Shared Care: Listed Alphabetically

Interim Statement for Requests for Shared Care Agreements for Historic Patients

SCA’s are currently listed alphabetically by drug name (or disease). Where a drug doesn’t have it’s own specific request form please use this one Shared Care Request Form

A programme of review of these shared care agreement documents is currently being undertaken. These are the current shared care agreements. If there are any concerns please contact Please do not send patient identifiable information as email may be unsecure.

ADHD (adults)   Request form 

ADHD (paediatric)   Request form



Amiloride (paediatric cardiology)

Amisulpride     Request form

Antipsychotics (atypical)

Antipsychotics (atypical) in personality disorder   Request form 

Apomorphine for treatment of Parkinsons’s disease     Request form

Aripiprazole long acting injection     Request form

Aripiprazole oral     Request form

Atomoxetine (adults)     Request form

Atomoxetine (paediatric)     Request form

Azathioprine (dermatology)

Azathioprine (adult gastroenterology)

Azathioprine (paediatric gastroenterology)

Azathioprine (rheumatology)     Request form


Captopril (paediatric cardiology)

Ciclosporin (dermatology)


Dabigatran (DVT and PE)

Denosumab (Prolia) for post-menopausal osteoporosis

Denosumab (Xgeva)  for prevention of skeletal events with bone metastases

Dexamfetamine (adults)     Request form

Dexamfetamine (paediatric)     Request form

Edoxaban (DVT and PE)

Enalapril (paediatric cardiology)

Flupenthixol decanoate     Request form

Fluphenazine decanoate     Request form

Furosemide (paediatric cardiology)


Guanfacine (adult)         Request form

Guanfacine (paediatric)    Request form

Haloperidol decanoate     Request form


Hydroxychloroquine     Request form

Leflunomide     Request form

Lisdexamfetamine (adults)     Request form

Lisdexamfetamine (paediatric)     Request form

Lisinopril (paediatric cardiology)

Lithium     Request form

Losartan (paediatric cardiology)

Mercaptopurine (paediatric gastroenterology)

Mercaptopurine (adult gastroenterology)

Mesalazine oral

Mesalazine (paediatric colitis)  Request form

Methotrexate oral (rheumatology)     Request form

Methotrexate oral (dermatology)

Methotrexate oral (Gastro)

Methylphenidate (adults)     Request form

Methylphenidate (paediatric)     Request form

Mianserin     Request form


Mycophenolate (renal transplant)

Olanzapine     Request form

Paliperidone palmitate long acting injection     Request form

Penicillamine (rheumatology)     Request form


Quetiapine     Request form


Risperidone long acting injection

Risperidone oral     Request form


Sacubitril / valsartan     Request form

Spironolactone (paediatric cardiology)

Sulfasalazine oral (rheumatology)     Request form

Sulfasalazine oral and rectal (gastroenterology)

Testosterone (adults)

Testosterone (paediatric)

Venlafaxine (high dose)     Request form

Zuclopenthixol decanoate     Request form