exceptional instances when the use of one of these products is necessary for a particular patient. A patient may be deemed exceptional if the patient has a clinical picture that is significantly different to the general population of patients with that condition and as a result of that difference the patient is likely to derive greater benefit from the intervention than might normally be expected for patients with that condition.

Criteria for inclusion on DNP/grey lists:

 

 

Criterion 1:

Products of low clinical effectiveness, where there is a lack of robust evidence of clinical effectiveness or there are significant safety concerns.

 

Criterion 2:

Products which are clinically effective but where more cost-effective products are available, including products that have been subject to excessive price inflation.

 

Criterion 3:

Products which are clinically effective but, due to the nature of the product, are deemed a low priority for NHS funding.

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Filter list by RAG status

 

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Filter list by BNF Chapter

 

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Filter list by Formulary drug

 

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Drug (proprietary
examples)

BNF
Chapter

Indications and
rationale

Formulary
drug

RAG
status

Information

Responsible
commissioner

Date added

Abacavir 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Abatacept 

10 

Biologics/Cytokine modulators 

Yes  

Red
 

 

NHSE for paediatric indications where adult TA available and for juvenile arthritis. CCG for adults. 

 

Abiraterone 

Prostate cancer (BUT not approved via cancer LDP)  

 

Red
 

 

NHSE 

 

Acamprosate 

Alcohol Dependence 

Yes  

Green
 

in conjuction with specialist service 

Public health 

 

Acetazolamide tablets 

11 

Glaucoma 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Acetazolomide 

Idiopathic intracranial hypertension 

 

Green
(following
specialist
advice) 

 

CCG 

 

Acitretin 

13 

Red status predominantly due to safety concerns in pregnancy. 

Yes  

Red
 

 

CCG 

 

Adalimumab 

10 

Biologics/Cytokine modulators 

Yes  

Red
 

 

NHSE for paediatric indications where adult TA available and for juvenile arthritis. CCG for adults. 

 

Adefovir 

Antivirals for treatment of Hepatitis B  

Yes  

Red
 

 

NHSE 

 

Aflibercept 

11 

Ophthalmic indications 

Yes  

Red
 

 

CCG 

 

Agomelatine 

Adults with major depressive disorder. 

Yes  

Red
 

 

CCG 

 

Alendronate plus Vitamin D (Fosavance®) 

Criterion 2  

DNP  

DNP
 

NICE - TA464

CKS - osteoporosis 

 

 

Alfacalcidol  

Patients with severe renal impairment requiring vitamin D therapy should be prescribed alfacalcidol. It is essential that plasma calcium monitoring is undertaken; frequency of monitoring should be determined by secondary care clinicians and communicated to primary care. 

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Alimemazine  

Criterion 2 

DNP  

DNP
 

Drug Tariff (Sept 2016) 

CCG 

 

Alipogene Tiparvovec 

Agents for the treatment of metabolic disorders 

 

Red
 

 

CCG 

 

Alirocumab 

Primary hypercholesterolaemia and mixed dyslipidaemia 

Yes  

Red
 

 

CCG 

 

Aliskiren 

 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Alitretinoin 

13 

Chronic hand eczema.  

Yes  

Red
 

 

CCG 

 

All prescription only toothpastes and mouth washes
e.g. Duraphat® toothpaste 

Criterion 3 

Grey  

Green
(following
specialist
initiation) 

Only dentists should prescribe such products due to the risk of patients developing fluorosis. 

CCG 

 

Alogliptin 

Gliptins (DPP-4 Inhibitors) As per NICE guidance and see new therapies recommendations  

Yes  

Green
 

 

CCG 

 

Alpha-1 Antitrypsin 

Agents for the treatment of metabolic disorders 

 

Red
 

 

CCG 

 

Alprostadil Cream 

Erectile dysfunction 

Yes  

Green
 

 

CCG 

 

Alteplase 

Fibrinolytics 

Yes  

Red
 

 

CCG 

 

Alu-Cap ® (Aluminium hydroxide) 

Phosphate Binding Agents  

 

Green
(following
specialist
initiation) 

 

CCG 

 

Amantadine 

Antiparkinson's drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Amantadine 

Multiple sclerosis (unlicensed) 

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Ambrisentan 

pulmonary hypertension  

 

Red
 

 

NHSE 

 

Amikacin eye drops 

11 

Anti-infective eye preparations 

Yes  

Red
 

 

CCG 

 

Aminophylline injection 

Severe or life-threatening acute asthma 

Yes  

Red
 

 

CCG 

 

Amiodarone 

 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Amisulpiride 

Antipsychotics (Oral)
Use in dementia patients (unlicensed). Local commissioning arrangements may vary and in some localities this remains an amber drug so please check with your CCG. Prescribing of antipsychotics in dementia is expected to be short term. In exceptional circumstances, longer term prescribing may be required [which would be outside of the product licence for any drugs which have a marketing authorisation for such use]. In these situations, there should still be regular review with the aim of reducing or stopping, and the best methods of ensuring continuity of supply should be negotiated between all healthcare professionals involved in that patient’s care.  

Yes  

Red
 

For new patients only 

CCG 

 

Amisulpride 

Atypical antipsychotics (Oral) All other unlicensed indications  

Yes  

Red
 

 

CCG 

 

Amisulpride 

Atypical antipsychotics (Oral) - Licensed Indications and also Unlicensed indications as recommended by NICE guidance (i.e. in psychotic depression or anxiety in bipolar patients).Red if no SCP  

Yes  

Amber
 

Oral Second Generation (Atypical) Antipsychotics for Adults - Review due 21/4/18 

CCG 

 

Amprenavir 

HIV medicines. 

Yes  

Red
 

 

NHSE 

 

Anagrelide 

Essential thrombocythaemia (review after 12 months).  

 

Red
 

 

CCG 

 

Anakinra 

10 

Biologics/Cytokine modulators 

 

Red
 

 

CCG 

 

Anastrazole 

Hormone Antagonists for treatment and chemoprevention of breast cancer  

 

Green
(following
specialist
initiation) 

 

CCG 

 

Anidulafungin 

Antifungal 

 

Red
 

 

NHSE 

 

Anti-D immunoglobulin 

14 

Antenatel anti-D prophylaxis 

 

Red
 

 

CCG 

 

Anti-thymocyte immunoglobulin 

Immunosuppressants  

 

Red
 

 

NHSE 

 

Antipsychotics 

Challenging behaviours in patients with intellectual disability  

 

Red
 

 

CCG 

 

Apixaban 

 

Yes  

Green
 

 

CCG 

 

Apomorphine injection 

Parkinson's disease. 

Yes  

Amber
 

Apomorphine use in Parkinson's Disease - Review due 1/1/18 

CCG 

 

Apraclonidine 0.5% eye drops 

11 

Glaucoma (unlicensed) 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Apraclonidine 1% eye drops 

11 

Glaucoma (unlicensed) 

Yes  

Red
 

 

CCG 

 

Apraclonidine eye drops 

11 

Ocular peri-operative drugs 

Yes  

Red
 

 

CCG 

 

Apremilast 

13 

Moderate to severe plaque psoriasis and active psoriatric arthritis 

Yes  

Red
 

 

CCG 

 

Aripiprazole 

Antipsychotics (Oral)
Use in dementia patients (unlicensed). Local commissioning arrangements may vary and in some localities this remains an amber drug so please check with your CCG. Prescribing of antipsychotics in dementia is expected to be short term. In exceptional circumstances, longer term prescribing may be required [which would be outside of the product licence for any drugs which have a marketing authorisation for such use]. In these situations, there should still be regular review with the aim of reducing or stopping, and the best methods of ensuring continuity of supply should be negotiated between all healthcare professionals involved in that patient’s care. 

Yes  

Red
 

For new patients only 

CCG 

 

Aripiprazole 

Atypical antipsychotics (Oral) All other unlicensed indications  

Yes  

Red
 

 

CCG 

 

Aripiprazole 

Atypical antipsychotics (Oral) - Licensed Indications and also Unlicensed indications as recommended by NICE guidance (i.e. in psychotic depression or anxiety in bipolar patients).Red if no SCP  

Yes  

Amber
 

Oral Second Generation (Atypical) Antipsychotics for Adults - Review due 21/4/18 

CCG 

 

Aripiprazole depot injection 

Antipsychotic depot injection (Schizophrenia) Only for those patients who are stable and if SCP available; or if under the care of a community psychiatric nurse. In some localities there may be commissioning arrangements in place to permit step down. 

Yes  

Amber
 

Aripiprazole Long-acting antipsychotic injection 

CCG 

 

Asenapine 

Antipsyschotic for use in acute phase only. NTS recommended in March 2012 that not for use in primary care. 

 

Red
 

 

CCG 

 

Atazanavir 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Atomoxetine 

ADHD  

Yes  

Amber
 

Methylphenidate, Atomoxetine , Dexamfetamine And Lisdexamfetamine For Attention Deficit Hyperactivity Disorder (ADHD) In Adults 

CCG 

 

Atorvastatin 30mg and 60 mg preparations 

Criterion 2 

DNP  

DNP
 

Drug Tariff 

 

 

Atosiban 

Premature labour 

 

Red
 

 

CCG 

 

Atovaquone 

Pneumocystis pneumonia - only to be used if other treatments e.g. co-trimoxazole have failed or are not suitable. 

 

Green
(following
specialist
advice) 

 

CCG 

 

Atripla® (Efavirenz + Tenofovir + Emtricitabine) 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Autologous chondrocyte implantation 

10 

Symptomatic articular cartilage defects of the knee 

 

Red
 

 

CCG 

 

Avanafil 

Erectile dysfunction 

Yes  

Green
 

 

CCG 

 

Azathioprine 

Autoimmune conditions, IBD (unlicensed), severe refractory eczema(unlicensed)  

 

Amber
 

Azathioprine and 6-Mercaptopurine for the treatment of IBD 

CCG 

 

Azathioprine 

13 

Dermatology indications 

Yes  

Amber
 

Azathioprine in Dermatology 

CCG 

 

Azathioprine 

10 

DMARDs Rheumatoid Arthritis. 

Yes  

Amber
 

Azathioprine in Rheumatological Conditions 

CCG 

 

Azathioprine 

Idiopathic pulmonary fibrosis 

 

Red
 

 

CCG (N.B. use not recommended by NICE) 

 

Azathioprine 

Immunosuppressants Licensed indications only. Red if no SCP  

 

Amber
 

 

NHSE for transplant immunosuppressant only. All other indications CCG. 

 

Azathioprine 

Neurological conditions 

 

Red
 

To remain RED until Shared Care Protocol approved 

CCG 

 

Azathioprine 

Post transplant use 

 

Amber
 

To remain amber until repatriation occurs 

NHSE 

 

Azathioprine  

Interstitial lung disease 

 

Amber
 

Azathioprine for Interstitial Lung Disease 

CCG 

 

Aztreonam Lysine Nebules 

Cystic fibrosis April 13: commissioned by NHS England  

 

Red
 

For new patients only 

NHSE 

 

Basiliximab 

Immunosuppressants - transplant 

 

Red
 

 

CCG 

 

Bee & wasp allergen (Pharmalgen®) 

Allergen immunotherapy 

Yes  

Red
 

 

CCG 

 

Belatacept 

Immunosuppressants - transplant 

 

Red
 

 

CCG 

 

Belimumab 

10 

Biologics/Cytokine modulators 

Yes  

Red
 

 

NHSE for paediatric indications where adult TA available and for juvenile arthritis. CCG for adults. 

 

Beta-Interferon 

Multiple Sclerosis  

 

Red
 

 

NHSE 

 

Betaine 

Agents for the treatment of metabolic disorders 

 

Red
 

 

CCG 

 

Betaine 

Homocystinuria 

 

Red
 

 

CCG 

 

Bevacizumab 

11 

Ophthalmic indications 

 

Red
 

 

CCG 

 

Bicalutamide 

For Prostate cancer 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Bio-oil 

Misc 

Criterion 1 

DNP  

DNP
 

Cosmetic product with no robust clinical trial data for efficacy. 

 

 

BioXtra® toothpaste and mouth rinse 

Misc 

Criterion 1  

DNP  

DNP
 

Saliva substitutes: choosing and prescribing the right product (UKMI; July 2015) 

 

 

Bivalirudin 

Hirudin 

Yes  

Red
 

 

CCG 

 

Boceprevir 

Hepatitis C 

Yes  

Red
 

 

NHSE 

 

Bosentan 

pulmonary hypertension, digital ulcers 

 

Red
 

 

NHSE 

 

Botulinum Toxin 

13 

Intradermal for hyperhydrosis. 

Yes  

Red
 

 

CCG 

 

Brivaracetam 

Antiepileptic Drugs. As per NICE guidance 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Brodalumab 

13 

Biologics/Cytokine modulators 

Yes  

Red
 

 

CCG 

19 07 2018 

Buprenorphine 

Opioid dependence 

Yes  

Other
 

Status depends on local commissioning arrangements for substance misuse or if GP with specialist interest 

CCG 

 

Buprenorphine (sublingual) 

Pain 

 

Green
(following
specialist
advice) 

 

CCG 

 

Buserelin 

Infertility Drugs  

Yes  

Red
 

 

CCG 

 

C1-esterase inhibitor 

Angioedema 

 

Red
 

 

NHSE 

 

Cabergoline 

Antiparkinson's drugs As per NICE guidance  

 

Green
(following
specialist
advice) 

 

CCG 

 

Calcichew 500mg chewable tablets 

Phosphate Binding Agents  

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Calcium 500mg and colecalciferol 200units (e.g. Calcichew D-3) 

Criterion 1 

DNP  

DNP
 

CKS: Osteoporosis – prevention of fragility fractures  

 

 

Calcium Resonium (oral) 

Hyperkalaemia 

Yes  

Green
 

 

CCG 

 

Canakinumab 

10 

Biologics/Cytokine modulators 

 

Red
 

 

CCG 

 

Canakinumab 

Inherited autoinflammatory disorders 

 

Red
 

 

CCG 

 

Cannabis extract (Sativex®) 

Criterion 3  

DNP  

DNP
 

NTS:Sativex® for the treatment of non-MS neuropathic pain (unlicensed indication)

(NICE Do not Do: Do not offer Sativex to treat spasticity in people with MS because it is not a cost effective treatment ) 

 

 

Capsaicin patch (Qutenza®) 

10 

Peripheral neuropathic pain in non-diabetic adults 

 

Red
 

 

CCG 

 

Carbamazepine 

Antiepileptic Drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Carbamazepine 

Bipolar disorder 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Carboprost 

Postpartum haemorrhage 

 

Red
 

 

CCG 

 

Carglumic acid 

Agents for the treatment of metabolic disorders 

 

Red
 

 

NHSE 

 

Cariprazine 

Criterion 2 

DNP  

DNP
 

 

CCG 

19 07 2018 

Carnitine 

Agents for the treatment of metabolic disorders 

 

Red
 

 

NHSE 

 

Caspofungin 

Antifungal 

Yes  

Red
 

 

NHSE 

 

Cefuroxime eye drops 

11 

Ocular peri-operative drugs 

Yes  

Red
 

 

CCG 

 

Cefuroxime intravitreal injection (Aprokam) 

11 

Prophylaxis of postoperative endophthalmitis after cataract surgery 

Yes  

Red
 

 

CCG 

 

Certolizumab Pegol 

10 

Biologics/Cytokine modulators 

Yes  

Red
 

 

NHSE for paediatric indications where adult TA available and for juvenile arthritis. CCG for adults. 

 

Cetrorelix 

Infertility Drugs  

 

Red
 

 

CCG 

 

Chemotherapy Drugs 

Chemotherapy - see NPSA alerts Refers to all drugs with direct anti-tumour activity, including cytotoxic agents, monoclonal antibodies, immunomodulatory agents (for example thalidomide, lenalidomide) and target treatments (for example imatinib, nilotinib and other tyrosine kinase inhibitors) and any other new classes of both parenteral and oral anti-cancer medicines.  

 

Red
 

 

NHSE 

 

Chenodeoxycholic acid 

Agents for the treatment of metabolic disorders 

 

Red
 

 

NHSE 

 

Chlorhexidine eye drops 

11 

Anti-infective eye preparations 

Yes  

Red
 

 

CCG 

 

Chlorpropamide 

Criterion 1 

DNP  

DNP
 

CKS: Type 2 diabetes 

 

 

Cholic acid 

Agents for the treatment of metabolic disorders 

 

Red
 

 

NHSE 

 

Chorionic gonadotropin 

Infertility Drugs  

 

Red
 

 

CCG 

 

Ciclosporin 

13 

Dermatology indications 

Yes  

Amber
 

Ciclosporin in
Dermatology
 

CCG 

 

Ciclosporin 

10 

DMARDs Rheumatoid Arthritis. 

Yes  

Amber
 

Ciclosporin in Rheumatological Conditions 

CCG 

 

Ciclosporin 

Immunosuppressants Licensed indications only. Red if no SCP  

 

Amber
 

 

CCG 

 

Ciclosporin 

Post transplant use 

 

Amber
 

To remain amber until repatriation occurs 

NHSE 

 

Ciclosporin eye drops 

11 

Keratosis due to dry eye disease 

Yes  

Green
(following
specialist
initiation) 

Use licensed product only 

CCG 

 

Cidofovir 

CMV 

 

Red
 

 

NHSE 

 

Cilostazol (Pletal®) 

Criterion 2 

DNP  

DNP
 

NICE: TA223 

 

 

Cinacalcet 

Primary hyperparathyroidism  

Yes  

Amber
 

Cinacalcet for primary hyperparathyroidism 

CCG 

 

Cinacalcet 

Secondary hyperparathyroidism (patient under regular review by secondary care)  

Yes  

Red
 

 

NHSE - hyperparathyroidism - dialysis patients only 

 

Clobazam 

Antiepileptic. As per NICE guidance 

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Clomifene 

Infertility Drugs  

Yes  

Red
 

 

CCG 

 

Clonazepam 

Antiepileptic. As per NICE guidance 

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Clozapine 

Atypical antipsychotics (Oral) All other unlicensed indications  

Yes  

Red
 

 

CCG 

 

Clozapine 

Except selected approved mental health trust programs.  

Yes  

Red
 

 

CCG 

 

Co-beneldopa 

Antiparkinson's drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Co-careldopa 

Antiparkinson's drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Co-careldopa + Entacapone (Stalevo®) 

Antiparkinson's drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Co-careldopa intestinal gel (Duodopa®) 

Criterion 3 

DNP  

DNP
 

NHS England: Clinical commissioning policy: Levodopa-carbidopa intestinal gel 

 

 

Co-proxamol 

Criterion 1 

DNP  

DNP
 

See NHS England guidance on items not for routine prescribing in primary care  

 

 

Co-trimoxazole 

 

 

Green
(following
specialist
advice) 

 

CCG 

 

Cod liver oil capsules 

Criterion 3 

DNP  

DNP
 

NHS Choices: Supplements who needs them 

 

 

Codeine and aspirin combination product (Co-codaprin®) 

Criterion 2 

DNP  

DNP
 

BNF: aspirin with codeine phosphate 8mg  

 

 

Coenzyme Q10 (includes ubiquinone and ubidecarenone)  

Criterion 3 Should only be used for the treatment of mitochondrial disorders under the care of a specialist  

Grey  

Green
(following
specialist
initiation) 

NICE CG181  

CCG 

 

Colesevelam hydrochloride 

Colesevelam for diarrhoea associated with bile acid malabsorption (nb unlicensed indication so must be used 2nd line)  

 

Green
(following
specialist
advice) 

 

CCG 

 

Colestyramine 

Bile acid sequestrant - GI indications. 

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Colistimethate - inhaled 

For Cystic Fibrosis patients (Colobreathe®) 

Yes  

Red
 

 

NHSE 

 

Colistimethate - nebulised 

For Cystic Fibrosis patients 

Yes  

Red
 

For new patients only  

NHSE 

 

Colistimethate - nebulised 

For Cystic Fibrosis patients 

Yes  

Amber
 

For existing patients only awaiting repatriation 

NHSE 

 

Colistimethate - nebulised 

For non- Cystic Fibrosis patients 

Yes  

Amber
 

Nebulised Colistimethate in adult patients with non-CF bronchiectasis or bronchial sepsis 

CCG 

 

Collagenase 

10 

Dupuytren's contracture 

Yes  

Red
 

 

CCG 

 

Combivir® 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Commercial eyelid cleansing preparations 

11 

Criterion 1 

DNP  

DNP
 

There is limited evidence to support the effectiveness of these products over traditional eyelid hygiene methods 

 

 

Conestat alfa 

Angioedema 

 

Red
 

 

NHSE 

 

Cough medicines 

Criterion 1 

DNP  

DNP
 

NICE CKS:
Common Cold
 

 

 

Cyanocobalamin tablets 

Criterion 3 Only for use in those patients who are truly unable to tolerate injections and who are vegan. 

Grey  

Green
 

BNF: drugs used in megaloblastic anaemias 

CCG 

 

Cyclophosphamide 

10 

DMARD 

 

Red
 

 

CCG 

 

Cyproterone 

Prostate cancer & male hypersexuality 

 

Green
(following
specialist
advice) 

 

CCG 

 

Cyproterone acetate 

Transgender use of hormone therapy. As per NHSE Primary Care Responsibilities in Prescribing and Monitoring Hormone Therapy for Transgender and Non-Binary Adultshttp://shsc.nhs.uk/wp-content/uploads/2016/04/SSC1620_GD-Prescribing.pdf 

 

Amber
 

 

(as per NHSE Shared care arrangements) 

 

Cysteamine bitartrate (also known and shown as mercaptamine)  

Agents for the treatment of metabolic disorders 

 

Red
 

 

NHSE 

 

Cysteamine hydrochloride 

Agents for the treatment of metabolic disorders 

 

Red
 

 

NHSE 

 

Cystistat® bladder instillations (medical device) 

 

 

Red
 

 

CCG 

 

Dabigatran 

 

Yes  

Green
 

 

CCG 

 

Daclatasvir 

Hepatitis C 

 

Red
 

 

CCG 

 

Dalteparin 

See entries for Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

Yes  

Other
 

 

CCG 

 

Dapoxetine (Priligy®) 

Criterion 1 Only for use in those patients whose condition is medically related or as part of a fertility programme, however other more cost effective options should be considered first. 

Grey  

Green
 

NTS:dapoxetine (Priligy®) for the on-demand treatment of Premature Ejaculation (PE) 

CCG 

 

Dapsone 

13 

Leprosy and dermatitis herpetiformis 

 

Green
(following
specialist
advice) 

 

CCG 

 

Daptomycin 

 

 

Red
 

 

CCG 

 

Darbepoetin 

6 (*except where no Virement programs exist). 

Yes  

Red
 

 

NHSE - Renal Dialysis only. Product with lowest procurement cost to be used (NICE CG114) 

 

Darunavir 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Deferasirox 

 

Yes  

Red
 

 

NHSE 

 

Deferiprone 

Alpha Thalassemia 

Yes  

Red
 

 

NHSE 

 

Degarelix 

Prostate cancer 

 

Amber
 

Degarelix in advanced hormone dependent prostate cancer 

CCG 

 

Denosumab (Prolia®) 

Osteoporosis in men & women 

Yes  

Amber
 

Denosumab for osteoporosis 

CCG 

 

Denosumab (XGEVA®) 

Oncology indication 

Yes  

Red
 

 

CCG 

 

Desferrioxamine 

see note 6 

Yes  

Red
 

 

NHSE 

 

Dexamethasone intravitreal implant 

11 

Ophthalmic indications  

Yes  

Red
 

 

CCG 

 

Dexamfetamine 

ADHD  

Yes  

Amber
 

Methylphenidate, Atomoxetine, Dexamfetamine And Lisdexamfetamine For Attention Deficit Hyperactivity Disorder (ADHD) In Adults 

CCG 

 

Diazoxide 

Chronic hypoglycaemia 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Dibotermin 

Bone morphogenic protein 

 

Red
 

 

CCG 

 

Dibrompropamidine eye ointment 

11 

Anti-infective eye preparations 

Yes  

Red
 

 

CCG 

 

Dicycloverine 

Criterion 2 

DNP  

DNP
 

 

CCG 

19 07 2018 

Didanosine 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Diesthylstilbestrol 

For Prostate cancer. 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Digoxin-specific antibody fragments 

Digoxin toxicity 

 

Red
 

 

CCG 

 

Diltiazem ointment 

Anal fissure 

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Dimethyl fumarate 

Multiple sclerosis 

 

Red
 

 

NHSE 

 

Dimethyl fumarate 

13 

Psoriasis 

Yes  

Red
 

 

CCG 

 

Disodium pamidronate 

IV Bisphosphonate 

 

Red
 

 

CCG 

 

Disulfiram 

Alcohol dependence Patient must be stabilised prior to transfer of prescribing. (> 3 months)  

Yes  

Amber
 

Disulfiram in the treatment of alcohol dependence - Review due Feb 2018 

Public health 

 

Dithranol (licensed preps) 

13 

Psoriasis 

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Dithranol (unlicensed preps) 

13 

Psoriasis 

Yes  

Red
 

 

CCG 

 

Diuretics with Potassium 

Criterion 2 

DNP  

DNP
 

BNF: Diuretics with potassium 

 

 

Domperidone 

For inadequate lactation on recommendation by secondary care (unlicensed). 

 

Green
 

 

CCG 

 

Donepezil 

Dementia - as per NICE TA 217. Local commissioning arrangements may vary and in some localities this is green on specialist advice so please check with your CCG 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Dornase alfa 

Cystic fibrosis  

Yes  

Amber
 

 

NHSE 

 

Dornase alfa (Pulmozyme®) 

Cystic fibrosis  

Yes  

Amber
 

 

NHSE 

 

Dosulepin (licensed and unlicensed uses)  

Criterion 1 

DNP  

DNP
 

See NHS England guidance on items not for routine prescribing in primary care

NICE “do not do” recommendation (CG90) 

 

 

Doxazosin MR 

Criterion 2 

DNP  

DNP
 

See NHS England guidance on items not for routine prescribing in primary care 

 

 

Dronedarone 

See New Therapies recommendation 

Yes  

Green
(following
specialist
initiation) 

Regular monitoring required, see SPC 

CCG 

 

Dulaglutide 

GLP-1 Agonists. As per NICE guidance and see new therapies recommendations  

Yes  

Green
 

 

CCG 

 

E-voke® electronic inhaler 

Misc 

Criterion 1 

DNP  

DNP
 

NTS: E-Voke® (nicotine) electronic inhaler device 

 

 

Edoxaban 

 

Yes  

Green
 

 

CCG 

 

Efavirenz 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Elosulfase alfa 

Mucopolysaccharidosis type IVa 

 

Red
 

 

CCG 

 

Eltrombopag 

See NICE Guidance 

Yes  

Red
 

 

CCG 

 

Emtricitabine 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Enfuvirtide 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Enoxaparin 

See entries for Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

Yes  

Other
 

 

CCG 

 

Entacapone 

Antiparkinson's drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Entecavir 

Antivirals for treatment of Hepatitis B  

 

Red
 

 

NHSE 

 

Epoetin alfa 

6 (*except where no Virement programs exist). 

Yes  

Red
 

 

NHSE - Renal Dialysis only. Product with lowest procurement cost to be used (NICE CG114) 

 

Epoetin beta 

6 (*except where no Virement programs exist). 

Yes  

Red
 

 

NHSE - Renal Dialysis only. Product with lowest procurement cost to be used (NICE CG114) 

 

Epotermin alfa (Osigraft®) 

Bone morphogenic protein 

 

Red
 

 

CCG 

 

Eproprostenol 

pulmonary hypertension 

 

Red
 

 

NHSE 

 

Ergotamine containing products (Migril) 

Criterion 1 

DNP  

DNP
 

NICE “do not do”: Do not offer ergots or opioids for the acute treatment of migraine 

 

 

Eslicarbazepine 

Antiepileptic Drugs As per NICE guidance  

 

Green
(following
specialist
advice) 

 

CCG 

 

Estradiol (oestradiol)  

Transgender use of hormone therapy. As per NHSE Primary Care Responsibilities in Prescribing and Monitoring Hormone Therapy for Transgender and Non-Binary Adultshttp://shsc.nhs.uk/wp-content/uploads/2016/04/SSC1620_GD-Prescribing.pdf 

 

Amber
 

GM supporting information for GPs 

(as per NHSE Shared care arrangements) 

 

Etanercept 

10 

Biologics/Cytokine modulators 

Yes  

Red
 

 

NHSE for paediatric indications where adult TA available and for juvenile arthritis. CCG for adults. 

 

Ethambutol 

Tuberculosis, antibiotic therapy. Local commissioning arrangements may vary. 

Yes  

Green
(following
specialist
initiation) 

 

NHSE = drug resistant TB only 

 

Ethosuximide 

Antiepileptic Drugs As per NICE guidance  

 

Green
(following
specialist
advice) 

 

CCG 

 

Etravirine 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Eviplera® (Emtricitabine + Rilpivirine + Tenofovir) 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Evolocumab 

Primary hypercholesterolaemia and mixed dyslipidaemia 

Yes  

Red
 

 

CCG 

 

Exemestane 

Hormone Antagonists for breast cancer 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Exenatide (Byetta® and Bydureon®) 

GLP-1 Agonists As per NICE guidance and see new therapies recommendations  

Yes  

Green
 

 

CCG 

 

Febuxostat 

10 

See NICE guidance. 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Ferric Carboxymaltose (Ferinject®) 

IV iron 

Yes  

Red
 

 

CCG 

 

Ferric Maltol 

In adults for the treatment of iron deficiency anaemia (IDA) in patients with inflammatory bowel disease (IBD) 

 

Green
(following
specialist
advice) 

Following gastroenterologist recommendation 

CCG 

 

Ferumoxytol (Rienso®) 

IV iron 

 

Red
 

 

CCG 

 

Fidaxomicin 

Clostridium difficile - following microbiology advice 

 

Green
(following
specialist
advice) 

 

CCG 

 

Filgrastim 

GCSF for neutropenia 

Yes  

Red
 

 

NHSE 

 

Finasteride 

Transgender use of hormone therapy. As per NHSE Primary Care Responsibilities in Prescribing and Monitoring Hormone Therapy for Transgender and Non-Binary Adultshttp://shsc.nhs.uk/wp-content/uploads/2016/04/SSC1620_GD-Prescribing.pdf 

 

Amber
 

GM supporting information for GPs 

(as per NHSE Shared care arrangements) 

 

Fingolimod 

See GM Neuroscience meds recommendation 

 

Red
 

 

NHSE 

 

Flecainide 

 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Flunarizine 

Headache 

 

Red
 

 

CCG 

 

Fluocinolone acetonide intraviteral implant 

11 

Ophthalmic indications 

Yes  

Red
 

 

CCG 

 

Fluorometholone eye drops 

11 

Local inflammation of eye (short-term use) 

Yes  

Red
 

 

CCG 

 

Flupentixol decanoate 

Antipsychotic depot injection (Schizophrenia) Only for those patients who are stable and if SCP available; or if under the care of a community psychiatric nurse. In some localities there may be commissioning arrangements in place to permit step down. 

Yes  

Amber
 

First generation (Typical) antipsychotic depots in adults  

CCG 

 

Fluphenazine decanoate 

Antipsychotic depot injection (Schizophrenia) Only for those patients who are stable and if SCP available; or if under the care of a community psychiatric nurse. In some localities there may be commissioning arrangements in place to permit step down. 

Yes  

Amber
 

First generation (Typical) antipsychotic depots in adults  

CCG 

 

Follitropin alfa 

Infertility Drugs  

 

Red
 

 

CCG 

 

Follitropin beta 

Infertility Drugs  

 

Red
 

 

CCG 

 

Fondaparinux 

All Surgical Specialities: Given post-operatively in conjunction with warfarin whilst waiting for the INR to come into range. 

 

Red
 

 

CCG 

 

Fondaparinux 

All Surgical Specialities: Warfarin replacement. Given pre-operatively for up to 5 days up until the day of surgery instead of taking warfarin. Allows INR to fall before operation. 

 

Red
 

 

CCG 

 

Fondaparinux 

DVT and PE treatment - initial 2 weeks or as per locally agreed pathways 

 

Red
 

 

CCG 

 

Fondaparinux 

DVT or PE in oncology patients undergoing cancer therapy or with metastatic disease. 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Fondaparinux 

DVT or PE in patient unable to stabilise on warfarin or NOACs, with an allergy or with contra-indication to warfarin and/or NOACs. This includes IVDU patients. 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Fondaparinux 

For travel prophylaxis in high risk patients (travelling time over 8 hrs) and only as per national recommendations. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2141.2010.08408.x/full 

 

Green
(following
specialist
advice) 

 

CCG 

 

Fondaparinux 

Immobile patients or those deemed to be at particularly high risk of DVT at home or in care situation in patients unable to tolerate/tale warfarin or NOACs 

 

Green
(following
specialist
advice) 

 

CCG 

 

Fondaparinux 

Obstetric Use: Patients with mechanical heart valves or those on long term warfarin prior to pregnancy should be discussed with consultant cardiologists/haematologists, ideally before pregnancy. 

 

Red
 

 

CCG 

 

Fondaparinux 

Prophylaxis of VTE during pregnancy.  

 

Red
 

Local commissioning arrangements may vary and may be amber if local agreement in some CCGs. 

CCG 

 

Fondaparinux 

Prophylaxis of VTE in oncology patients on VTE inducing therapy 

 

Red
 

 

CCG 

 

Fondaparinux 

Prophylaxis Post-operative use [e.g. hips, knees, general surgical] 

 

Red
 

 

CCG 

 

Fondaparinux 

Treatment of DVT/PE in pregnancy. First line treatment of choice. 

 

Red
 

Local commissioning arrangements may vary and may be amber if local agreement in some CCGs. 

CCG 

 

Fondaparinux 

Use by fertility clinics, and also to prevent miscarriage 

 

Red
 

 

CCG 

 

Fosamprenavir 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Fosfomycin (oral) 

Uncomplicated UTI caused by multiple antibacterial organisms on advice of microbiologist  

 

Green
(following
specialist
advice) 

 

CCG 

 

Fulvestrant 

Criterion 2 

DNP  

DNP
 

NICE TA239, TA503 

 

 

Fumarate esters (Fumaderm®) 

13 

Psoriasis  

 

Red
 

 

CCG 

 

Gabapentin 

Antiepileptic Drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Galantamine 

Dementia - as per NICE TA 217. Local commissioning arrangements may vary and in some localities this is green on specialist advice so please check with your CCG 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Gamolenic Acid/ Starflower oil (Epogam®) and Efamast®) 

Criterion 1 

DNP  

DNP
 

No evidence to support use  

 

 

Ganciclovir 

CMV 

 

Red
 

 

NHSE 

 

Ganciclovir eye gel 

11 

Herpes simplex infection 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Gemeprost 

Induction of abortion 

 

Red
 

 

CCG 

 

Gentamicin eye drops 

11 

Anti-infective eye preparations 

Yes  

Red
 

 

CCG 

 

Glatiramer acetate 

Multiple Sclerosis  

 

Red
 

 

NHSE 

 

Glecaprevir-pibrentasvir 

Hepatitis C 

Yes  

Red
 

 

NHSE 

 

Gliclazide MR (Diamicron MR®) 

Criterion 2 

DNP  

DNP
 

BNF note: equivalent therapeutic effect to standard prep  

 

 

Glucosamine (+/- chondroiton) 

10 

Criterion 1 

DNP  

DNP
 

See NHS England guidance on items not for routine prescribing in primary care

NTS: Glucosamine sulfate (Glusartel®) for the treatment of osteoarthritis of the knee

NICE: “do not do” recommendation (CG177) 

 

 

Glycerol phenylbutyrate 

Agents for the treatment of metabolic disorders 

 

Red
 

 

NHSE 

 

Gold injection 

10 

DMARDs Rheumatoid Arthritis. 

 

Amber
 

Sodium Aurothiomalate (Gold) for Rheumatological Conditions 

CCG 

 

Golimumab 

10 

Biologics/Cytokine modulators 

Yes  

Red
 

 

NHSE for paediatric indications where adult TA available and for juvenile arthritis. CCG for adults. 

 

Goserelin 

For all other unlicensed indications (including long term use > 6 months)  

Yes  

Red
 

 

CCG 

 

Goserelin 

Licensed Indications (Pre-op management prior to endometrial ablation/ fibroid surgery). 

Yes  

Amber
 

 

CCG 

 

Goserelin 

Licensed Indications (Prostate cancer for all and breast cancer for Goserelin). 

Yes  

Amber
 

Goserelin (Zoladex), Leuprorelin (Prostap) or Triptorelin (Decapeptyl SR) in the treatment of prostate cancer 

CCG 

 

Goserelin 

Precocious puberty and for testosterone castration in sex offenders (unlicensed) 

Yes  

Red
 

 

CCG 

 

Goserelin 

Transgender use of hormone therapy. As per NHSE Primary Care Responsibilities in Prescribing and Monitoring Hormone Therapy for Transgender and Non-Binary Adultshttp://shsc.nhs.uk/wp-content/uploads/2016/04/SSC1620_GD-Prescribing.pdf 

Yes  

Amber
 

GM supporting information for GPs 

(as per NHSE Shared care arrangements) 

 

Granisetron (5-HT3 antagonist anti-emetics) 

Post op and following chemotherapy.  

Yes  

Red
 

 

CCG 

 

Grass Pollen Extract (Grazax®) 

Criterion 2 

DNP  

DNP
 

NTS: Grazax for grass pollen induced hay fever in adults 

 

 

Growth Hormone (Somatropin) 

For primary and secondary hypo- pituitarism. 

Yes  

Amber
 

 

CCG 

 

Growth Hormone - adults 

Except in proven primary and secondary hypopituitarism.  

Yes  

Red
 

 

NHSE 

 

Guselkumab 

13 

Biologics/Cytokine modulators 

Yes  

Red
 

 

CCG 

20 07 2018 

Haloperidol decanoate 

Antipsychotic depot injection (Schizophrenia) Only for those patients who are stable and if SCP available; or if under the care of a community psychiatric nurse. In some localities there may be commissioning arrangements in place to permit step down. 

Yes  

Amber
 

First generation (Typical) antipsychotic depots in adults 

CCG 

 

Herbal medicines 

Misc 

Criterion 1 

DNP  

DNP
 

GM EUR Complementary and Alternative Therapies policy  

 

 

Homeopathic medicines 

Misc 

Criterion 1 

DNP  

DNP
 

GM EUR Complementary and Alternative Therapies policy 

 

 

Human Arginate 

Agents for the treatment of metabolic disorders 

 

Red
 

 

NHSE 

 

Human Heterologous Liver Cells 

Agents for the treatment of metabolic disorders 

 

Red
 

 

NHSE 

 

Hydroxycarbamide 

Essential thrombocythaemia, myelofibrosis or polycythaemia with high risk of complications. 

 

Amber
 

Hydroxycarbamide for myleoproliferative disorders 

NHSE 

 

Hydroxycarbamide 

Sickle Cell Disease 

 

Amber
 

Hydroxycarbamide for sickle cell disease 

CCG 

 

Hydroxychloroquine 

10 

DMARDs Rheumatoid Arthritis. 

Yes  

Amber
 

Hydroxychloroquine for Rheumatological Conditions 

CCG 

 

Ibandronic acid 

Breast cancer. 

 

Amber
 

Ibandronate for breast cancer 

CCG 

 

Icatibant 

Angioedema 

 

Red
 

 

NHSE 

 

Idarucizumab 

Dabigatran reversal agent 

Yes  

Red
 

 

CCG 

 

Idoxuridine in dimethyl sulfoxide (Herpid®) 

13 

Criterion 1 

DNP  

DNP
 

No evidence to support use  

 

 

Iloprost 

pulmonary hypertension  

 

Red
 

 

NHSE 

 

Imiquimoid cream 

13 

Actinic keratosis 

 

Green
 

 

CCG 

 

Imiquimoid cream 

13 

Genital warts 

Yes  

Green
(following
specialist
initiation) 

Local commissioning arrangements may vary. 

CCG 

 

Immediate-release fentanyl 

Criterion 2 Only to be used in patients undergoing palliative care treatment where the recommendation to use immediate release fentanyl is in line with NICE CG140 and has been made by a multi-disciplinary team and/or other healthcare professional with a recognised specialism in palliative care. 

Grey  

Green
(following
specialist
initiation) 

See NHS England guidance on items not for routine prescribing in primary care  

CCG 

 

Immunoglobulin (Normal) 

14 

 

 

Red
 

 

NHSE 

 

Immunoglobulin Varicella-Zoster (VIG)  

14 

Normally available through local Trust Virology departments.  

 

Green
Green (if patient fulfils the DH criteria) 

 

Public health 

 

Indinavir 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Infliximab 

10 

Biologics/Cytokine modulators 

Yes  

Red
 

 

NHSE for paediatric indications where adult TA available and for juvenile arthritis. CCG for adults. 

 

Inositol Nicotinate (Hexopal®) 

Criterion 1 

DNP  

DNP
 

NICE: TA223 

 

 

Insulin and GLP-1 Agonist combination 

Not to be initiated in primary care 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Interferon alfa-2a 

 

 

Red
 

 

NHSE 

 

Interferon alfa-2b 

 

 

Red
 

 

NHSE 

 

Interferon beta 

Multiple Sclerosis  

 

Red
 

 

CCG 

 

Interferon gamma-1b 

 

 

Red
 

 

CCG 

 

Iron - all modified release iron preparations 

Criterion 1 

DNP  

DNP
 

BNF: No therapeutic advantage and should not be used 

 

 

Iron Dextran (Cosmofer®) 

IV iron 

Yes  

Red
 

 

CCG 

 

Iron Isomaltoside 1000 (Monofer®) 

IV iron 

Yes  

Red
 

 

CCG 

 

Iron Sucrose (Venofer®) 

IV iron 

Yes  

Red
 

 

CCG 

 

Isocarboxazid 

Non-reversible MAOI 

 

Red
 

For new patients only 

CCG 

 

Isoniazid 

Tuberculosis, antibiotic therapy. Local commissioning arrangements may vary. 

Yes  

Green
(following
specialist
initiation) 

 

NHSE = drug resistant TB only 

 

Isotretinoin (oral) 

13 

Red status predominantly due to safety concerns in pregnancy. 

Yes  

Red
 

 

CCG 

 

IV Formulations 

Misc 

unless part of an agreed local pathway.  

 

Red
 

 

CCG or NHSE depends on indication and drug 

 

Ivabradine  

Heart Failure. See IPNTS recommendation. Not to be initiated in primary care.  

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Ivacaftor 

Cystic fibrosis  

 

Red
 

 

NHSE 

 

Ivermectin Cream 

13 

Acne rosacea 

 

Green
 

 

CCG 

 

Kaletra® (Lopinavir + Ritonavir) 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Ketamine 

For Chronic Pain management  

 

Red
 

 

CCG 

 

Ketamine 

For short term use at end of life subject to local arrangements. Please note: unlicensed indication.  

 

Amber
 

Under direction and advice of palliative care team. Local commissioning arrangements may vary 

CCG 

 

Ketamine 

For use in palliative care SCP/information sheet available. Please note: unlicensed indication.  

 

Amber
 

Under direction and advice of palliative care team. Local commissioning arrangements may vary 

CCG 

 

Ketoconazole (for oral administration) 

Criterion 1 

DNP  

DNP
 

See MHRA Drug Safety Update for information on safety concerns 

 

 

Ketoconazole (oral) 

Cushing's disease 

 

Red
 

 

CCG 

 

Ketorolac eye drops 

11 

Ocular peri-operative drugs 

Yes  

Red
 

 

CCG 

 

Kivexa® (Abacavir + Lamivudine) 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Lacosamide 

Antiepileptic Drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Lactase drops e.g. Colief® 

Misc 

Criterion 1 

DNP  

DNP
 

BNF Appendix 2.5 NICE CKS – Colic – infantile (Nov 2014): Lactase drops 

 

 

Lamivudine 

Antivirals for treatment of Hepatitis B  

 

Red
 

 

NHSE 

 

Lamivudine 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Lamotrigine 

Antiepileptic Drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Lanolin cream (Lansinoh HPA®) 

13 

Criterion 1 

DNP  

DNP
 

Cochrane Review 2014: Interventions for treating painful nipples among breastfeeding women  

 

 

Lanreotide 

Acromegaly 

 

Red
 

 

NHSE 

 

Lanreotide 

All other licensed and unlicensed indications 

 

Red
 

 

NHSE 

 

Lanthanum 

Phosphate Binding agent in both dialysis and non-dialysis patients 

Yes  

Green
(following
specialist
initiation) 

 

NHSE 

 

Ledipasvir 

Hepatitis C 

 

Red
 

 

CCG 

 

Leflunomide 

10 

DMARDs for Rheumatoid Arthritis. 

Yes  

Amber
 

Leflunomide for Rheumatological Conditions 

CCG 

 

Lenograstim 

GCSF for neutropenia 

Yes  

Red
 

 

NHSE 

 

Lesinurad 

10 

Criterion 2 

DNP  

DNP
 

NICE TA506 

 

 

Letrozole 

Hormone Antagonists for breast cancer 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Leuprorelin 

For all other unlicensed indications (including long term use > 6 months)  

Yes  

Red
 

 

CCG 

 

Leuprorelin 

Licensed Indications (Pre-op management prior to endometrial ablation/ fibroid surgery). 

Yes  

Amber
 

 

CCG 

 

Leuprorelin 

Licensed Indications (Prostate cancer for all and breast cancer for Goserelin). 

Yes  

Amber
 

Goserelin (Zoladex), Leuprorelin (Prostap) or Triptorelin (Decapeptyl SR) in the treatment of prostate cancer 

CCG 

 

Leuprorelin 

Precocious puberty and for testosterone castration in sex offenders (unlicensed) 

Yes  

Red
 

 

CCG 

 

Leuprorelin 

Transgender use of hormone therapy. As per NHSE Primary Care Responsibilities in Prescribing and Monitoring Hormone Therapy for Transgender and Non-Binary Adultshttp://shsc.nhs.uk/wp-content/uploads/2016/04/SSC1620_GD-Prescribing.pdf 

Yes  

Amber
 

GM supporting information for GPs 

(as per NHSE Shared care arrangements) 

 

Levetiracetam 

Antiepileptic Drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Levocarnitine 

Agents for the treatment of metabolic disorders 

 

Red
 

 

NHSE 

 

Levocetirizine (Xyzal®) 

Criterion 2 

DNP  

DNP
 

CKS: Allergic Rhinitis 

 

 

Levofloxacin eye drops 

11 

Anti-infective eye preparations 

Yes  

Red
 

 

CCG 

 

Levopromazine 

Palliative Care 

Yes  

Green
 

 

CCG 

 

Lidocaine plasters 

Criterion 1 Only to be used in patients who have been treated in line with NICE CG173 but are still experiencing neuropathic pain associated with previous herpes zoster infection (post-herpetic neuralgia).  

Grey  

Green
 

See NHS England guidance on items not for routine prescribing in primary care

NICE CG173 (Neuropathic pain in adults: pharmacological management in non-specialist settings)  

CCG 

 

Linaclotide  

IBS-C 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Linagliptin 

Gliptins (DPP-4 Inhibitors) As per NICE guidance and see new therapies recommendations  

Yes  

Green
 

 

CCG 

 

Linezolid 

 

Yes  

Red
 

 

CCG 

 

Liothyronine (T3)  

Criterion 2 Hypothyroid crisis and short-term use post-thyroid surgery only 

Grey  

Red
 

For new patients only 

CCG 

 

Liothyronine (T3)  

Criterion 2 Only for individuals who, in exceptional circumstances, have an on-going need for liothyronine as confirmed by a consultant NHS endocrinologist.  

Grey  

Green
(following
specialist
initiation) 

See NHS England guidance on items not for routine prescribing in primary care  

CCG 

 

Liothyronine combination products (including Armour Thyroid) 

Criterion 2 

DNP  

DNP
 

See NHS England guidance on items not for routine prescribing in primary care  

 

 

Liraglutide 

GLP-1 Agonists As per NICE guidance and see new therapies recommendations  

Yes  

Green
 

 

CCG 

 

Liraglutide for obesity (Saxenda®) 

Criterion 1 

DNP  

DNP
 

NTS Liraglutide for obesity 

 

 

Lisdexamfetamine 

ADHD  

Yes  

Amber
 

Methylphenidate, Atomoxetine , Dexamfetamine And Lisdexamfetamine For Attention Deficit Hyperactivity Disorder (ADHD) In Adults 

CCG 

 

Lithium 

Prophylaxis of Cluster Headache 

Yes  

Amber
 

 

CCG 

 

Lithium 

 

Yes  

Amber
 

Lithium for patients over 18 years old including those aged 65 years and older 

CCG 

 

Lixisenatide 

GLP-1 Agonists As per NICE guidance and see new therapies recommendations  

Yes  

Green
 

 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

All Surgical Specialities: Given post-operatively in conjunction with warfarin whilst waiting for the INR to come into range. 

 

Red
 

 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

All Surgical Specialities: Warfarin replacement. Given pre-operatively for up to 5 days up until the day of surgery instead of taking warfarin. Allows INR to fall before operation. 

 

Red
 

 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

DVT and PE treatment - initial 2 weeks or as per locally agreed pathways 

 

Red
 

 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

DVT or PE in oncology patients undergoing cancer therapy or with metastatic disease. 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

DVT or PE in patient unable to stabilise on warfarin or NOACs, with an allergy or with contra-indication to warfarin and/or NOACs. This includes IVDU patients. 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

For travel prophylaxis in high risk patients (travelling time over 8 hrs) and only as per national recommendations. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2141.2010.08408.x/full 

 

Green
(following
specialist
advice) 

 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

Immobile patients or those deemed to be at particularly high risk of DVT at home or in care situation in patients unable to tolerate/tale warfarin or NOACs 

 

Green
(following
specialist
advice) 

 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

Obstetric Use: Patients with mechanical heart valves or those on long term warfarin prior to pregnancy should be discussed with consultant cardiologists/haematologists, ideally before pregnancy. 

 

Red
 

 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

Prophylaxis of VTE during pregnancy.  

 

Red
 

Local commissioning arrangements may vary and may be amber if local agreement in some CCGs. 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

Prophylaxis of VTE in oncology patients on VTE inducing therapy 

 

Red
 

Commissioning of this service will commence from the 1st April 2015 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

Prophylaxis of VTE in oncology patients on VTE inducing therapy 

 

Red
 

 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

Prophylaxis Post-operative use [e.g. hips, knees, general surgical] 

 

Red
 

 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

Thromboprophylaxis after delivery 

 

Red
 

 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

Thromboprophylaxis for high risk patients who have suffered a fracture and are in plaster 

 

Red
 

 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

Treatment of DVT/PE in pregnancy. First line treatment of choice. 

 

Red
 

Local commissioning arrangements may vary and may be amber if local agreement in some CCGs. 

CCG 

 

Low Molecular Weight Heparins (Dalteparin, Enoxaparin, Tinzaparin) 

Use by fertility clinics, and also to prevent miscarriage 

 

Red
 

 

CCG 

 

Lubiprostone 

Constipation - as per NICE guidance 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Lurasidone 

For the treatment of schizophrenia in adults aged 18 years and older who require antipsychotic treatment, who have previously had a trial of but not responded to aripiprazole, and who fulfil one of the following criteria:
• Patient gained weight on other antipsychotics and there is a need for the BMI to move towards the normal range
• Patients for whom there is a need to avoid weight gain and metabolic adverse effects, e.g. patients with diabetes, cardiovascular disease
• Patients with a prolonged QTc interval  

Grey  

Amber
 

Treat as RED
pending SCP 

CCG 

19 07 2018 

Macitentan 

Pulmonary arterial hypertension 

 

Red
 

 

NHSE 

 

Mannitol inhaler 

Cystic fibrosis  

Yes  

Red
 

 

NHSE 

 

Maraviroc 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Melatonin (Circadin®) . 

Circadian rhythm disorders /insomnia in service users with LD aged 18-55 where behavioural interventions have failed and ongoing treatment in CAMHS graduates where clinically indicated 

 

Amber
 

 

CCG 

 

Melatonin (licensed product only)  

Adult patients over 55. See New Therapies recommendation.  

 

Green
 

Not recommended for use.  

CCG 

 

Memantine 

Dementia - as per NICE TA 217. Local commissioning arrangements may vary and in some localities this is green on specialist advice so please check with your CCG 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Menotropin 

Infertility Drugs 

 

Red
 

 

CCG 

 

Meprobamate 

Criterion 1 

DNP  

DNP
 

BNF: meprobamate 

 

 

Mercaptamine (cysteamine) 

Agents for the treatment of metabolic disorders 

 

Red
 

 

NHSE 

 

Mercaptopurine 

Inflammatory bowel diseases. Unlicensed but in BNF. 

Yes  

Amber
 

Azathioprine and 6-Mercaptopurine for the treatment of IBD 

CCG 

 

Mesalazine 

GI Indications 

Yes  

Green
(following
specialist
initiation) 

Oral Methotrexate for Rheumatological Conditions 

CCG 

 

Metformin 

For PCOS 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Metformin 

Reduction in risk or delay of onset of T2DM in adult, overweight patients with impaired glucose tolerance and/or increased HbA1c who are: - at high risk of developing overt T2DM and - still progressing towards T2DM despite implementation of intensive lifestyle change for 3-6 months 

Yes  

Green
 

Green (following specialist initiation). Second-line treatment to intensive lifestyle intervention. 

CCG 

 

Metformin  

Use in pregnancy (N.B. Unlicensed indication) 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Methadone 

Opioid dependence 

Yes  

Other
 

Status depends on local commissioning arrangements for substance misuse or if GP with specialist interest 

CCG 

 

Methotrexate 

10 

DMARDs Rheumatoid Arthritis. 

Yes  

Amber
 

Oral Methotrexate for Rheumatological Conditions 

CCG 

 

Methotrexate 

Oral. Inflammatory bowel disease (unlicensed indication but in BNF)  

Yes  

Amber
 

 

CCG 

 

Methotrexate 

Parenteral Formulations.  

 

Red
 

 

CCG / NHSE depending on indication 

 

Methotrexate (Metoject® brand only) Subcutaneous injection  

Crohn's disease 

Yes  

Amber
 

 

CCG 

 

Methotrexate (Metoject®) Subcutaneous injection 

10 

DMARDs Rheumatoid Arthritis. 

Yes  

Amber
 

 

CCG 

 

Methotrexate (Metoject®) Subcutaneous injection 

13 

Psoriais and Psoriatic Arthritis 

 

Amber
 

 

CCG 

 

Methotrexate (oral) 

13 

Dermatology indications 

Yes  

Amber
 

 

CCG 

 

Methotrexate (oral) 

Oral. Inflammatory bowel disease (unlicensed indication but in BNF)  

Yes  

Amber
 

 

CCG 

 

Methoxy polyethylene glycol-epoetin beta 

6 (*except where no Virement programs exist). 

Yes  

Red
 

 

NHSE - Renal Dialysis only. Product with lowest procurement cost to be used (NICE CG114) 

 

Methylphenidate 

ADHD  

Yes  

Amber
 

Methylphenidate, Atomoxetine , Dexamfetamine And Lisdexamfetamine For Attention Deficit Hyperactivity Disorder (ADHD) In Adults 

CCG 

 

Methysergide 

Unlicensed  

 

Red
 

 

CCG 

 

Metolazone 

Heart failure 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Metyrapone 

Cushings syndrome 

Yes  

Red
 

 

CCG 

 

Micafungin 

Antifungal 

Yes  

Red
 

 

NHSE 

 

Midazolam (buccal) 

Epilepsy 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Midodrine 

For hypotensive states 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Mifamurtide 

Osteosarcoma 

 

Red
 

 

NHSE 

 

Mifeprostone 

Induction of abortion 

 

Red
 

 

CCG 

 

Moclobemide 

Reversible MAOI 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Modafinil 

Parkinson's disease 

 

Amber
 

To remain RED until Shared Care Protocol approved 

CCG 

 

Modafinil 

Sleepiness associated with narcolepsy 

Yes  

Amber
 

To remain RED until Shared Care Protocol approved 

CCG 

 

Molludab (potassium hydroxide 5%) topical solution for the treatment of molluscum contagiosum 

13 

Criterion 1 

DNP  

DNP
 

CKS: Molluscum contagiosum 

 

 

Moxisylyte (Opilon®) 

Criterion 1 

DNP  

DNP
 

CKS: Raynaud's Phenomenon 

 

 

Multivitamin and mineral preparations for the management of age-related macular degeneration (ARMD) e.g. Icaps, Occuvite preservision, Preservision lutein, Viteyes original plus-lutein, Ocuvite lutein, Visionace, Vitalux-plus) 

Criterion 1 

DNP  

DNP
 

See NHS England guidance on items not for routine prescribing in primary care 

 

 

Mycophenolate 

13 

Dermatology indications 

Yes  

Amber
 

Mycophenolate mofetil in Dermatology 

CCG 

 

Mycophenolate 

10 

DMARDs Rheumatoid Arthritis. 

Yes  

Amber
 

Mycophenolate Mofetil for Rheumatological Conditions 

CCG 

 

Mycophenolate 

Immunosuppressants Licensed indications only. Red if no SCP  

 

Amber
 

 

NHSE for transplant immunosuppressant only. All other indications CCG. 

 

Mycophenolate 

Interstitial Lung Disease 

 

Amber
 

Mycophenolate for Interstitial Lung Disease 

CCG 

 

Mycophenolate 

Post transplant use 

 

Amber
 

To remain amber until repatriation occurs 

NHSE 

 

Nalmefene 

Alcohol Dependence As per NICE guidance and see new therapies recommendations. Nalmefene should only be prescribed in conjunction with continuous psychosocial support focused on treatment adherence and reducing alcohol consumption provided by a specialist alcohol service. 

Yes  

Green
 

Public health 

 

Naloxegol for opioid induced constipation 

Opioid induced constipation 

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Naltrexone 

Opioid Dependence 

Yes  

Amber
 

 

Public health 

 

Naltrexone 

Opioid dependence 

Yes  

Other
 

Status depends on local commissioning arrangements for substance misuse  

CCG 

 

Naltrexone 

Unlicensed use. Recommended in NICE guidance for max 6 months duration. To remain under specialist community alcohol teams. 

Yes  

Red
 

 

Public health 

 

Naltrexone for alcohol disorders  

Recommended in NICE guidance for max 6 months duration. To remain under specialist community alcohol teams.  

Yes  

Red
 

 

Public health 

 

Naltrexone-bupropion (Mysimba®▼) 

Criterion 2 

DNP  

DNP
 

NICE TA494 

 

 

Naproxen & esomeprazole combination product (Vimovo®) 

10 

Criterion 2 

DNP  

DNP
 

CKS: Proven GORD 

 

 

Natalizumab 

Multiple Sclerosis  

 

Red
 

 

NHSE 

 

Nefopam 

Criterion 3 Only to be used in those patients with moderate to severe chronic liver disease who require analgesia stronger than paracetamol in whom NSAIDS and moderate strength opiates are contraindicated  

Grey  

Green
 

Due to the high cost of nefopam, a lack of evidence of superior efficacy over other analgesics, and its side effect profile, there is no rationale for the routine use of nefopam.  

CCG 

 

Nevirapine 

HIV medicines.  

Yes  

Red
 

 

NHSE 

 

Nintedanib 

Idiopathic pulmonary fibrosis 

 

Red
 

 

NHSE 

 

Nitisinone 

Agents for the treatment of metabolic disorders 

 

Red
 

 

NHSE 

 

Obeticholic acid (Ocaliva) 

Agents for the treatment of metabolic disorders 

 

Red
 

 

NHSE 

 

Ocriplasmin intraviteral injection 

11 

Ophthalmic indications 

Yes  

Red
 

 

CCG 

 

Octreotide 

Acromegaly 

 

Red
 

 

NHSE 

 

Octreotide 

All other licensed and unlicensed indications 

 

Red
 

 

NHSE 

 

Ofloxacin eye drops 

11 

Anti-infective eye preparations 

Yes  

Red
 

 

CCG 

 

Olanzapine 

Antipsychotics (Oral)
Use in dementia patients (unlicensed). Local commissioning arrangements may vary and in some localities this remains an amber drug so please check with your CCG. Prescribing of antipsychotics in dementia is expected to be short term. In exceptional circumstances, longer term prescribing may be required [which would be outside of the product licence for any drugs which have a marketing authorisation for such use]. In these situations, there should still be regular review with the aim of reducing or stopping, and the best methods of ensuring continuity of supply should be negotiated between all healthcare professionals involved in that patient’s care.  

Yes  

Red
 

For new patients only 

CCG 

 

Olanzapine 

Atypical antipsychotics (Oral) All other unlicensed indications  

Yes  

Red
 

 

CCG 

 

Olanzapine 

Atypical antipsychotics (Oral) - Licensed Indications and also Unlicensed indications as recommended by NICE guidance (i.e. in psychotic depression or anxiety in bipolar patients).Red if no SCP  

Yes  

Amber
 

Oral Second Generation (Atypical) Antipsychotics for Adults - Review due 21/4/18 

CCG 

 

Olanzapine pamoate 

Antipsychotic depot injection (Schizophrenia)  

 

Red
 

 

CCG 

 

Omalizumab 

Allergic asthma prophylaxis. 

Yes  

Red
 

 

NHSE 

 

Omalizumab 

Severe chronic spontaneous urticaria 

Yes  

Red
 

 

CCG 

 

Ombitasvir-paritaprevir-ritonavir 

Hepatitis C 

 

Red
 

 

CCG 

 

Omega-3-acid ethyl ester (Omacor®)  

Criterion 1
Omega-3-fatty acids (e.g. Omacor) should only be used for the treatment of hypertriglyceridaemia under the care of a lipid management specialist, all patients receiving this medication, other than for hypertriglyceridaemia under a lipid management specialist, should have the medication discontinued  

Grey  

Green
(following
specialist
initiation) 

See NHS England guidance on items not for routine prescribing in primary care

NICE: CG181 

CCG 

 

Ondansetron (5-HT3 antagonist anti-emetics) 

For exceptional use in non oncology patients with chronic emesis following consultant recommendation and where all other options have failed.  

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Ondansetron (5-HT3 antagonist anti-emetics) 

Post op and following chemotherapy.  

Yes  

Red
 

 

CCG 

 

Opicapone 

Parkinson's disease 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Osvaren®  

Phosphate Binding Agents  

Yes  

Green
(following
specialist
initiation) 

 

NHSE/CDF for all chemotherapy indications 

 

Oxcarbazepine 

Antiepileptic Drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

NHSE/CDF for all chemotherapy indications 

 

Oxycodone/naloxone MR tablets (Targinact®) 

Criterion 2 

DNP  

DNP
 

See NHS England guidance on items not for routine prescribing in primary care 

 

 

Paliperidone 

Antipsychotics (Oral)
Use in dementia patients (unlicensed). Local commissioning arrangements may vary and in some localities this remains an amber drug so please check with your CCG. Prescribing of antipsychotics in dementia is expected to be short term. In exceptional circumstances, longer term prescribing may be required [which would be outside of the product licence for any drugs which have a marketing authorisation for such use]. In these situations, there should still be regular review with the aim of reducing or stopping, and the best methods of ensuring continuity of supply should be negotiated between all healthcare professionals involved in that patient’s care. 

 

Red
 

For new patients only 

CCG 

 

Paliperidone 

Atypical antipsychotics (Oral) All other unlicensed indications  

 

Red
 

 

CCG 

 

Paliperidone 

Atypical antipsychotics (Oral) - Licensed Indications and also Unlicensed indications as recommended by NICE guidance (i.e. in psychotic depression or anxiety in bipolar patients).Red if no SCP  

 

Amber
 

 

CCG 

 

Paliperidone palmitate 

Antipsychotic depot injection (Schizophrenia) Only for those patients who are stable and if SCP available; or if under the care of a community psychiatric nurse. In some localities there may be commissioning arrangements in place to permit step down. 

Yes  

Amber
 

Paliperidone Long-acting antipsychotic injection 

CCG 

 

Palonosetron (5-HT3 antagonists anti-emetics) 

Post op and following chemotherapy.  

 

Red
 

 

CCG 

 

Pancreatin (Creon®) 

 

Yes  

Green
(following
specialist
initiation) 

 

NHSE/CDF for all chemotherapy indications 

 

Paracetamol and tramadol combination product (Tramacet®) 

Criterion 2 

DNP  

DNP
 

See NHS England guidance on items not for routine prescribing in primary care 

 

 

Parathyroid hormone 

Osteoporosis 

Yes  

Red
 

 

NHSE/CDF for all chemotherapy indications 

 

Pasireotide 

Cushing's disease 

 

Red
 

 

NHSE 

 

Pegaptanib sodium 

11 

Ophthalmic indications 

 

Red
 

 

NHSE 

 

Pegfilgrastim 

GCSF for neutropenia 

Yes  

Red
 

 

NHSE 

 

Peginterferon alfa-2a 

 

 

Red
 

 

NHSE 

 

Peginterferon alfa-2b 

 

 

Red
 

 

NHSE 

 

Pegvisomant 

Acromegaly 

Yes  

Red
 

 

NHSE/CDF for all chemotherapy indications 

 

Pen needles 8 mm, 10 mm or 12 mm in length 

Criterion 1 

DNP  

DNP
 

Forum for Injection Technique (FIT) guidance 

 

 

Pen needles costing in excess of £6 per 100 

Criterion 2 

DNP  

DNP
 

See cost comparison chart in formulary chapter 6.1.1.3 

 

 

Penicillamine 

10 

DMARDs Rheumatoid Arthritis. 

 

Amber
 

 

CCG 

 

Penicillin eye drops 

11 

Anti-infective eye preparations 

Yes  

Red
 

 

NHSE/CDF for all chemotherapy indications 

 

Pentoxifylline (Trental®) 

Criterion 1 

DNP  

DNP
 

NICE: TA223 

 

 

Perampanel 

Antiepileptic Drugs As per NICE guidance  

 

Green
(following
specialist
advice) 

 

CCG 

 

Pergolide 

Antiparkinson's drugs As per NICE guidance  

 

Green
(following
specialist
advice) 

 

NHSE/CDF for all chemotherapy indications 

 

Perindopril arginine 

Criterion 2 

DNP  

DNP
 

See NHS England guidance on items not for routine prescribing in primary care 

 

 

Phenelzine 

Non-reversible MAOI 

Yes  

Red
 

For new patients only 

CCG 

 

Phenobarbital 

Antiepileptic Drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Phenytoin 

Antiepileptic Drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

PHMB eye drops 

11 

Anti-infective eye preparations 

Yes  

Red
 

 

CCG 

 

Phosex® (Calcium acetate) 

Phosphate Binding Agents  

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

PhosLo® (Calcium acetate) 

Phosphate Binding Agents  

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Phosphate infusion 

 

Yes  

Red
 

 

CCG 

 

Pimecrolimus 

13 

Eczema and Psoriasis 

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Pipotiazine palmitate 

Antipsychotic depot injection (Schizophrenia) Only for those patients who are stable and if SCP available; or if under the care of a community psychiatric nurse 

 

Amber
 

 

NHSE 

 

Pirfenidone 

Idiopathic pulmonary fibrosis 

Yes  

Red
 

 

NHSE 

 

Piroxicam oral therapies 

10 

Criterion 1 Systemic piroxicam should be initiated only by specialists as a second-line treatment for arthritis. Patients who currently take piroxicam should be reassessed at a routine appointment. 

Grey  

Green
(following
specialist
initiation) 

RA: Drug Safety Update 

CCG 

 

Pitolisant 

Narcolepsy 

 

Red
 

 

CCG 

 

Pollinex® (all forms) 

Criterion 1. Pollinex should only be prescribed in accordance with local commissioning arrangements. 

Grey  

Red
 

North West Allergy and Clinical Immunology Network on the NW England use of Pollinex products for pollen allergen immunotherapy - April 2014

NHS England Prescribed Specialist Services manual 

NHSE 

 

Posaconazole  

 

Yes  

Red
 

 

CCG 

 

Pramipexole 

Antiparkinson's drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Prasugrel 

Percuataneous coronary intervention 

Yes  

Green
(following
specialist
initiation) 

 

CCG 

 

Prazosin - unlicensed indications 

Criterion 1 Only to be used for licensed indications and not for PTSD 

Grey  

Green
(following
specialist
initiation) 

US VA/DoD: Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder 

CCG 

 

Prednisolone EC tablets 

Criterion 2 

DNP  

DNP
 

UKMI Q&A: Is there any evidence to support the use of enteric coated (EC) over uncoated prednisolone tablets 

 

 

Prednisolone enema 

GI Indications 

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Prednisolone foam 

GI Indications 

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Prednisolone suppositories 

GI Indications 

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Prednisone MR tablets (Lodotra®) 

Criterion 2 

DNP  

DNP
 

NTS: Prednisone Modified Release Tablet (Lodotra®) for the treatment of moderate to severe, active rheumatoid arthritis 

 

 

Pregabalin 

Antiepileptic Drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Pregabalin 

Neuropathic pain 

Yes  

Green
 

 

CCG 

 

Primidone 

Antiepileptic Drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

NHSE/CDF for all chemotherapy indications 

 

Progesterone suppositories 

When used in treatment of Infertility  

 

Red
 

 

CCG 

 

Propamidine eye drops 

11 

Anti-infective eye preparations 

Yes  

Green
 

 

CCG 

 

Propylthiouracil 

Hyperthyroidism. See FDA warning re extra monitoring required. Prescribing to remain within specialist care until patient stable 

Yes  

Green
(following specialist initiation)  

 

CCG 

 

Prucalopride 

Chronic constipation in women when other laxatives fail to provide an adequate response 

Yes  

Green
(following specialist initiation)  

 

CCG 

 

Pyrazinamide 

Tuberculosis, antibiotic therapy. Local commissioning arrangements may vary. 

Yes  

Green
(following specialist initiation)  

 

CCG 

 

Quetiapine 

Antipsychotics (Oral)
Use in dementia patients. Local commissioning arrangements may vary and in some localities this remains an amber drug so please check with your CCG. Prescribing of antipsychotics in dementia is expected to be short term. In exceptional circumstances, longer term prescribing may be required [which would be outside of the product licence for any drugs which have a marketing authorisation for such use]. In these situations, there should still be regular review with the aim of reducing or stopping, and the best methods of ensuring continuity of supply should be negotiated between all healthcare professionals involved in that patient’s care.  

Yes  

Red
 

For new patients only 

CCG 

 

Quetiapine 

Atypical antipsychotics (Oral) All other unlicensed indications  

Yes  

Red
 

 

CCG 

 

Quetiapine 

Atypical antipsychotics (Oral) - Licensed Indications and also Unlicensed indications as recommended by NICE guidance (i.e. in psychotic depression or anxiety in bipolar patients).Red if no SCP  

Yes  

Amber
 

Oral Second Generation (Atypical) Antipsychotics for Adults - Review due 21/4/18 

CCG 

 

Quetiapine 

Atypical antipsychotics (Oral) - Use in dementia patients (unlicensed). Local commissioning arrangements may vary and in some localities this remains an amber drug so please check with your CCG. 

Yes  

Red
 

For new patients only 

CCG 

 

Raloxifene 

Chemoprevention in women at moderate and high risk of breast cancer 

 

Green
(following
specialist
initiation) 

 

CCG 

 

Raltegravir 

HIV medicines.  

Yes  

Red
 

 

NHSE/CDF for all chemotherapy indications 

 

Ranibizumab intravitreal injection 

11 

Ophthalmic indications 

Yes  

Red
 

 

CCG 

 

Ranolazine 

Stable angina 

Yes  

Green
(following
specialist
advice) 

 

CCG 

 

Rasagiline 

Antiparkinson's drugs As per NICE guidance  

Yes  

Green
(following
specialist
advice) 

 

NHSE 

 

Rasburicase 

10 

Hyperuricaemia associated with cytotoxic drugs 

 

Red
 

 

NHSE 

 

Reslizumab 

Severe eosinophilic asthma 

Yes  

Red
 

 

NHSE 

 

RESPeRATE® 

Criterion 1 

DNP  

DNP
 

NICE CG127 

 

 

Reteplase 

Fibrinolytics 

 

Red
 

 

CCG 

 

Retigabine 

Antiepileptic Drugs As per NICE guidance  

 

Red
 

 

NHSE 

 

Ribavirin 

Hepatitis C and RSV  

Yes  

Red
 

 

NHSE = drug resistant TB only 

 

Rifabutin 

Tuberculosis, antibiotic therapy. Local commissioning arrangements may vary. 

Yes  

Green
(following
specialist
initiation) 

 

NHSE = drug resistant TB only 

 

Rifampicin 

Tuberculosis, antibiotic therapy. Local commissioning arrangements may vary. 

Yes  

Green
(following
specialist
initiation) 

 

NHSE = drug resistant TB only 

 

Rifater® (Rifampicin + isoniazid + pyrazinamide) 

Tuberculosis, antibiotic therapy. Local commissioning arrangements may vary. 

Yes  

Green
(following
specialist
initiation)