Leicestershire Traffic Light System

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Drug Name	Classification	Clinical Indication	Comments
5-AMINOLAEVULINIC ACID GEL (Ameluz®)	Black	Actinic keratosis
ABACAVIR / LAMIVUDINE (Kivexa®)	Red
ABACAVIR/DOLUTEGRAVIR/LAMIVUDINE (Triumeq®)	Red	HIV
ABATACEPT	Red	Rheumatoid arthritis	In line with NICE TA 195 and NICE TA 280
ABATACEPT	Red	Juvenile idiopathic arthritis	In line with NICE TA 373
ABIRATERONE	Red
ACAMPROSATE	Amber Simple	Alcohol dependence
ACENOCOUMAROL	Green	Anticoagulation	For patients currently being treated with phenindione.
ACENOCOUMAROL	Red	Anticoagulation	New patients only.
ACETYLCYSTEINE 10% preservative free eye drops	Amber Simple	Ocular lubricants
ACETYLCYSTEINE EFFERVESCENT TABLETS (NACYS®) (UPDATED)	Green	COPD Reduction of sputum viscosity	LMSG Mucolytic prescribing guide
ACITRETIN	Red
ACLIDINIUM / FORMOTEROL INHALER (Duaklir Genuair®)	Green	COPD	LABA/LAMA combination product – to be used in line with updated COPD Guidelines
ACLIDINIUM INHALER 322 micrograms	Green	COPD	For patients that cannot manage tiotropium handihaler
ACTIKERALL	Green	Actinic keratoses
Actipatch® (NEW)	Black	Joint and muscle pain
ADALIMUMAB	Red	Rheumatoid and psoriatic arthritis; ankylosing spondylitis; refractory Crohn's disease	Added indication: Refractory Crohn’s disease
ADALIMUMAB (NEW)	Red	Juvenile idiopathic arthritis	In line with NICE TA 373
ADALIMUMAB	Red	Psoriasis	In line with NICE TA 146
ADALIMUMAB	Red	Hidradenitis suppurativa	In line with NICE TA 392
ADALIMUMAB	Red	Moderate to severe ulcerative colitis	In line with NICE TA 329
ADALIMUMAB	Red	Plaque psoriasis in children	In line with NICE TA 455
ADALIMUMAB	Red	Behcet’s disease	Alternative to infliximab once established on therapy. Subcutaneous preparation able to be administered at home.
ADALIMUMAB (NEW)	Red	Non-infectious uveitis	In line with NICE TA 460
ADAPALENE / BENZOYL PEROXIDE (Epiduo®)	Green	Acne vulgaris
Adios®	Black	Herbal slimming aid
ADVASIL CONFORM®	Amber Simple	Hypertrophic Scars	Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform® Guidance For Use
AFATINIB	Red
AFLIBERCEPT (Eylea®) (UPDATED)	Red	Wet age related macular degeneration. Diabetic macular oedema. Macular oedema due to central retinal vein occlusion and branch retinal vein occlusion. Choroidal neovascularisation.	In line with NICE TA294, NICE TA346, NICE TA305, NICE TA409, NICE TA486
Age-Related Macular Degeneration - Dietary Supplements	Black	Age-related macular degeneration (AMD)	Not approved by local committee
AGOMELATINE	Amber Full SCA	Depression	Full SCA
ALBIGLUTIDE (Eperzan®)	Black	Type 2 diabetes	Not yet reviewed
ALEMTUZUMAB	Red	Relapsing, remitting multiple sclerosis	In line with NICE TA 312
ALENDRONIC ACID	Green	Osteoporosis	In line with NICE TA 464
ALENDRONIC ACID + VITAMIN D	Black	Postmenopausal osteoporosis
ALENDRONIC ACID EFFERVESCENT TABLETS (Binosto®)	Green	Osteoporosis	For patients that cannot swallow tablets. Not suitable for administration via a feeding tube.
ALFENTANIL	Green Conditional	Pain management in severe renal impairment for palliative care	In line with Palliative Care Guidance only.
ALIMEMAZINE (UPDATED)	Green Conditional	Various	Historic patients who have tried or not been suitable for other sedating antihistamines or melatonin. GP to continue prescribing. Important: Patients currently taking alimemazine should be discussed with the specialist and not have treatment stopped abruptly without a review.
ALIMEMAZINE (UPDATED)	Red	Various	Historic patients who have not tried or been considered for alternatives. Patients to be reviewed by secondary care. Secondary care to prescribe if continuing treatment required. Important: Patients currently taking alimemazine should be discussed with the specialist and not have treatment stopped abruptly without a review.
ALIMEMAZINE (UPDATED)	Black	Various	New patients. Current patients should be discussed with the prescribing specialist and not have treatment stopped abruptly without appropriate review.
ALIROCUMAB (Praluent®)	Red	Primary hypercholesterolaemia	In line with NICE TA 393
ALIROCUMAB (Praluent®) (NEW)	Black	Adults with established atherosclerotic cardiovascular disease to reduce cardiovascular risk by lowering LDL-C levels	Not yet reviewed
ALISKIREN	Amber Full SCA	Hypertension	Full SCA
ALITRETINOIN	Red	Severe chronic hand eczema	In line with NICE TA 177
ALOGLIPTIN	Green	Type 2 diabetes
ALPHA-1 ANTITRYPSIN (Respreeza®)	Black	Emphysema in adults	Not yet reviewed
ALPROSTADIL cream (Vitaros®)	Black	Erectile dysfunction
ALPROSTADIL uretheral sticks and injections (NEW)	Green	Erectile dysfunction	Not prescribable under the NHS for treatment of erectile dysfunction except in men who meet the criteria listed in part XVIIIB of the Drug Tariff. The prescription must be endorsed ‘SLS’. Maximum 4 doses per month to be prescribed.
Alutard Bee venom ® (NEW)	Black	Preventative treatment for bee sting allergy	Not yet reviewed
Alutard Wasp venom ® (NEW)	Black	Preventative treatment for wasp sting allergy	Not yet reviewed
AMANTADINE	Amber Simple	Parkinson's disease	Click on drug name for further detail
AMANTADINE	Amber Simple	For fatigue in Multiple sclerosis	Amantadine for fatigue in Multiple sclerosis: prescribing notes
AMIFAMPRIDINE (Firdapse®)	Black	Lambert-Eaton myasthenic syndrome
AMILORIDE	Amber Full SCA	Heart failure and hypertension in infants and children	Full SCA
AMISULPRIDE	Amber Full SCA	Schizophrenia	Full SCA Request form
AMPHOTERICIN 0.15% preservative free eye drops	Red
ANAGRELIDE	Red
ANAKINRA (Kineret®) (UPDATED)	Red	Periodic fevers and autoinflammatory diseases	Requested for UHL as part of NHS England commissioning policy
ANASTROZOLE	Amber Simple	Adjuvant therapy in early breast cancer
ANASTROZOLE (NEW)	Amber Simple	Off label chemoprevention to reduce incidence of breast cancer.	Use in line with NICE CG 164
ANIDULAFUNGIN	Black	Invasive candidiasis
ANTICANCER DRUGS	Red	Neoplastic disease	Classified as BLACK or RED unless an exception for shared care (see this list).
ANTIPSYCHOTICS-Atypical	Amber Full SCA	All licensed indications, personality disorder	Full SCA Full SCA personality disorder
ANTIRETROVIRALS	Red	HIV
ANTITHROMBIN recombinant	Black	Congenital antithrombin deficiency
APIXABAN	Green	Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation	Use in line with DOAC Initiation Pack
APIXABAN	Amber Simple	Treatment and secondary prevention of DVT and PE	In line with NICE TA 341
APOMORPHINE	Amber Full SCA	Parkinson's disease	Full SCA Request form
APRACLONIDINE	Red	Glaucoma
APREMILAST (Otezla®)	Red	Psoriasis	In line with NICE TA 419
APREMILAST (Otezla®) (UPDATED)	Red	Psoriatic arthritis	In line with NICE TA 433
ARGATROBAN (Exembol®) (NEW)	Black	For anticoagulation in adult patients with heparin-induced thrombocytopenia type II.
ARIPIPRAZOLE LONG-ACTING INJECTION (Abilify Maintena®)	Amber Full SCA	Maintenance treatment of schizophrenia in patients currently stabilised on oral aripiprazole	Full SCA Request form
ARIPIPRAZOLE oral	Amber Full SCA	Schizophrenia. Treatment and recurrence of mania. Control of agitation and disturbed behaviour in schizophrenia	Full SCA Request form
ASENAPINE	Black	Manic episodes of bipolar disorder.
ATALUREN	Red	Duchenne muscular dystrophy	In line with NICE HST3
ATAZANAVIR	Red
ATAZANAVIR / COBICISTAT (Evotaz®)	Red	HIV infection
ATOMOXETINE	Amber Full SCA	Attention deficit hyperactivity disorder (ADHD)	Adults Full SCA Children and adolescents Full SCA
ATOVAQUONE	Red
ATROPINE EYE DROPS	Green Conditional	Palliative care in line with guidance	Conditional on recommendation from palliative care team. Palliative Care Prescribing
AVANAFIL	Black	Erectile dysfunction	Not yet reviewed
AVIPTADIL/PHENTOLAMINE intracavernosal injection (Invicorp®) (UPDATED)	Green	Erectile dysfunction
AXITINIB	Red
AZATHIOPRINE (NEW)	Red	Generalised Myasthenia gravis
AZATHIOPRINE	Amber Full SCA	Dermatological disease	Full SCA
AZATHIOPRINE	Amber Full SCA	Paediatric Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease)	Full SCA
AZATHIOPRINE	Amber Full SCA	Rheumatological disease	Full SCA Request form
AZATHIOPRINE	Amber Full SCA	Inflammatory Bowel Disease (Ulcerative Colitis, Crohn's Disease) & Autoimmune Hepatitis	Full SCA
AZILSARTAN	Black	Hypertension
AZTREONAM	Red	Infection in cystic fibrosis
BALSALAZIDE	Amber Full SCA	Ulcerative colitis	Full SCA
BARICITINIB (Olumiant®)	Red	Moderate-to-severe rheumatoid arthritis	In line with NICE TA 466
BASILIXIMAB (Simulect®) (NEW)	Red	Immunosuppressive therapy for Kidney Transplant in Adults and Children/Young People	In line with NICE TA 481, NICE TA 482
BATH EMOLLIENTS (UPDATED)	Black	Skin	Leave on emollients should be used instead.
BECAPLERMIN	Black
BECLOMETASONE DIPROPIONATE / FORMOTEROL (Fostair®)	Green	Asthma COPD	Prescribe in line with Adult Asthma Guideline
BECLOMETASONE Inhaler - CFC free	Green	Asthma	QVAR brand recommended for adults. Clenil Modulite brand recommended only for children.
BEDAQUILINE	Red	Multi-drug resistant tuberculosis
BELATACEPT (Nulojix®) (NEW)	Red	Immunosuppressive therapy for Kidney Transplant in Adults and Children/Young People	In line with NICE TA 481, NICE TA 482
BENRALIZUMAB (NEW)	Red	Severe Eosinophilic Asthma	In line with NICE TA565 Implementation date 6^th June 2019
BETA-INTERFERON-1a (Avonex®) (NEW)	Red	Multiple sclerosis in adults	In line with NICE TA 527
BETA-INTERFERON-1a (Rebif®) (NEW)	Red	Multiple sclerosis in adults	In line with NICE TA 527
BETA-INTERFERON-1b (Betaferon®) (NEW)	Red	Multiple sclerosis in adults	In line with NICE TA 527
BETA-INTERFERON-1b (Extavia®) (NEW)	Red	Multiple sclerosis in adults	In line with NICE TA 52
BETAMETHASONE plaster (Betesil®)	Black	Inflammatory skin disorders not responding to less potent corticosteroids	Not approved by local committee
BEVACIZUMAB	Red	Retinopathy of prematurity either first line or as a second line rescue treatment.
BEXAROTENE	Red
BEZLOTOXUMAB (Zinplava®)	Black	Prevention of recurrence of Clostridium difficile infection	Not yet reviewed
BICALUTAMIDE	Amber Simple	Prostate cancer
BICTEGRAVIR, EMTRICITABINE, AND TENOFOVIR ALAFENAMIDE (Biktarvy®) (UPDATED)	Red	HIV	As per NHSE Clinical commissioning Policy
BILASTINE	Black	Allergic rhinoconjunctivitis and urticaria
BIMATOPROST / TIMOLOL eye drops (Ganfort®)	Green	Glaucoma	If prescribed in line with Glaucoma Algorithm
BIMATOPROST / TIMOLOL preservative free eye drops (Ganfort UD®)	Green	Glaucoma	If prescribed in line with Glaucoma Algorithm
BIMATOPROST preservative free eye drops	Green	Glaucoma	If prescribed in line with Glaucoma Algorithm
Bio-Oil®	Black	Skincare product
BIOBRAN MGN-3	Black	Adjuvant to cancer treatment	Cancer Research UK statement
BOSENTAN	Red	Pulmonary hypertension	Specialist centres only
BOSUTINIB	Red
BOTULINUM TOXIN	Red	Various indications	Policy in development
BOTULINUM A TOXIN	Red	Chronic migraine	see NICE TA 260
BOTULINUM A TOXIN (Dysport®)	Black		Not yet reviewed
BOTULINUM A TOXIN (Xeomin®)	Red	As per licence
BOTULINUM NEUROTOXIN TYPE A (Xeomin®) (NEW)	Red	Chronic sialorrhoea	In line with NICE TA 605
BREXPIPRAZOLE (Rexulti ®) (NEW)	Black	Antipsychotics	LPT prescribing group have reviewed and found no significant advantages over existing formulary products
BRIMONIDINE CUTANEOUS GEL	Green	Facial erythema of rosacea (fixed erythema not flushing)	Review after one month and discontinue if no benefit
BRINZOLAMIDE / BRIMONIDINE (Simbrinza®) eye drops	Green	Glaucoma	If prescribed in line with Glaucoma Prescribing Algorithm
BRINZOLAMIDE / TIMOLOL (Azarga®)	Green	Glaucoma	If prescribed in line with Glaucoma Prescribing Algorithm
BRIVARACETAM (UPDATED)	Amber Simple	Epilepsy (third line agent)
BRODALUMAB (Kyntheum®) (NEW)	Red	Moderate to severe plaque psoriasis	In line with NICE TA 511
BROLUCIZUMAB (Beovu®) (NEW)	Black	Treatment of neovascular (wet) age-related macular degeneration (AMD).	Not yet reviewed
BROMOCRIPTINE (UPDATED)	Amber Simple	Hyperprolactinaemic disorders	Annual monitoring undertaken in secondary care Primary care should be aware of fibrotic reactions
BUDESONIDE (1mg orodipersible tablet) (Jorveza®) (UPDATED)	Red	Eosinophilic esophagitis
BUDESONIDE (Budenofalk®)	Amber Simple	Autoimmune hepatitis, Crohn's disease, ulcerative colitis
BUDESONIDE / FORMOTEROL INHALER (DuoResp Spiromax®)	Green	Asthma & COPD	Prescribe by brand as Budesonide/Formoterol devices not interchangeable. For new patients and existing patients over 18 years after a review by a healthcare professional and counselling of patient to ensure correct use of device
BUDESONIDE 64mcg NASAL SPRAY (Benacort®) (NEW)	Black
BUDESONIDE and FORMETEROL (Fobumix®) Easyhaler (NEW)	Green	Asthma
BUDESONIDE M/R TABLETS (Cortiment®) (NEW)	Amber Simple	Ulcerative colitis	See formulary for place in therapy
BUPRENORPHINE	Green	Severe pain	including transdermal patch
BUPRENORPHINE PROLONGED RELEASE INJECTION (Buvidal®) (UPDATED)	Red	Substance misuse	Turning Point are piloting this in a small number of patients. If a patient is admitted to hospital contact turning point for advice about alternatives: 0116 3732117 – Direct dial to prescribing team 0116 3732108 – Direct Dial to Clinical Admin 0330 303 6000 – Main Switchboard
BUROSUMAB (Crysvita®) (NEW)	Black	X-linked hypophosphataemia in children and young people	Not yet reviewed
BUSERELIN (Suprecur®)	Red	IVF
BUSULFAN	Red
CABERGOLINE	Black	Parkinson's disease	Black for new patients, existing patients to remain on therapy.
CABERGOLINE (UPDATED)	Amber Simple	Hyperprolactinaemic disorders	Annual monitoring undertaken in secondary care Primary care should be aware of fibrotic reactions
CABERGOLINE	Red	Suppression of lactation
CABOZANTINIB (Cabometyx®) (NEW)	Black	Treatment of advanced renal cell carcinoma.
CALCIPOTRIOL/BETAMETHASONE CUTANEOUS FOAM (Enstilar®)	Green	Psoriasis vulgaris	Management of Psoriasis in Primary Care
CALCITONIN injection	Red		New patients only
CANAGLIFLOZIN	Amber Simple	Type 2 diabetes	Click on drug name for further details
CANAGLIFLOZIN	Green Conditional	Type 2 diabetes	Conditional on prescriber being competent to select appropriate patients.
CANAGLIFLOZIN / METFORMIN (Vokanamet®)	Black	Type 2 diabetes	Not yet reviewed
CANAKINUMAB (NEW)	Red	Treating periodic fever syndromes
CANGRELOR (Kengrexal®) (NEW)	Red	When undergoing PCI and cannot take oral P2Y12 inhibitors
CANNABIDIOL(Epidyolex®) (UPDATED)	Red	Seizures associated with Dravet syndrome or Lennox-Gastaut syndrome in combination with clobazam	In line with NICE TA614 and NICE TA615
CANNABIS Derivative (Sativex®)	Black	Multiple sclerosis	see East Midlands policy
CANNABIS OIL (NEW)	Black	ALL	Not yet reviewed
CAPECITABINE	Red
CAPHOSOL®	Red	Oral mucositis in head & neck cancer patients
CAPLACIZUMAB (Cablivi®) (NEW)	Black	Aquired thrombotic thrombocytopenic purpura in conjunction with plasma exchange and immunosuppression in adults	Not yet reviewed.
CAPSAICIN 8% patch (Qutenza®)	Red	Peripheral neuropathic pain	Only if unresponsive to other treatments in local guidance.
CAPSAICIN 8% PATCH (Qutenza®)	Black	Diabetic neuropathy
CAPTOPRIL	Amber Full SCA	Heart failure and hypertension in infants and children	Full SCA
CARIPRAZINE(Reagila®) (UPDATED)	Red	Schizophrenia	As per LPT managed requirements/protocol
CASPOFUNGIN	Red
CEFEPIME (Renapime®) (NEW)	Black	Antibiotic	Not yet reviewed
CEFIXIME	Green	Gonorrhoea
CEFOTAXIME	Red
CEFOXITIN (Renoxitin®) (NEW)	Red	Antibiotic
CEFTAROLINE	Red	Confirmed MRSA community acquired pneumonia and complicated skin and soft tissue infections	On advice of a consultant microbiologist only
CEFTAZIDIME	Red
CEFTAZIDIME / AVIBACTAM (Zavicefta®) (UPDATED)	Red	As per antimicrobial advice	Prescribe by brand to prevent confusion.
CEFTOBIPROLE (Zevtera®) (NEW)	Black	For Hospital and community-acquired pneumonia in adults.
CEFTOLOZANE-TAZOBACTAM (Zerbaxa®) (NEW)	Red	As per antimicrobial advice
CEFUROXIME 5% eye drops	Red
CELECOXIB (NEW)	Amber Simple	Inflammatory pain associated with cancer or other palliative conditions
CELECOXIB (UPDATED)	Black	Pain not associated with cancer or palliative care
CELECOXIB (Onsenal®)	Black	Familial adenomatous polyposis
CENEGERMIN (Oxervate®) (NEW)	Black	Neurotrophic keratitis	Not recommended in NICE TA 532
CERITINIB (Zykadia®)	Black	Lung cancer	Not yet reviewed
CERTOLIZUMAB PEGOL	Red	Rheumatoid arthritis	In line with NICE TA 375 and NICE TA 415
CERTOLIZUMAB PEGOL	Red	Ankylosing spondylitis and non-radiographic axial spondyloarthritis	In line with NICE TA 383
CERTOLIZUMAB PEGOL	Red	Psoriatic arthritis	In line with NICE TA 445
CERTOLIZUMAB PEGOL (Cimzia®) (NEW)	Red	Moderate to severe plaque psoriasis	In line with NICE TA574 Implementation date 17^th July 2019
CETRORELIX (Cetrotide®)	Red	IVF
CHENODEOXYCHOLIC ACID (NEW)	Red	Inborn error of bile synthesis
CHLORAMBUCIL	Red
CHLORHEXIDINE 2% EYE DROPS	Black	Fungal keratitis	Not approved by local committee
CHLORHEXIDINE GLUCONATE 1% cream (Eczmol®)	Green	Adjunctive therapy for decreasing bacterial load only in cases of recurrent infected atopic eczema in children.
CHLORHEXIDINE GLUCONATE 1% cream (Eczmol®)	Black	Eczema and Dermatitis	Not approved by local committee
CHONDROSPHERE (Spherox®) (NEW)	Red	Autologous chondrocyte implantation for treating symptomatic articular cartilage defects of the knee in adults	In line with NICE TA 508
CHORIONIC GONADOTROPHIN (Pregnyl®)	Red	IVF
CICA-CARE®	Amber Simple	Hypertrophic Scars	Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform® Guidance For Use
CICLOSPORIN OPTHALMIC EMULSION (Ikervis®)	Amber Simple	Dry eye disease	In line with NICE TA 369
CICLOSPORIN Oral	Amber Full SCA	Dermatological disease	Full SCA
CIDOFOVIR	Red	CMV retinitis
CINACALCET	Amber Full SCA	Secondary hyperparathyroidism	Shared care request is mandatory Full SCA
CINACALCET	Red	Primary hyperparathyroidism
CINNARIZINE / DIMENHYDRINATE (Arlevert®)	Amber Simple	Dizziness in Meniere's disease	Click on drug name for further details
CIPROFLOXACIN 0.2% preservative free eye drops	Red
CIPROFLOXACIN 2mg/ml ear drops (Cetraxal®) (UPDATED)	Green	Acute otitis externa	Please see appropriate antimicrobial guidance for treatment advice in otitis externa. Antimicrobial Guidance for Primary Care
CIPROFLOXACIN eye ointment	Green	Eye infections	Second-line to chloramphenicol
CIPROFLOXACIN HYDROCHLORIDE 3mg / FLUOCINOLONE ACETONIDE 0.25mg (Cetraxal Plus®) (NEW)	Black	Acute otitis externa (AOE). Acute otitis media in patients with tympanostomy (AOMT)	Not yet reviewed.
CITALOPRAM (UPDATED)	Amber Simple	Mental health indications as per the children’s BNF for children and young people
CLADRIBINE (UPDATED)	Red	Relapsing-remitting multiple sclerosis	In line with NICE TA616
Clindamycin plus tretinoin (Treclin®)	Green	Acne	Second choice in line with local algorithm
CLOMIPHENE	Red
CLONIDINE TRANSDERMAL PATCH (Catapres®) (NEW)	Red	Hypertension
CLOZAPINE	Red		Leicestershire Partnership Trust consultants only
CO-PROXAMOL	Black	Analgesia	Due to safety concerns
Cobicistat (Tybost®)	Red	HIV infection
COBICISTAT / ELVITEGRAVIR / EMTRICITABINE / TENOFOVIR (Stribild)	Red	HIV
COBIMETINIB (Cotellic®)	Black	Melanoma	Not yet reviewed
COLESEVELAM	Black	Primary and familial hypercholesterolaemia	Not yet reviewed
COLESEVELAM	Amber Simple	Bile acid malabsorption	Off label use second line to colestyramine if that is not tolerated.
COLESTILAN	Black	Hyperphosphataemia with renal failure	Following local review
COLISTIMETHATE SODIUM (Colobreathe®) INHALATION POWDER	Red	Cystic Fibrosis
COLISTIN	Red	IV for cystic fibrosis
COLISTIN	Amber Full SCA	Pseudomonas aeruginosa lung infections (Nebulised)	Shared care request is mandatory Full SCA (Colomycin) Full SCA (Promixin®)
COLLAGENASE	Red
COLLAGENASE CLOSTRIDIUM HISTOLYCUM	Red	Dupuytrens	In Line with NICE TA 459
COPPER HISTIDINE (NEW)	Red	Menkes disease
CORNEAL EPITHELIAL CELLS (Ex vivo expanded autologous human) containing stem cells (Holoclar®)	Red	Moderate-severe limbal stem cell deficiency after eye burns	In line with NICE TA 467
CRIZOTINIB	Red
CYANOCOBALAMIN (UPDATED)	Black	Vitamin B12	Initially for new patients only. Implementation date for all patients September 2020 to allow time for review. Exception to this traffic light is use as per Covid pandemic vitamin B12 advice
CYCLOPHOSPHAMIDE	Red
DABIGATRAN (UPDATED)	Amber Simple	Venous thromboembolism (treatment and long term secondary prevention)	In line with NICE TA 327
DABIGATRAN	Green	Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation	Use in line with DOAC Initiation Pack
DABIGATRAN	Red	Prevention of Venous Thromboembolism (VTE) following knee / hip replacement surgery	In line with NICE TA 157
DABRAFENIB	Red
DACLATASVIR	Red	Hepatitis C	In line with NICE TA 364
DACLATASVIR	Red	Patients with hepatitis C who have Cirrhosis	NHSE policy statement Reviewed by TAS
DACLIZUMAB	Red	Relapsing forms of multiple sclerosis	In line with NICE TA 441
DALBAVANCIN (UPDATED)	Red	Bacterial skin infections	As per antimicrobial working party recommendations
DALTEPARIN	Green	Low INR	In line with Warfarin Guidelines for Primary Care
DALTEPARIN (NEW)	Amber Simple	Antenatal Indications
DALTEPARIN (UPDATED)	Green	Thromboprophylaxis and Treatment of DVT & PE
DAPAGLIFLOZIN	Amber Simple	Type 2 diabetes	Simple amber if GP does not feel competent to initiate. Use in line with NICE TA 288
DAPAGLIFLOZIN	Green Conditional	Type 2 diabetes	Conditional on prescriber being competent to select appropriate patients
DAPAGLIFLOZIN (NEW)	Amber Simple	With insulin for treating Type 1 diabetes	In line with NICE TA597 Implementation date 28^th November 2019
DAPAGLIFLOZIN / METFORMIN (Xigduo®)	Black	Type 2 diabetes	Not yet reviewed
DAPOXETINE	Black	Premature ejaculation	Not yet reviewed
DAPTOMYCIN	Red	Complicated Gram +ve skin/soft tissue infections
DARBEPOETIN	Red	Anaemia of chronic kidney disease
DARIFENACIN	Black	Urinary incontinence/urgency
DARUNAVIR	Red	HIV infection
DARUNAVIR / COBICISTAT (Rezolsta®)	Red	HIV infection
DARVADSTROCEL (Alofisel®) (UPDATED)	Black	Complex perianal fistulas in adults with Crohn’s disease	Not recommended by NICE TA 556
DASABUVIR	Red	Patients with hepatitis C who have Cirrhosis	NHSE policy statement Reviewed by TAS
DASATINIB	Red
DEFERASIROX	Red	Iron overload
DEFERIPRONE	Red
DEGARELIX	Amber Simple	Treatment of prostate cancer
DEKAS (UPDATED)	Amber Simple	Vitamin Supplement for paediatric and adult patients with cystic fibrosis
DEKAS VITAMINS (various formulations) (NEW)	Black	Depending on formulation, bariatric surgery or liver disease	Not yet reviewed
DELAFLOXACIN MEGLUMINE (Quofenix®) (NEW)	Black	Acute bacterial skin and skin structure infections	Not yet reviewed
DENOSUMAB (Prolia®) (UPDATED)	Amber Full SCA	Osteoporosis	Full SCA Request form
DENOSUMAB (Xgeva®)	Amber Full SCA	Prevention of skeletal related events in adults with bone metastases from solid tumours other than prostate	Full SCA
DENOSUMAB (Xgeva®)	Red	Prevention of skeletal related events in adults with bone metastases from solid tumours other than prostate	Red for patients with severe renal impairment (creatinine clearance less than 30ml/min)
DEQUALINIUM CHLORIDE VAGINAL TABLETS (Fluomizin®)	Black	Bacterial vaginosis
Dermatix®	Black	Dressing for treatment of scars
DERMATOPHAGOIDES PTERONYSSINUS ALLERGEN EXTRACT (Acarizax®)	Red	Immunotherapy treatment for house dust mite and allergic rhinitis.
DESFERRIOXAMINE	Red
DESIRUDIN	Red
DESMOPRESSIN ORAL LYOPHILISATE (Noqdirna ®) (NEW)	Green	Symptomatic treatment of nocturia due to idiopathic nocturnal polyuria in adults	To be started in primary care only. Please click drug name for more information.
DEXAMETHASONE intravitreal implant	Red	Non-infectious uveitis. Macular oedema due to retinal vein occlusion	In line with NICE TA 460 NICE TA 229 NICE TA349
DEXAMFETAMINE	Amber Full SCA	Attention deficit hyperactivity disorder (ADHD)	Adults Full SCA Children and adolescents Full SCA
DEXIBUPROFEN	Black	Pain and inflammation
DEXMEDETOMIDINE (Dexdor®) (NEW)	Red	Sedation of intubated paediatric patients in an intensive care setting.
DIAMORPHINE NASAL SPRAY (Ayendi®)	Black	Acute severe pain in children and adolescents	Not yet reviewed
DICLOFENAC GEL 3% (Solaraze®)	Green	Actinic keratosis
DIDANOSINE	Red
DIENOGEST (Zalkya®) (NEW)	Black	Treatment of endometriosis.	Not yet reviewed
DIMETHYL FUMARATE	Red	Multiple sclerosis	In line with NICE TA 320
DIMETHYL FUMARATE	Red	Moderate to severe plaque psoriasis	In line with NICE TA 475
DINOPROSTONE	Red	Induction of labour
DISODIUM PAMIDRONATE	Red
DISULFIRAM	Amber Simple	Adjunct in alcohol dependence
DOLASETRON	Black	Chemotherapy-induced nausea & vomiting
DOLUTEGRAVIR	Red	HIV
DOLUTEGRAVIR /LAMIVUDINE (Dovato®) (UPDATED)	Red	HIV-1 in adults and adolescents over 12 years
DOLUTEGRAVIR/RILPIVIRINE (Juluca®) (UPDATED)	Red	HIV-1 in adults
DONEPEZIL (UPDATED)	Amber Simple	Alzheimer's disease	In line with NICE NG 97 Change in traffic light status from 1st October 2018.
DORAVIRINE (Pifeltro®) (NEW)	Red	HIV
DORIPENEM	Black	Complicated intra-abdominal and urinary tract infection
DORIPENEM	Red	Hospital acquired/ventilator associated pneumonia
DORNASE ALFA	Amber Simple	Cystic fibrosis
DOXEPIN oral (NEW)	Red	Urticaria paediatrics	Unlicensed
DOXYCYCLINE Controlled release (Efracea®)	Black	Rosacea	Not approved by local committee
DOXYLAMINE SUCCINATE AND PYRIDOXINE (Xonvea®) (NEW)	Black	Nausea and vomiting in pregnancy	Not yet reviewed
DRONEDARONE	Red	Atrial fibrillation	New patients only
DROPERIDOL	Red	Post operative nausea & vomiting	3rd line
DULAGLUTIDE	Amber Simple	Type 2 Diabetes	If prescriber has not received specific training.
DULAGLUTIDE	Green Conditional	Type 2 diabetes	Conditional on prescriber being trained to select and train patients – use in conjunction with updated NICE Clinical Guideline. Once a week preparation.
DULOXETINE	Green	Diabetic neuropathy	To be used in conjunction with Neuropathic Pain Guidelines
DULOXETINE	Green	Stress incontinence
DULOXETINE	Red	Fibromyalgia	For use by Pain Clinic only
DUPILUMAB (NEW)	Red	Moderate to severe atopic dermatitis	In line with NICE TA 534
DUTASTERIDE / TAMSULOSIN (Combodart®)	Green	Benign Prostatic Hyperplasia
ECULIZUMAB (Soliris ®) (NEW)	Black	Treatment of neuromyelitis optica spectrum disorder in adults who are anti-aquaporin-4 antibody-positive with a relapsing course of the disease	Not yet reviewed
EDOXABAN (UPDATED)	Amber Simple	DVT and PE	Use in line with NICE TA354
EDOXABAN	Green	Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation	Use in line with NICE TA355 DOAC Initiation Pack
EFAVIRENZ	Red
EFAVIRENZ / EMTRICITABINE / TENOFOVIR (Atripla®)	Red
EFLORNITHINE	Black	Female facial hirsuitism	Not approved by local committee
ELBASVIR/GRAZOPREVIR (Zepatier)	Red	Hepatitis C	In line with NICE TA 413
ELEXACAFTOR/IVACAFTOR/TEZACAFTOR (Trikafta®) (NEW)	Red	Cystic fibrosis as part of managed access programme	Also known as VX-445/VX-661/VX-770
ELTROMBOPAG	Red	Chronic immune thrombocytopenic purpura (ITP)	In line with NICE TA293
ELUXADOLINE (Truberzi®)	Red	Irritable bowel syndrome with diarrhoea	In line with NICE TA 471
ELVITEGRAVIR/COBICISTAT/EMTRICITABINE/TENOFOVIR ALAFENAMIDE (Genvoya®)	Red	HIV infection
EMICIZUMAB (Hemlibra®) (UPDATED)	Red	Severe congenitial haemophilia A without factor VIII inhibitors
EMPAGLIFLOZIN	Amber Simple	Type 2 diabetes	Amber if GP does not feel competent to initiate. Use in line with NICE TA 336
EMPAGLIFLOZIN	Green Conditional	Type 2 diabetes	Conditional on prescriber being competent to select appropriate patients
EMPAGLIFLOZIN / LINAGLIPTIN (Glyxambi®)	Black	Type 2 diabetes mellitus in adults	New formulation Not yet reviewed
EMPAGLIFLOZIN/METFORMIN (Synjardy®)	Black	Type 2 diabetes	Not yet reviewed
EMTRICITABINE	Red
EMTRICITABINE / RILPIVIRINE / TENOFOVIR (Eviplera®)	Red
EMTRICITABINE / RILPIVIRINE / TENOFOVIR ALAFENAMIDE (Odefsey®)	Red	HIV infection
EMTRICITABINE 200mg /TENOFOVIR DISOPROXIL 245mg (Ictastan®) (NEW)	Black	HIV	Not yet reviewed.
EMTRICITABINE/TENOFOVIR ALAFENAMIDE (Descovy®)	Red	HIV infection
ENALAPRIL	Amber Full SCA	Heart failure and hypertension in infants and children	Full SCA
ENFUVIRTIDE	Red
ENOXAPARIN	Red	Acute coronary syndrome
ENOXAPARIN (UPDATED)	Red	Thromboprophylaxis and treatment of DVT	Courses started during the dalteparin shortage can be continued to be supplied in primary care
ENOXAPARIN BECAT prefilled syringes (NEW)	Black	Parenteral anticoagulant
ENTACAPONE	Amber Simple	Parkinson's disease	Click on drug name for further details
ENTECAVIR	Red	Chronic hepatitis B
EPISIL®	Red	Oral mucositis in paediatric patients following chemotherapy
EPLERENONE	Green	Post myocardial infarction with proven LVH
EPOETIN DELTA	Black	Anaemia of renal failure
EPOETIN intravenous	Red		HDU
EPOETIN subcutaneous	Red	Anaemia of Chronic Kidney Disease
ERDOSTEINE	Black	Mucolytic - acute exacerbation of chronic bronchitis	Not approved by local committee
ERENUMAB 70mg injection (NEW)	Black	Migraine prophylaxis	Not yet reviewed.
ERLOTINIB	Red
ERTAPENEM	Red	Resistant Gram negative infections (ESBL)
ERTAPENEM IV	Green	Extended Spectrum Beta Lactamase (ESBL) Urinary Tract Infection (UTI)	UTI in line with Primary care ESBL Guidance
ERTUGLIFLOZIN (Steglatro®) (UPDATED)	Green Conditional	Type 2 diabetes mellitus (for 18 years and over) as monotherapy	In line with NICE TA 572 Conditional on prescriber being competent to select appropriate patients
ERTUGLIFLOZIN (Steglatro®) (UPDATED)	Amber Simple	Type 2 diabetes mellitus (for 18 years and over) as monotherapy or with metformin or with metformin and a dipeptidyl peptidase-4 inhibitor	In line with NICE TA 572 and NICE TA 583
ESCITALOPRAM	Black	All indications except treatment resistant depression and generalised anxiety disorder	Not approved by local committee
ESCITALOPRAM	Green	Treatment resistant depression and generalised anxiety disorder
ESLICARBAZEPINE	Amber Simple	Treatment resistant epilepsy
ESTRADIOL / NOMEGESTROL (Zoely®)	Black	Combined oral contraceptive
ESTRAMUSTINE	Red
ETANERCEPT	Red	Juvenile idiopathic arthritis	In line with NICE TA 373
ETANERCEPT	Red	Plaque psoriasis in children	In line with NICE TA 455
ETANERCEPT	Red	DMARD for RA, including weekly SC injection
ETANERCEPT	Red	Plaque psoriasis	In line with NICE TA103
ETELCALCETIDE injection (Parsabiv)	Red	Secondary hyperparathyroidism in adult patients with chronic kidney disease on haemodialysis therapy	Inline with NICE TA 448
ETHINYLESTRADIOL / DESOGESTREL (Alenvona®)	Black	Oral contraceptive	Not yet reviewed
ETOPOSIDE	Red
ETRAVIRINE	Red
EVENING PRIMROSE OIL (GAMOLENIC ACID) (Epogam® or Efamast®)	Black	Cyclical breast pain/mastalgia. Atopic eczema	No evidence to support use for these indications. Marketing authorisations were withdrawn in 2002
EVEROLIMUS	Red	Angiomyolipomas associated with tuberous sclerosis
EVEROLIMUS (Certican®)	Red	Immunosuppressive therapy for Kidney Transplant in Adults and Children/Young People	In line with NICE TA 481, NICE TA 482
EVEROLIMUS (Votubia®) (NEW)	Red	Refractory focal onset seizures associated with tuberous sclerosis complex	As per NHSE Clinical Commissioning Policy
EVOLOCUMAB subcutaneous injection (Repatha®)	Red	Primary hypercholesterolaemia or mixed dyslipidaemia	In line with NICE TA 394
EVRA® patch	Green	Contraception
EXEMESTANE	Amber Simple	Adjuvant therapy in early breast cancer
EXENATIDE (UPDATED)	Amber Simple	Type 2 Diabetes	If prescriber has not received specific training. To be used in line with NICE Guidelines CG66 Once a week preparation (Bydureon®) is formulary. Twice daily preparation (Byetta®) is non-formulary. However, existing patients may remain on treatment.
EXENATIDE	Green Conditional	Type 2 diabetes	Once a week preparation (Bydureon®) is formulary. Conditional on prescriber being trained to select and train patients. Use in conjunction with Updated Nice Clinical Guideline. ————————- Twice daily preparation (Byetta®) is non formulary. However, existing patients may remain on treatment
EZETIMIBE	Green
EZETIMIBE + SIMVASTATIN (Inegy®)	Black	Hypercholesterolaemia
FAMPRIDINE	Black	Multiple Sclerosis
FEBUXOSTAT	Green	Gout (2nd line after allopurinol)	In line with NICE TA 164
FENTANYL BUCCAL FILM (Breakyl®)	Black	Breakthrough cancer pain in patients already on opioids	Not yet reviewed
FENTANYL BUCCAL Tablets (Effentora buccal®) (NEW)	Black	Breakthrough pain for patients with cancer	Not yet reviewed
FENTANYL intranasal spray	Black	Breakthrough cancer pain
FENTANYL Sublingual (Abstral®)	Green Conditional	Breakthrough cancer pain in patients already on opioids. Palliative care in line with guidance	Conditional on recommendation from palliative care team. See: Palliative care – drugs for use only after specialist recommendation
FENTANYL TRANSDERMAL SYSTEM (IONSYS®)	Black	Post-operative pain
FENTICONAZOLE	Black	Vulvovaginal candidiasis
FERRIC MALTOL(Feraccru®) (UPDATED)	Amber Simple	Iron deficiency anaemia in IBD after at least two failed oral treatment options
FERUMOXYTOL INJECTION (Rienso®)	Black	Iron deficiency anaemia in chronic kidney disease
FESOTERODINE	Black	Urinary frequency
FIBRINOGEN (Riastap®) (NEW)	Red	Treatment of severe bleeding in acquired hypofibrinogenemia resulting from operative interventions, in particular after cardiac surgery
FIBRINOGEN CONCENTRATE (Human) (FibCLOT®)	Black	Treatment and perioperative prophylaxis of bleeding in patients with congenital hypo- or afibrinogenaemia with bleeding tendency	New formulation Not yet reviewed
FIDAXOMICIN	Amber Simple	Clostridium difficile infection	GP can initiate if in line with Community Clostridium difficile Care Pathway
FILGRASTIM	Red
FINGOLIMOD	Red	Multiple Sclerosis	NICE supported. EMSCG funding.
FLUDARABINE	Red
FLUNARIZINE	Red	Migraine prophylaxis in adults
FLUNARIZINE	Red	Alternating hemiplegia/refractory migraine in children	Unlicensed
FLUOCINOLONE ACETONIDE (Iluvien®) intravitreal implant	Red	Diabetic macular oedema	In line with NICE TA301
FLUOCINOLONE ACETONIDE INTRAVITRAL IMPLANT (Iluvien®) (NEW)	Red	Recurrent non-infectious uveitis	In line with NICE TA590 Implementation date 31st October 2019
FLUOXETINE (UPDATED)	Amber Simple	Mental health indications as per the children’s BNF for children and young people
FLUPENTIXOL (oral)	Green Conditional	Schizophrenia and other psychoses	If used for schizophrenia or psychoses to be initiated only after diagnosis and advice to use this typical antipsychotic has been discussed with specialist
FLUPENTIXOL DECANOATE	Amber Full SCA	Schizophrenia	Full SCA Request form
FLUPHENAZINE DECANOATE	Amber Full SCA	Schizophrenia	Full SCA Request form
FLUTICASONE / AZELASTINE NASAL SPRAY (Dymista®)	Green	Rhinitis	To be used in line with the Allergic Rhinitis Pathway
FLUTICASONE / FORMOTEROL INHALER (Flutiform®)	Black	Asthma	Reviewed by LLR Respiratory Prescribing Group.
FLUTICASONE / VILANTEROL INHALER (Relvar®)	Black	Asthma	Reviewed by LLR Respiratory Prescribing Group.
FLUTICASONE FUROATE (Avamys®)	Green	Allergic rhinitis
FLUTICASONE/ SALMETEROL XINAFOATE INHALER (AirFluSal Forspiro®)	Black	COPD and Asthma	Reviewed by LLR Respiratory Prescribing Group.
FOLINIC ACID	Red
FOLLITROPHIN alfa	Red	IVF
FONDAPARINUX	Red	Heparin Induced Thrombocytopenia (HIT)
FOSAMPRENAVIR	Red
FOSFOMYCIN IV	Red	Only in line with advice from UHL microbiology	Please note that there is a separate traffic light entry for oral Fosfomycin.
FOSFOMYCIN Oral	Green	Extended Spectrum Beta Lactamase (ESBL) Urinary Tract Infection (UTI)	UTI in line with Primary care Multi-resistant Lower UTI Guidance.
FOSTAMATINIB (Tavlesse®) (NEW)	Black	Chronic immune thrombocytopenia	Not yet reviewed
FreeStyle Libre® Sensor (UPDATED)	Amber Simple	Diabetes glucose monitoring inline with NHSE criteria.	As per LMSG freestyle libre documents An initiation letter is required for an initial six month trial. Continuation dependent on letter detailing improvement in the NHSE England parameters.
FREMANEZUMAB (Ajovy®) (UPDATED)	Red	Prevention of migraine	In line with NICE TA631 Implementation date 3^rd september 2020
FULVESTRANT	Amber Simple	Oestrogen receptor positive metastatic or locally advanced breast cancer in post menopausal women in whom disease progresses or relapses while on or after other anti oestrogen therapy	Secondary care will administer first three doses.
FUROSEMIDE	Amber Full SCA	Heart failure and hypertension in infants and children	Full SCA
GABAPENTIN	Green	Neuropathic pain	To be used in conjunction with Neuropathic Pain Guidelines
GALANTAMINE	Red	Alzheimer's disease	Leicestershire Partnership Trust consultants only
GALCANEZUMAB (Emgality ®) (NEW)	Black	Migraine prophylaxis	Not yet reviewed
GAMMAGLOBULIN	Red
GANCICLOVIR	Red
GANCICLOVIR 0.15% EYE GEL	Black	Acute herpetic keratitis	Only GREEN whilst Aciclovir eye ointment 3% is not available. Definite diagnosis only.To be used in line with local guidance Ganciclovir 0.15% eye gel
GANIRELIX ACETATE (Fyremadel®) (NEW)	Red	Prevention of premature luteinising hormone (LH) surges in women undergoing ovarian stimulation for IVF
GEFITINIB	Red
GENTAMICIN	Red	IV and inhalation
GENTAMICIN 1.5% preservative free eye drops	Red
GLATIRAMER ACETATE (Copaxone®) (NEW)	Red	Multiple sclerosis in adults	In line with NICE TA 527 Implementation date 27^th September 2018
GLECAPREVIR-PIBRENTASVIR (Maviret®) (NEW)	Red	Hepatitis C	In line with NICE TA 499
GLUCODRATE®	Amber Simple	High Output Stoma (HOS)
GLUCOSAMINE	Black	Osteoarthritis
GLYCEROL PHENYLBUTYRATE (Ravicti®) (NEW)	Black	Chronic management of patients with urea cycle disorders (UCDs)	Not yet reviewed
GLYCERYL TRINITRATE Ointment 0.4%	Green	Anal fissure
GLYCOPROTEIN IIb/IIIa inhibitors	Red
GLYCOPYRRONIUM (Sialanar®)	Black	Persistent drooling in children and adolescents with neurological conditions, such as cerebral palsy, epilepsy and neurodegenerative diseases
GLYCOPYRRONIUM / BECLOMETASONE / FORMOTEROL metered dose Inhaler (Trimbow®) (NEW)	Green	Maintenance of COPD.
GLYCOPYRRONIUM BROMIDE oral solution 1mg/5ml	Black	Peptic ulcer (add-on therapy)	Not yet reviewed
GLYCOPYRRONIUM INHALER (Seebri Breezhaler®)	Black	COPD	Following review by LLR Respiratory Prescribing Group and Therapeutic Advisory Service
GLYCOPYRRONIUM LIQUID (Colonis) (NEW)	Amber Simple	Sialorrhoea in paediatrics
GOLD salts	Red	Rheumatoid arthritis	Red for new patients Full SCA to remain for existing patients
GOLIMUMAB	Red	Psoriatic arthritis (PA) and Rheumatoid arthritis(RA)in line with NICE guidance	PA see NICE TA 220 RA see NICE TA 225
GOLIMUMAB	Red	Ankylosing spondylitis	In line with NICE TA 233
GOLIMUMAB	Red	Moderate to severe active ulcerative colitis	In line with NICE TA 329
GOLIMUMAB (NEW)	Red	Non-radiographic axial spondyloarthritis	In line with NICE TA 497
GONADORELIN ANALOGUES	Green	Prostate cancer	GP can give first injection to patients in whom anti-androgen treatment has been started by secondary care clinician.
GONADORELIN ANALOGUES	Amber Simple	Gender reassignment	Must be prescribed in line with recommendations from specialist. The nearest specialist is Nottingham.
GOSERELIN	Green	Prostatic carcinoma	GP can give first injection to patients in whom anti-androgen treatment has been started by secondary care clinician. Local guidance
GOSERELIN	Amber Simple	Endometriosis, uterine fibroids
GOSERELIN 3.6mg (Zoladex®)	Amber Simple	Breast cancer	Zoladex 3.6mg implant is the only licensed product for breast cancer
GRANISETRON	Black	Chemotherapy-induced nausea
GRANISETRON oral and injection	Green Conditional	Palliative care in line with guidance	Conditional on recommendation from palliative care team. Palliative Care Prescribing
GRANISETRON patch	Black	Chemotherapy-induced nausea	Not yet reviewed
GRASS POLLEN ALLERGEN EXTRACT subcutaneous injection (Pollinex®)	Red	Grass pollen allergies
GRASS POLLEN ALLERGEN EXTRACT sublingual (Grazax®)	Amber Full SCA	Grass pollen allergies	Full SCA
GUANFACINE	Amber Full SCA	ADHD - Adult	Adult Full SCA and Request Form
GUANFACINE	Amber Full SCA	ADHD - Peadiatric	Paediatric Full SCA and Request Form
GUSELKUMAB (UPDATED)	Red	Moderate to severe plaque psoriasis in adults	In line with NICE TA 521.
HALOPERIDOL (oral)	Green Conditional	Schizophrenia and psychoses	If used for schizophrenia or psychoses to be initiated only after diagnosis and advice to use typical antipsychotic has been discussed with specialist
HALOPERIDOL DECANOATE	Amber Full SCA	Schizophrenia	Full SCA Request form
HEPARIN	Red	Full IV anticoagulation
HEPARIN SODIUM FLUSH	Green	Flushing solution for maintenance of patency of intravenous devices
HEPATITIS C treatments	Red
HERBAL MEDICINES that are unregistered	Black		Not approved by local committee
HERBAL MEDICINES with a Marketing Authorisation	Black		Reviewed upon request by a consultant or GP prescribing lead
HERBAL MEDICINES with a Traditional Herbal Registration	Black		Not approved by local committee
HISTIDINE TRYTOPHAN KETOGLUTARATE MANITOL (Custodiol®) (NEW)	Red	For myocardial protection in complex cardiac surgery. For organ preservation in transplant surgery
HOMEOPATHIC MEDICINES	Black	Various	Not approved by local committee see Position Statement
HUMAN COAGULATION FACTOR X (NEW)	Red	Herediatry factor X deficiency
HUMAN CYTOMEGALOVIRUS IMMUNOGLOBULIN (CMVIG) (Cytotect CP Biotest®) (NEW)	Black	Clinical manifestations of cytomegalovirus infection in patients subjected to immunosuppressive therapy	Not yet reviewed
HYALURONIC ACID DERIVATIVE (Synvisc®)	Black	Black in all indications EXCEPT for pain relief in osteoarthritis of shoulder joint (RED)
HYALURONIC ACID DERIVATIVE (Synvisc®)	Red	Pain relief in osteoarthritis of shoulder joint.
HYDROCORTISONE (Alkindi®)(Granules in capsules for opening)	Black	Adrenal insufficiency in infants	Not yet reviewed
HYDROCORTISONE 1% / OXYTETRACYCLINE 3% (Terra-Cortril®)	Black	Overgranulation of wounds	Not approved by local committee
HYDROCORTISONE INJECTION	Amber Simple	Emergency HC injection kit	Kit for patients with Addison’s disease or high risk due to long term steroid use. Dose to be recommended by specialist, normally 50 or 100mg. HC Emergency Kit for Paediatrics: Prescribing and supply details
HYDROCORTISONE modified release (Plenadren®)	Black	Hypoadrenalism (once daily dose)
HYDROXYCARBAMIDE (UPDATED)	Amber Full SCA	Myeloproliferative disorders, sickle cell anaemia
HYDROXYCARBAMIDE SOLUTION (Xromi®) (NEW)	Black	Prevention of vaso-occlusive complications of Sickle Cell disease	Not yet reviewed
HYDROXYCHLOROQUINE	Amber Full SCA	Rheumatological disease	Full SCA Request form
IBANDRONIC ACID - IV	Red	Postmenopausal osteoporosis
IBANDRONIC ACID - Oral	Amber Simple	Breast cancer bone metastases
IBANDRONIC ACID 50mg tablets (NEW)	Amber Simple	Prevention of mestastases in early breast cancer patients with low female sex hormones	First three months of prescribing due to renal monitoring to be from the hospital. Stop date to be recorded as total treatment with bisphosphonate to be 36 months. Unlicensed use see NICE ES 15 for more information.
IBANDRONIC ACID Oral monthly	Green	Postmenopausal osteoporosis	In line with NICE TA 464 Use only when compliance with oral therapy is an issue
ICATIBANT acetate	Red	Hereditary angioedema
IDARUBICIN	Red
IDARUCIZUMAB (Praxbind)	Red	Reversal of severe bleeding due to dabigatran
IDEBENONE (Raxone®)	Black	Leber’s hereditary optic neuropathy	Not yet reviewed
IDELALISIB	Red
IDURSULFASE	Black	Hunter syndrome (mucopolysaccharidosis II)
IMATINIB	Red
IMIPENEM	Red
IMIQUIMOD CREAM 3.75% (Zyclara®)	Black	Actinic keratosis of face and scalp
IMIQUIMOD cream 5% (Aldara®)	Red	Basal cell carcinoma
IMIQUIMOD cream 5% (Aldara®)	Green	Actinic keratoses	In line with Actinic Keratoses treatment pathway
IMMUNOGLOBULINS	Red
INDACATEROL (Breezhaler®) (UPDATED)	Black	COPD	Reviewed by LLR Respiratory Prescribing Group, deemed not appropriate for review by TAS
INDACATEROL / GLYCOPYRRONIUM INHALER (Ultibro Breezhaler®)	Black	COPD	Reviewed by LLR Respiratory Prescribing Group, deemed not appropriate for review by TAS
INDINAVIR	Black
INFLIXIMAB	Red	All indications
INGENOL MEBUTATE GEL (Picato®)	Black	Actinic keratosis (non hypertrophic)	To black due to MHRA alert
INSULIN ASPART (Fiasp®) (UPDATED)	Green Conditional	Type 1 and 2 diabetes mellitus in adults	Conditional on prescriber being competent to select appropriate patients.
INSULIN DEGLUDEC (Tresiba®)	Green Conditional	Diabetes mellitus in adults	Conditional on prescriber being trained to select appropriate patients MUST BE PRESCRIBED BY BRAND NAME
INSULIN DEGLUDEC (Tresiba®)	Amber Simple	Diabetes mellitus in adults	Simple amber if prescriber has not received specific training. MUST BE PRESCRIBED BY BRAND NAME
INSULIN DEGLUDEC / LIRAGLUTIDE (combination product) (Xultophy®)	Green Conditional	Diabetes	Conditional on prescriber being trained to select and train patients.
INSULIN DEGLUDEC/LIRAGLUTIDE (combination product) (Xultophy®)	Amber Simple	Diabetes	For those who have not had the training.
INSULIN GLARGINE (Toujeo® 300units per ml)	Green Conditional	Diabetes mellitus in adults. First line concentrated insulin of choice in insulin resistant patients requiring large amounts of insulin. Please take extra care in prescribing	Conditional on prescriber being competent to select appropriate patients. UKMI – Product Safety Assessment Report MUST BE PRESCRIBED BY BRAND NAME
INSULIN GLARGINE / LIXISENATIDE (Suliqua®) (UPDATED)	Black	Type 2 Diabetes mellitus in combination with metformin	New formulation Not yet reviewed
INSULIN GLULISINE (Apidra®)	Green Conditional	Type 1 and 2 diabetes	Conditional on prescriber being competent to select appropriate patients
INSULIN LISPRO (Humalog®) U200	Green Conditional	Diabetes Mellitus	Conditional on prescriber being competent to select appropriate patients
INSULIN LISPRO (Humalog®) U200	Amber Simple	Diabetes Mellitus	Amber if GP does not feel competent to initiate.
INTERFERON ALFA	Red
INTERFERON BETA	Red
INTERFERON GAMMA (Immukin®) (NEW)	Red	For mycobacterial infections and pulmonary and miliary
IRON(III) ISOMALTOSIDE 1000 (Diafer®)	Red	Iron deficiency (renal use only)
ISAVUCONAZOLE	Red	Invasive aspergillosis and mucormycosis
ISOTRETINOIN - Oral	Red	Severe acne
ISOTRETINOIN - Topical	Green	Mild-moderate acne
IVABRADINE	Green	Chronic stable angina	For patients who cannot tolerate beta blockers
IVABRADINE	Amber Simple	Chronic heart failure
IVACAFTOR (Kalydeco®)	Red	Cystic fibrosis	As per NHSE policy statement
IVERMECTIN CREAM	Green	Moderate to severe papulo-pustula rosacea
IXEKIZUMAB (NEW)	Red	Psoriatic arthritis after inadequate response to DMARDs	In line with NICE TA 537 Implementation date 8^th November 2018
IXEKIZUMAB	Red	Psoriasis	In line with NICE TA 442
KELO-COTE®	Amber Simple	Hypertrophic Scars	Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform® Guidance For Use
KETAMINE	Green Conditional	Palliative care in line with guidance	Conditional on recommendation from palliative care team. Palliative Care Prescribing
KETOCONAZOLE TABLETS	Black	Fungal infections	Risk of hepatotoxicity outweighs benefit MHRA alert
KETOPROFEN / OMEPRAZOLE (Axorid®)	Black	Pain and inflammation for patients at risk of NSAID associated ulcers
KETOROLAC	Green Conditional	Palliative care in line with guidance	Conditional on recommendation from palliative care team. Palliative Care Prescribing
KETOTIFEN (NEW)	Amber Simple	Mast Cell Activation Syndrome (MCAS)
KETOTIFEN UNIT DOSE EYE DROPS (Ketofall®) (NEW)	Green	Seasonal allergic conjunctivitis	After OTC products have been tried.
Klean-Prep®	Red	Bowel cleansing
LACOSAMIDE	Amber Simple	Resistant epilepsy
LAMIVUDINE	Red
LAMIVUDINE / ZIDOVUDINE	Red
LAMOTRIGINE (NEW)	Amber Simple	Bipolar disorder
LANADELUMAB (Takhyzro®) (NEW)	Red	Preventing recurrent attacks of hereditary angioedema	In line with NICE TA606
LANREOTIDE	Red	Neuroendocrine tumours
LANREOTIDE	Red	Acromegaly	New patients only
LANREOTIDE	Green Conditional	Palliative Care	Link to Palliative Care Guidelines
LANTHANUM CARBONATE	Amber Simple	Hyperphosphataemia with renal failure
LAPATINIB	Red
LATANOPROST preservative free eye drops	Green	Glaucoma	If prescribed in line with Glaucoma Prescribing Algorithm
LAUROMACROGOL 400 (Aethoxysklerol®) (NEW)	Black	Sclerotherapy of varicose veins of the lower extremities	Not yet reviewed
LECICARBON A® suppositories	Black	Laxative or bowel preparation	Not yet reviewed
LEDIPASVIR/SOFOSBUVIR (Harvoni®)	Red	Hepatitis C	In line with NICE TA 363
LEFLUNOMIDE	Amber Full SCA	Rheumatological disease	Full SCA Request form
LENOGRASTIM	Red
LENVATINIB tablets (Kisplyx®)	Black	Renal cell carcinoma
LETERMOVIR (Prevymis®) (NEW)	Red	Prevention of cytomegalovirus disease after a stem cell transplant	In line with NICE TA591 Implementation date 31st October 2019
LETROZOLE	Amber Simple	Adjuvant therapy in early breast cancer
LEUPRORELIN	Amber Simple	Endometriosis, uterine fibroids
LEUPRORELIN	Green	Prostate cancer (subcutaneous injection for patients at risk of haematoma)	GP can give first injection to patients in whom anti-androgen treatment has been started by secondary care clinician. Local guidance
LEVETIRACETAM	Green Conditional	Palliative care in line with guidance	Conditional on recommendation from palliative care team. Palliative Care Prescribing
LEVETIRACETAM - IV	Red	Epilepsy	Restricted to patients who are already maintained on the oral preparation
LEVETIRACETAM - Oral	Amber Simple	Epilepsy
LEVODOPA/CARBIDOPA infusion (Duodopa)	Red	Parkinson's disease	Treatment algorithm Specialist centres only
LEVOFLOXACIN Eyedrops - unpreserved	Red	Bacterial keratitis
LEVOFLOXACIN NEBULISER SOLUTION (Quinsair®) (UPDATED)	Red	Chronic Pseudomonas lung infection in cystic fibrosis (adults)
LEVONORGESTREL-RELEASING INTRAUTERINE SYSTEM (Levosert®) (UPDATED)	Green	Contraception or heavy menstrual bleeding
LIDOCAINE patch	Green	Postherpetic neuralgia	To be used in conjunction with Neuropathic Pain Guidelines
LIDOCAINE patch (UPDATED)	Red	Focal neuropathic pain
LIDOCAINE Patch	Black	All other indications (except postherpetic neuralgia and focal neuropathic pain)
LIDOCAINE/PRILOCAINE cutaneous spray (Fortacin)	Black	Primary premature ejaculation	Not yet reviewed
LINACLOTIDE	Green	Moderate to severe irritable bowel syndrome with constipation
LINAGLIPTIN	Green	Type 2 Diabetes
LIOTHYRONINE	Red	Concomitant therapy with thyroxine	For patients who have hypothyroidism who have had inadequate response to thyroxine alone, in line with guidance
LIPEGFILGRASTIM	Black	Chemotherapy-induced neutropenia	Not yet reviewed locally
LIRAGLUTIDE (Saxenda®)	Black	Obesity in type 2 diabetes	Not yet reviewed
LIRAGLUTIDE (Victoza®)	Green Conditional	Type 2 diabetes	For patients unable to tolerate lixisenatide. Conditional on prescriber being trained to select and train patients – Use in conjunction with Updated NICE Clinical Guideline
LIRAGLUTIDE (Victoza®)	Amber Simple	Type 2 diabetes	If prescriber has not received specific training.
LISDEXAMFETAMINE DIMESYLATE	Amber Full SCA	ADHD when response to methylphenidate is inadequate	Adults Full SCA Children and adolescents Full SCA
LISINOPRIL	Amber Full SCA	Heart failure and hypertension in infants and children	Full SCA
LITHIUM SALTS	Amber Full SCA	Mania, Bipolar Disorder, Recurrent Depression or Aggressive or Self-mutilating behaviour.	Full SCA Request form
LIXISENATIDE	Green Conditional	Type 2 diabetes	Conditional on prescriber being trained to select and train patients
LIXISENATIDE	Amber Simple	Type 2 diabetes	If prescriber has not received specific training.
LOMITAPIDE (Lojuxta®) (UPDATED)	Red	Homozygous familial hypercholesterolaemia	Requested for UHL as part of NHS England commissioning policy.
LOMUSTINE	Red
LOPINAVIR / RITONAVIR (Kaletra®)	Red
LOSARTAN	Amber Full SCA	Heart failure and hypertension in infants and children	Full SCA
LOTEPREDNOL eye drops (Lotemax®)	Red	Post-operative inflammation following ocular surgery
LOXAPINE inhalation powder (Adasuve®)	Black	Rapid control of mild-moderate agitation in schizophrenia or bipolar disorder	Not yet reviewed
LUBIPROSTONE (UPDATED)	Green	Chronic refractory constipation	Discontinued in the UK for commercial reasons
LUMACAFTOR /IVACAFTOR (Orkambi®)	Red	Cystic fibrosis	As per NHSE policy statement
LURASIDONE (UPDATED)	Black	Psychosis not associated with schizophrenia
LURASIDONE	Amber Full SCA	Schizophrenia in adults aged 18 years and over unable to tolerate or non-responsive to aripiprazole. or those who are not suitable for clozapine.	Full SCA Request form
LUTROPIN ALFA, FOLLITROPIN ALFA (Pergoveris®) (NEW)	Black	Stimulation of follicular development	Not yet reviewed
MacuLEH Light®	Black	Age-related macular degeneration	Not approved by local committee see Guideline
MAGNESIUM ASPARTATE DIHYDRATE (Magnaspartate®)	Amber Simple	Magnesium deficiency	Licensed preparation now available. This will be used in preference to any unlicensed preparations.
MANNITOL dry powder inhaler	Red	Cystic fibrosis
MARAVIROC	Red
MEDROXYPROGESTERONE ACETATE DEPOT INJECTION (Sayana Press®)	Green	Long-term contraception
MELATONIN	Black	Primary insomnia in adults. Circadian asynchrony in elderly institutionalised patients
MELATONIN	Amber Simple	Free running circadian rhythm and delayed sleep phase syndrome	Simple Amber only applies to Circadin m/r tablets or oral solution 5mg/5ml. Other formulations are secondary care only.
MELATONIN	Red	Learning disability (Adult). Huntington's disease. Parkinson's disease.
MELATONIN	Red	Acute circadian asynchrony in hospitalised patients on ITU, HDU and other care areas
MELATONIN (Colonis®) (NEW)	Black	Jet lag
MELATONIN (doses of 10mg daily or less)	Amber Simple	Sleep disorders children (see comments) continued in adults if proven efficacy in childhood	Sleep onset insomnia and delayed sleep phase syndrome. Simple Amber only applies to Circadin m/r tablets or oral solution 5mg/5ml. Other formulations are secondary care only. See LMSG guidance for further information.
MELATONIN (doses over 10mg daily)	Red	Sleep disorders children (see comments), continued in adults if proven efficacy in childhood	Sleep onset insomnia and delayed sleep phase syndrome in children
MELATONIN M/R 1mg and 5mg tablets (Slenyto ®) (UPDATED)	Black	Treatment of insomnia not covered by the simple amber status
MELATONIN M/R 1mg and 5mg tablets (Slenyto®) (UPDATED)	Amber Simple	Insomnia for children aged 2-18 years with Autism Spectrum Disorder and or Smith-Magenis.	New patients only
MELPHALAN	Red
MEMANTINE	Red	Nystagmus
MEMANTINE (UPDATED)	Amber Simple	Alzheimer's disease	in line with NICE NG 97 Change in traffic light status from 1st October 2018
MENOTROPHIN (Menopur®)	Red	IVF
MEPIFORM®	Amber Simple	Hypertrophic Scars	Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform® Guidance For Use
MEPOLIZUMAB (Nucala®)	Red	To treat severe refractory eosinophilic asthma.	For use by specialist respiratory clinician in line with NICE TA 431
MERCAPTAMINE (Cystadrops®)	Black	Corneal cystine crystal deposits in patients aged ≥ two years with cystinosis	New formulation Not yet reviewed
MERCAPTOPURINE	Amber Full SCA	Paediatric Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease)	Full SCA
MERCAPTOPURINE	Red	Leukaemia
MERCAPTOPURINE	Amber Full SCA	Inflammatory Bowel Disease (Ulcerative Colitis, Crohn's Disease) & Autoimmune Hepatitis	Full SCA
MEROPENEM	Red
MEROPENEM and Vaborbactam (Vaborem®) (NEW)	Red	Infections known/suspected to be caused by KPC producing bacteria
MESALAZINE (Mezavant® XL)	Black	Ulcerative colitis	Not supported by local committee
MESALAZINE ORAL (prescribe by brand)	Amber Full SCA	Ulcerative colitis, Crohn' s disease and paediatric colitis	Full SCA adult Full SCA paediatric
MESALAZINE RECTAL	Amber Simple	Ulcerative colitis and Crohn's disease
METHADONE	Green Conditional	Palliative care in line with palliative care guidance.	Conditional on recommendation from palliative care team. Palliative Care Prescribing
METHADONE (oral) but note NOT 10mg/1ml (NEW)	Amber Simple	Chronic pain with ongoing advice from specialist services on dose reduction
METHADONE 10mg/1ml oral liquids	Black	All indications	This is to prevent dosing errors. The 1mg/1ml oral liquid strength remains available.
METHOTREXATE Injection	Red
METHOTREXATE Oral	Amber Full SCA	Rheumatological disease	Full SCA Request form
METHOTREXATE Oral	Amber Full SCA	Dermatological disease	Full SCA
METHOTREXATE Oral	Red	Severe refractory asthma
METHOTREXATE Oral	Amber Full SCA	Crohn's Disease	Full SCA
METHYLNATREXONE	Green Conditional	Palliative care in line with guidance.	Conditional on recommendation from palliative care team. Palliative Care Prescribing
METHYLPHENIDATE	Green Conditional	Palliative care in line with guidance	Conditional on recommendation from palliative care team. Palliative Care Prescribing
METHYLPHENIDATE (+'CR')	Amber Full SCA	Attention deficit hyperactivity disorder (ADHD)- prescribe CR formulation by brand name only	For information about products please see relevant Shared Care. Adults: Full SCA Children & adolescents: Full SCA
MEXILETINE	Red	Ventricular arrhythmia	New patients. Existing prescribing in primary care to continue.
MEXILETINE (Namuscla®) (NEW)	Black	Symptomatic treatment of myotonia in adult patients with non-dystrophic myotonic disorders	Not yet reviewed
MIANSERIN (UPDATED)	Amber Simple	Depression	Mianserin is simple amber once the specialist has prescribed and monitored FBC for the first three months. After this time there are no on-going monitoring requirements but treatment should be stopped and a full blood count obtained if fever, sore throat, stomatitis, or other signs of infection develop. Seek advice from specialist in this scenario.
MIDAZOLAM (Buccolam®)	Amber Simple	Status epilepticus
MIDAZOLAM buccal	Green Conditional	Palliative care in line with guidance.	Conditional on recommendation from palliative care team. Palliative Care Prescribing
MIDODRINE	Amber Simple	Severe orthostatic hypotension	Licensed product now available
MIDOSTAURIN (Rydapt®) (NEW)	Black	Newly diagnosed FLT3 mutation-positive acute myeloid leukaemia, aggressive systemic mastocytosis, systemic mastocytosis with associated haematological neoplasm, or mast cell leukaemia.
MIFEPRISTONE	Red
MIGLUSTAT	Black	Niemann-Pick type C disease
MIRABEGRON	Green	Symptoms of urinary frequency, urgency and urge incontinence	In line with Overactive Bladder Pathway
MITOTANE	Red
MODAFINIL	Amber Full SCA	Daytime sleepiness associated with Narcolepsy and existing patients being treated for Daytime Sleepiness associated with Obstructive Sleep Apnoea Syndrome, Idiopathic Hypersomnia & Shift Work Sleep Disorder.	Full SCA
MOLLUDAB®	Black	Molluscum contagiosum	Not yet reviewed.
MOLOGRAMOSTIN	Red
MOLUTREX®	Black	Molluscum contagiosum	Not yet reviewed
MOVICOL liquid®	Black	Constipation
MOVICOL® ready to take solution in sachet	Black	Constipation	Not yet reviewed
Moviprep®	Red	Prior to endoscopy	3rd line if intolerant to Klean Prep®
MOXIFLOXACIN	Red	Multi-drug resistant tuberculosis
MOXIFLOXACIN	Black	Respiratory tract infections (general)
MUCODIS®	Red	Oral mucositis in head & neck cancer patients
MYCOPHENOLATE	Red	Interstitial lung diseases (Connective tissue disease related ILD) unresponsive to other immunosuppressives.
MYCOPHENOLATE (UPDATED)	Amber Full SCA	Immunosuppression following renal transplantation	Exception agreed to red status: Full shared care to allow GPs to continue supplying to historical patients still on shared care where appropriate for patient and the GP agrees. Full SCA
MYCOPHENOLATE (NEW)	Red	Immunosuppression following renal transplantation
MYCOPHENOLATE MOFETIL	Red	Specialist rheumatology prescribing for severe lupus, severe polymyositis or systemic vasculitis
MYCOPHENOLATE MOFETIL	Red	Specialist heamatology use in graft versus host disease in bone marrow transplant
NABILONE	Black	Chemotherapy induced nausea and vomiting
NALDEMEDINE TOSYLATE(Rizmoic®) (NEW)	Black	opioid-induced constipation	Not yet reviewed
NALMEFENE	Green	Alcohol dependence	In line with NICE TA 325
NALOXEGOL	Green	Opiod induced constipation	In line with NICE TA345 Laxative Algorithm
NALOXONE	Green Conditional	Palliative care in line with guidance.	Conditional on recommendation from palliative care team. Palliative Care Prescribing
NALOXONE nasal spray (Nyxoid®) (UPDATED)	Red	Opioid overdose	Turning Point Only
NALTREXONE	Red	Pruritus in liver disease	Unlicensed indication
NALTREXONE	Amber Simple	Opioid dependence	To be initiated by specialists for maintenance treatment to help prevent relapse in opioid dependence. NICE TA 115
NALTREXONE (low dose) (NEW)	Red	Mast Cell Activation Syndrome (MCAS)
NALTREXONE / BUPROPION M/R (Mysimba®) (NEW)	Black	Managing obesity	NICE TA 494 not supported for managing obesity in adults
NAPROXEN / ESOMEPRAZOLE (Vimovo®)	Black	Osteoarthritis, RA & ankylosing spondylitis
NARSOPLIMAB (NEW)	Red	IgA Nephropathy
NATALIZUMAB	Red	Rapidly evolving relapsing-remitting multiple sclerosis
Natamycin 5% eye drops	Red	Fungal keratitis (moulds only)
NEBIVOLOL	Green	Hypertension	Black for all other indications
NEBIVOLOL	Black	All indications excluding hypertension (Green)
NELFINAVIR	Black
NETUPITANT/PALONOSETRON capsules (Akynzeo®)	Black	Prevention of nausea and vomiting associated with chemotherapy	Not yet reviewed
NEVIRAPINE	Red
NILOTINIB	Red
NINTEDANIB (Ofev®)	Red	Idiopathic Pulmonary Fibrosis	In line with NICE TA 379
NINTEDANIB (Vargatef®)	Black	Lung cancer	Not yet reviewed
NONACOG BETA PEGOL (Refixia®) (NEW)	Black	Haemophilia B	Not yet reviewed.
NUVARING®	Green	Contraception
OBETICHOLIC ACID	Red	Primary Biliary cholangitis	In line with NICE TA 443
OCRELIZUMAB (NEW)	Red	Relapsing-remitting multiple sclerosis	In line with NICE TA 533 Implementation date 25^th October 2018
OCRELIZUMAB (NEW)	Red	Primary progressive multiple sclerosis	In line with NICE TA585
OCRIPLASMIN INJECTION (Jetrea®)	Red	Vitreomacular traction
OCTREOTIDE	Red	Acromegaly	New patients only
OCTREOTIDE	Red	GEP tumours and post-pancreatic surgery
OCTREOTIDE	Green Conditional	Palliative care in line with guidance	Conditional on recommendation from palliative care team. Palliative Care Prescribing
OLANZAPINE	Green Conditional	Palliative care in line with guidance	Conditional on recommendation from palliative care team. Palliative Care Prescribing
OLANZAPINE Oral	Amber Full SCA	Schizophrenia. Combination therapy for mania. Preventing recurrence in bipolar disorder. Monotherapy for mania. Control of agitation and disturbed behaviour in schizophrenia or mania. Personality disorder.	Full SCA Full SCA personality disorder
OLANZAPINE PAMOATE MONOHYDRATE (Zypadhera®)	Red	Schizophrenia	Requires case by case consideration by Prescribing Group
OLMESARTAN/AMLODIPINE/HYDROCHLOROTHIAZIDE (Sevikar HCT)	Black	Non-adherence due to polypharmacy
OLODATEROL INHALER	Black	COPD	Not yet reviewed
OLOPATADINE	Green	Hay fever
OMALIZUMAB	Red	Asthma	In line with NICE TA 278
OMALIZUMAB	Red	Chronic spontaneous urticaria	NICE TA 339
OMBITASVIR/PARAPREVIR/RITONAVIR (Viekirax®)	Red	Hepatitis C	In line with NICE TA 365 (with or without dasabuvir)
OMEGA-3 ACID ETHYL ESTERS (Dualtis®)	Black	Secondary prevention of MI, hypertriglyceridaemia	Not yet reviewed
OMEGA-3 ACID ETHYL ESTERS (Omacor®)	Amber Simple	Hypertriglyceridaemia
OMEGA-3 ACID ETHYL ESTERS (Omacor®)	Black	Secondary prevention of MI	Contains Omega-3 acid ethyl esters
ONDANSETRON (UPDATED)	Green	Nausea	Further information when used for palliative care can be found in the Palliative Care Prescribing Guide
OPICAPONE capsules (Ongentys®) (UPDATED)	Amber Simple	Parkinson's disease
ORLISTAT	Green
OSILODROSTAT PHOSPHATE (Isturisa®) (NEW)	Black	Treatment of endogenous Cushing’s syndrome
OSIMERTINIB (Tagrisso®)	Black	Non-small-cell lung cancer
OSPEMIFENE (Senshio®) (NEW)	Black	Vulvar and vaginal atrophy in post-menopausal women	Not yet reviewed
OSVAREN® (previously known as REPHOREN®)	Amber Simple	Hyperphosphataemia
OXYBUPROCAINE HYDROCORTISONE	Red	Local anaesthetic
OXYBUTYNIN patch	Green	Symptomatic treatment of urge incontinence in unstable bladder	For use only in patients who cannot take oral medication See Overactive bladder pathway
OXYCODONE / NALOXONE (Targinact®)	Amber Simple	Severe pain in patients with opioid-induced bowel dysfunction
OXYCODONE HYDROCHLORIDE / NALOXONE (combination product) prolonged release tablet (Targinact®)	Black	Post colorectal surgery	Reviewed by TAS – No evidence to support use for this indication.
PALIPERIDONE PALMITATE Long-Acting Injection	Amber Full SCA	Maintenance in schizophrenia in patients previously responsive to risperidone.	Full SCA Request form
PALIVIZUMAB	Red
PALONOSETRON	Black	Nausea and vomiting with chemotherapy
PARATHYROID HORMONE (Natpar®) (UPDATED)	Red	Post-trial continuation of treatment of chronic hypoparathyroidism when standard therapy alone is inadequate.
PARAVIT CF® (NEW)	Amber Simple	Vitamin Supplement for paediatric and adult patients with cystic fibrosis
PARECOXIB(Dynastat ®) (NEW)	Amber Simple	Inflammatory pain associated with cancer or other palliative conditions
PARICALCITOL	Black	Secondary hyperparathyroidism in renal failure
PASIREOTIDE subcutaneous injection (Signifor®)	Black	Cushing’s disease	Not yet reviewed
PATIROMER (Veltassa®) (UPDATED)	Red	Hyperkalaemia	In line with NICE TA623
PATISIRAN (Onpattro®) (NEW)	Black	Hereditary transthyretin-mediated amyloidosis in adult patients with stage 1 or stage 2 polyneuropathy	Not yet reviewed
PAZOPANIB	Red
PEGINTERFERON BETA-1a (Plegridy®) (NEW)	Red	Relapsing-remitting multiple sclerosis	In line with NICE TA624
PEGLOTICASE	Black	Gout	Not supported by NICE
PENICILLAMINE	Red	Wilson's disease
PENICILLAMINE	Amber Full SCA	Rheumatoid arthritis	Full SCA Request form
PENTHROX® (NEW)	Red	Emergency relief of moderate to severe pain in conscious adults	Emergency department use only
PENTOSAN POLYSULFATE SODIUM (Elmiron®) (UPDATED)	Red	Bladder pain syndrome characterised by either glomerulations or Hunner’s lesions	In line with NICE TA610
PERAMPANEL (Fycompa®)	Amber Simple	Refractory epilepsy
PERGOLIDE	Amber Simple	Parkinson's disease	Click on drug name for further details
PIMECROLIMUS cream	Green	Dermatitis
PIRFENIDONE (Esbriet®) (UPDATED)	Red	For Idiopathic pulmonary fibrosis	In line with NICE TA 504 (Replaces NICE TA 282)
PITOLISANT (Wakix®) (NEW)	Amber Simple	Narcolepsy
PITRESSIN	Red	Myomectomy
PIVMECILLINAM	Green	Extended Spectrum Beta Lactamase (ESBL) Urinary Tract Infection (UTI)	UTI in line with Primary care Multi-resistant lower UTI Guidance
PLASMA-LYTE 148 & 5% GLUCOSE solution for infusion (NEW)	Red	Source of water, electrolyte and calories or as a alkalinising agent
POLIHEXANIDE 0.02% eye drops	Red
Pollinex Quattro	Black	Severe hayfever caused by tree & grass pollen
POMALIDOMIDE	Red
PONATINIB	Red
POSACONAZOLE	Red	Severe fungal infections
PRAMIPEXOLE	Amber Full SCA	Parkinson's Disease, Restless Legs Syndrome and other limb movement disorders	Click on drug name for further details Full SCA
PRASTERONE PESSARY (Intrarosa®) (UPDATED)	Amber Simple	Vulvar and vaginal atrophy in postmenopausal women having moderate to severe symptoms
PRASUGREL	Amber Simple	ACS where immediate primary percutaneous coronary intervention for ST segment-elevation MI is necessary or stent thrombosis has occurred during clopidogrel treatment.	Excludes pts over 75yrs and /or weight less than 60kg Duration summary for primary care
PREGABALIN	Green	Neuropathic pain	To be used in conjunction with Neuropathic Pain Guidelines
PREGABALIN	Amber Simple	Refractory epilepsy
PREGABALIN	Amber Simple	Generalised anxiety disorder
PRILOCAINE	Red	Spinal Anaesthesia
PRO-SIL®	Amber Simple	Hypertrophic Scars	Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform® Guidance For Use
PROCARBAZINE	Red
PROGESTERONE PESSARIES (Cyclogest®)	Amber Simple	Maintenance of pregnancy following IVF or when there is a risk of pre-term delivery
PROXYMETACAINE HYDROCHLORIDE	Red	Local anaesthetic
PRUCALOPRIDE (UPDATED)	Green	Chronic refractory constipation
PYRIDOSTIGMINE	Amber Simple	Myasthenia gravis	Includes sustained release formulation (Mestinon Timespan).
QLAIRA®	Black	Contraception	Not approved by local committee
QUETIAPINE	Amber Full SCA	Schizophrenia. Mania (either alone or in combination with mood stabilisers). Depression in bipolar disorder. Adjunctive treatment in major depressive disorder. Personality disorder.	Full SCA Full SCA personality disorder
QUETIAPINE	Green Conditional	Palliative care in line with guidance.	Conditional on recommendation from palliative care team. Palliative Care Prescribing
QUINAGOLIDE	Amber Simple	Hyperprolactinaemia
RABBIT ANTI-HUMAN THYMOCYTE IMMUNOGLOBULIN (Thymoglobuline®) (NEW)	Red	Immunosuppressive therapy for Kidney Transplant in Adults and Children/Young People	In line with NICE TA 481, NICE TA 482
RACECADOTRIL (Hidrasec®)	Black	Diarrhoea
RALOXIFENE (NEW)	Amber Simple	Off label chemoprevention to reduce incidence of breast cancer.	Use in line with NICE CG 164
RALOXIFENE (NEW)	Black	Primary prevention of osteoporotic fragility in menopausal women	Not recommended in NICE TA 160
RALOXIFENE (NEW)	Amber Simple	Secondary prevention of osteoporotic fragility in menopausal women	In line with NICE TA 161
RALTEGRAVIR	Red	Multi-resistant HIV, Needlestick injury
RANIBIZUMAB (Lucentis®)	Red	Age-related macular degeneration, diabetic macular oedema, retinal vein occlusion
RANOLAZINE	Green	Chronic stable angina	In line with NICE CG 126
RASAGILINE	Amber Simple	Parkinson's disease	Click on drug name for further details
RAVULIZUMAB (Ultomiris®) (NEW)	Black	Paroxysmal nocturnal haemoglobinuria	Not yet reviewed
REGORAFENIB	Red
REMDESIVIR (Veklury®) (NEW)	Red	Treatment of coronavirus disease 2019
REPAGLINIDE	Green
RESLIZUMAB	Red	Severe Eosinophilic Asthma	In line with NICE TA 479
RESPERATE device	Black	Hypertension	Reviewed by Dr A. Stanley, Hypertension Clinic
RETAPAMULIN	Black	Bacterial skin infections
RETIGABINE	Red	Treatment resistant epilepsy
RIBAVIRIN	Red
RIBOFLAVIN eye drops	Red	Peri-operative use during collagen cross linkage
RIFAMPICIN/ISONIAZID/PYRAZINAMIDE/ETHAMBUTOL (Voractiv)	Red	Tuberculosis
RIFAPENTINE (Priftin®) (NEW)	Red	Latent TB
RIFAXIMIN	Amber Simple	Reduction in recurrence of hepatic encaphalopathy
RIFAXIMIN	Black	Traveller's diarrhoea
RILPIVIRINE	Red
RILUZOLE	Amber Full SCA	Amylotrophic lateral sclerosis form of motor neurone disease	Full SCA
RIMEXOLONE	Red
RIOCIGUAT	Black	Pulmonary hypertension
RISANKIZUMAB (Skyrizi®) (UPDATED)	Red	Moderate to severe plaque psoriasis	In line with NICE TA596
RISEDRONATE SODIUM	Green	Osteoporosis	In line with NICE TA 464
RISPERIDONE LONG-ACTING INJECTION (Risperdal Consta®)	Amber Full SCA	Schizophrenia and other psychoses in patients tolerant to oral risperidone.	Full SCA Request form
RISPERIDONE Oral	Amber Full SCA	Acute and chronic psychoses. Mania. Short term (up to 6 weeks) of persistent aggression in patients with moderate to severe AD. Short term (up to 6 weeks) treatment of persistent aggression in conduct disorder. Personality disorder.	Full SCA Full SCA personality disorder
RITONAVIR	Red
RITUXIMAB	Red	Immunobullous diseases	In line with NHS England policy
RITUXIMAB	Red	Lymphoma, Rheumatoid arthritis
RIVAROXABAN	Amber Simple	Cardioversion
RIVAROXABAN	Red	ACS	In line with NICE TA 335
RIVAROXABAN	Green	Prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation	Use in line with DOAC Initiation Pack
RIVAROXABAN	Black	Prevention of VTE in adults undergoing hip or knee replacement
RIVAROXABAN	Amber Simple	Treatment and secondary prevention of DVT and PE	In line with NICE TA 261 or NICE TA 287
RIVAROXABAN (Xarelto®) (NEW)	Amber Simple	Preventing atherothrombotic events in people with coronary or peripheral artery disease	In line with NICE TA607
RIVASTIGMINE (UPDATED)	Amber Simple	Alzheimer's disease	in line with NICE NG 97 Change in traffic light status from 1st October 2018
ROFLUMILAST	Amber Simple	COPD	In line with NICE TA 461
ROMIPLOSTIM (Nplate®)	Red	Chronic immune (idiopathic) thrombocytopenic purpura (ITP)	Use in line with NICE TA 221
ROMOSOZUMAB SOLUTION FOR INJECTION (Evenity®) (NEW)	Black	Severe osteoporosis in postmenopausal women at high risk of fracture	Not yet reviewed
ROPINIROLE	Amber Simple	Parkinson's Disease, Restless Legs Syndrome and other limb movement disorders	Click on drug name for further details
ROPIVACAINE 2 mg/ml solution for infusion dispensed via ReadyfusOR® infusion pump (NEW)	Black	For acute post operative pain in adults
ROSIGLITAZONE (Avandia®, Avandamet®)	Black	Withdrawn
ROSUVASTATIN	Green	Hypercholesterolaemia
ROTIGOTINE	Amber Full SCA	Parkinson's disease, Restless Legs Syndrome and other limb movement disorders	Click on drug name for further details Full SCA
RUFINAMIDE	Amber Simple	Lennox-Gastaut syndrome in patients aged over 4 years
RUXOLITINIB	Red
SACUBITRIL / VALSARTAN (Entresto®)	Amber Full SCA	Heart failure	Full SCA Request form
SAFINAMIDE (Xadago®) (UPDATED)	Amber Simple	Parkinson’s Disease
SAQUINAVIR	Red
SARILUMAB (NEW)	Red	Moderate to Severe Rheumatoid Arthritis	In line with NICE TA 485
SATIVEX	Black	Treatment of spasticity associated with Multiple Sclerosis	EM Policy
SAXAGLIPTIN (Onglyza®)	Green	Type 2 Diabetes.	Non-formulary choice.
SAXAGLIPTIN / METFORMIN (Komboglyze®)	Black	Type 2 Diabetes
SECUKINUMAB	Red	Psoriatic arthritis	In line with NICE TA 445
SECUKINUMAB	Red	Psoriasis	In line with NICE TA 350
SECUKINUMAB	Red	Ankylosing spondylitis.	Use in line with NICE TA 407
SELEGILINE	Amber Simple	Parkinson's disease	Click on drug name for further details
SELEXIPAG (Uptravi®)	Black	Pulmonary arterial hypertension	Not yet reviewed
SEMAGLUTIDE (Ozempic®) injection (UPDATED)	Green Conditional	GLP 1 analogue	Conditional on prescriber being competent to select appropriate patients.
SEMAGLUTIDE (Rybelsus®) (NEW)	Black	Treatment of adults with insufficiently controlled type 2 diabetes	Not yet reviewed
SEMAGLUTIDE(Ozempic®) injection	Amber Simple	GLP 1 analogue	Simple amber if prescriber not competent to select appropriate patients
SERTRALINE (UPDATED)	Amber Simple	Mental health indications as per the children’s BNF for children and young people
SEVELAMER	Amber Simple	Hyperphosphataemia
SILDENAFIL	Red	Pulmonary arterial hypertension
SILDENAFIL ORAL SUSPENSION (Revatio®)	Black	Pulmonary artery hypertension
SILICONE GEL / GEL SHEETS	Amber Simple	Hypertrophic Scars	Includes: Kelocote®, Pro-Sil®, Cica-Care®, Advasil Conform® and Mepiform® Guidance For Use
SILK GARMENTS (UPDATED)	Black	Skin
SIMEPREVIR	Red	Hepatitis C
SIPONIMOD FUMARIC ACID (Mayzent®) (NEW)	Black	Secondary progressive multiple sclerosis with active disease	Not yet reviewed
SIROLIMUS (NEW)	Red	Immunosuppression post renal transplant
SIROLIMUS (UPDATED)	Amber Full SCA	Immunosuppression post renal transplant	Exception agreed to red status: Full shared care to allow GPs to continue supplying to historical patients still on shared care where appropriate for patient and the GP agrees. Full SCA
SIROLIMUS GEL (NEW)	Red	Angiofibromas associated with tuberous sclerosis complex
SITAGLIPTIN	Green	Type 2 diabetes	In line with NICE CG 87
SITAGLIPTIN / METFORMIN (Janumet®)	Black	Type 2 diabetes
SODIUM CHLORIDE 5% preservative free eye drops or 5% ointment	Amber Simple	Ocular lubricants
SODIUM CITRATE 10.11% eye drops	Red
SODIUM CROMOGLICATE (Nalcrom®) (NEW)	Red	Food allergy
SODIUM HYALURONATE, CO-ENZYME Q10 AND VITAMIN E COMBINATION EYE DROP (VisuXl ®) (NEW)	Green	Severe dry eye and corneal healing post-surgery
SODIUM OXYBATE	Amber Simple	Treatment of cataplexy associated with narcolepsy
SODIUM VALPROATE SR (Episenta®)	Black	Epilepsy	Not approved by local committee
SODIUM ZIRCONIUM CYCLOSILICATE (Lokelma®) (UPDATED)	Red	Hyperkalaemia	In line with NICE TA599. Implementation date 4^th December 2019.
SOFOSBUVIR	Red	Hepatitis C
SOFOSBUVIR/VELPATASVIR (Epclusa®)	Red	Hepatitis C	In line with NICE TA 430
SOFOSBUVIR–VELPATASVIR-VOXILAPREVIR (Vosevi®) (NEW)	Red	For Chronic hepatitis C	IMPLEMENTATION from 21st May 2018 In line with NICE TA 504
SOLIFENACIN	Green	Urinary incontinence
SOLIFENACIN / TAMSULOSIN (Vesomni®)	Green	Benign prostatic hyperplasia	In line with Male LUTS Pathway
SOLRIAMFETOL (Sunosi®) (NEW)	Black	Improve wakefulness and reduce excessive daytime sleepiness (EDS) in adult patients with narcolepsy	Not yet reviewed
SOMATROPIN (Growth Hormone)	Red	Growth disorders	New patients supplied through healthcare at home
SORAFENIB	Red
SOYBEAN OIL EYE DROPS (Emustil®)	Black	Ocular lubricant	Not yet reviewed
SPIRONOLACTONE	Amber Full SCA	Heart failure and hypertension in infants and children	Full SCA
STAVUDINE	Black
STRIBILD	Red	HIV
SUCROFERRIC OXYHYDROXIDE (Velphoro®)	Red	Treatment/prevention of hyperphosphataemia of chronic kidney disease
SUFENTANIL (Zalviso®) sublingual tablets	Black	Acute post-operative pain	Not yet reviewed
SUGAMMADEX	Red	Reversal of neuromuscular blockade	Emergency use only.
SULFASALAZINE	Amber Full SCA	Rheumatological disease	Full SCA Request form
SULFASALAZINE	Red	Inflammatory Bowel Disease in Paediatrics
SULFASALAZINE ORAL & RECTAL	Amber Full SCA	Ulcerative colitis and Crohn's disease	Shared care request is mandatory Full SCA
SULPIRIDE	Green Conditional	Schizophrenia	If for use in schizophrenia or psychoses–to be initiated after discussion with specialist
SUNITINIB	Red
SYMTUZA® (NEW)	Red	Combination HIV treatment	As part of NHS England Clinical Commissioning policy
SYNVISC®	Black	Black in ALL indications except for Pain relief in osteoarthritis of shoulder joint (RED)
SYNVISC®	Red	Pain relief in oesteoarthritis of shoulder joint.
SYSTANE® ULTRA preservative free eye drops	Amber Simple	Ocular lubricants	Use in line with guidance Leicestershire Guide to Prescribing Ocular Lubricants
TACROLIMUS capsules (Adoport®, Prograf® or Modigraf®) (UPDATED)	Amber Full SCA	Immunosuppression post renal transplant - prescribe by brand name only as different brands are not interchangeable	Exception agreed to red status: Full shared care to allow GPs to continue supplying to historical patients still on shared care where appropriate for patient and the GP agrees. Full SCA
TACROLIMUS capsules (Adoport®, Prograf® or Modigraf®) (NEW)	Red	Immunosuppression post renal transplant - prescribe by brand name only as different brands are not interchangeable
TACROLIMUS capsules (Advagraf®)	Black	Immunosuppression	Modified-release
TACROLIMUS ointment	Green	Dermatitis
TACROLIMUS SR (Envarsus®)	Red	Prophylaxis of transplant rejection in adult kidney transplants
TADALAFIL	Black	Benign prostatic hyperplasia
TADALAFIL	Green	Erectile dysfunction	For patients who have not responded to sildenafil or to vardenafil. Daily dose not supported
TADALAFIL (Adcirca®)	Black	Pulmonary arterial hypertension
TAFAMIDIS (NEW)	Red	Transthyretin amyloidosis with cardiomyopathy as part of EAMS
TAFLUPROST/TIMOLOL preservative free eye drops (Taptiqom®)	Black	Glaucoma	Not yet reviewed
TAMOXIFEN	Amber Simple	Treatment and prevention of breast cancer
TAMSULOSIN capsules	Green	Benign prostatic hypertrophy
TAMSULOSIN tablets	Black	Benign prostatic hypertrophy
TAPENTADOL immediate release	Black	Acute pain
TAPENTADOL sustained release	Amber Simple	Moderate to severe chronic pain (pain clinic recommendation only)
TEDIZOLID PHOSPHATE tablets and infusion (Sivextro®)	Black	Skin infection	Not yet reviewed
TEDUGLUTIDE injection	Black	Short bowel syndrome	Not yet reviewed
TEGAFUR / GIMERACIL / OTERACIL	Red
TEGAFUR / URACIL	Red
TEICOPLANIN	Green	Cellulitis (in primary care)	To be used in conjunction with the Cellulitis-Teicoplanin Pathway
TEICOPLANIN	Red	All indications except cellulitis in primary care
TEMOZOLOMIDE	Red
TENOFOVIR	Red
TENOFOVIR / EMTRICITABINE (Truvada®)	Red
TENOFOVIR ALAFENAMIDE (Vemlidy®)	Black	Hepatitis B	New formulation Not yet reviewed
TERIFLUNOMIDE	Red	Multiple sclerosis	In line with NICE TA 303
TERIPARATIDE (UPDATED)	Red	Osteoporosis in men and women
TESTOSTERONE	Amber Full SCA	Replacement therapy in children and adolescents	Full SCA
TESTOSTERONE	Amber Full SCA	Adult male hypogonadism	Full SCA
TESTOSTERONE	Amber Full SCA	Gender reassignment	To be used and monitored in line with guidance/written information from specialist centre consultant/team (nearest clinic is in Nottinghamshire*) (NB no formal SCA in place but written guidance from specialist) Gender dysphoria services: a guide for GPs and other healthcare professionals
TESTOSTERONE buccal	Black	Male hypogonadism
TESTOSTERONE GEL (Tostran ®) (UPDATED)	Amber Simple	Testosterone deficiency in menopausal women (unlicensed)	Tostran brand only. As per NICE NG 23
TESTOSTERONE Patches (Intrinsa®)	Black	Hypoactive sexual desire disorder in women	Not approved by local committee
TEZACAFTOR AND IVACAFTOR (Symkevi ®) (NEW)	Red	Cystic Fibrosis
THALIDOMIDE	Red	Angiodysplasias	Historical entry to match formulary
THALIDOMIDE	Black	Multiple myeloma
TICAGRELOR	Amber Simple	Troponin positive Acute Coronary Syndromes in NSTEMI patients	Duration summary for primary care
TIGECYCLINE	Red	Skin and soft tissue infections
TILDRAKIZUMAB (Ilumetri®) (NEW)	Red	Moderate to severe plaque psoriasis	In line with NICE TA575 Implementation date 17^th July 2019
TIMOLOL LA Gel-Forming Eye Drops	Red	Small infantile haemangiomas	In line with GOSH guidance
TIOGUANINE	Red
TIOTROPIUM (Braltus Zonda®)	Green	COPD	Use in line with Leicestershire LAMA Prescribing Guide
TIOTROPIUM (Spiriva HandiHaler® or Spiriva Respimat®)	Green	COPD
TIOTROPIUM (Spiriva Respimat®)	Amber Simple	Asthma
TIOTROPIUM/OLODATEROL (Spiolto Respimat®)	Green	COPD	NEW LABA/LAMA combination product – to be used in line with updated COPD Guidelines
TIPRANAVIR	Red	HIV infection
TIPRANAVIR	Red
TIVOZANIB (Fotivda®) (NEW)	Black	Advanced renal cell carcinoma	Not yet reviewed
TIZANIDINE	Amber Full SCA	MS spasticity	SCA to be developed. Existing primary care prescribing to continue.
TOBRAMYCIN (Vantobra®)	Black	Chronic pulmonary infection due to Pseudomonas aeruginosa	New formulation Not yet reviewed
TOBRAMYCIN inhalation	Red	Cystic fibrosis
TOBRAMYCIN injection	Red
TOCILIZUMAB	Red	Juvenile idiopathic arthritis	In line with NICE TA 373
TOCILIZUMAB (NEW)	Red	Treating giant cell arteritis.	In Line with NICE TA 518
TOCILIZUMAB	Red	Rheumatoid arthritis	In line with NICE Technology Appraisal TA247 Both the intraveneous and subcutaneous preparations are RED
TOCILIZUMAB (NEW)	Red	Adult onset stills disease	Requested for UHL as part of NHS England commissioning policy.
TOCILIZUMAB (NEW)	Black	Treatment of chimeric antigen receptor induced cytokine release syndrome	Not yet reviewed.
TOFACITINIB (NEW)	Red	Active psoriatic arthritis after inadequate response to DMARDS	In line with NICE TA543 Implementation date 3rd January 2019
TOFACITINIB (NEW)	Red	Moderately to severely active ulcerative colitis	In line with NICE TA 547 Implementation date 28th February 2019
TOFACITINIB (NEW)	Red	Moderate to Severe Rheumatoid Arthritis	In line with NICE TA 480
TOLCAPONE (NEW)	Black	Parkinson's disease	For exceptions please see red traffic light
TOLCAPONE (UPDATED)	Red	Parkinson's disease	For patient’s requiring continuation of treatment after review only
TOLVAPTAN (Jinarc®)	Red	Autosomal dominant polycystic kidney disease	In line with NICE TA 358
TOLVAPTAN (Samsca®)	Black	Hyponatraemia secondary to SIADH
TOPIRAMATE	Green	Migraine
TOPIRAMATE	Amber Simple	Epilepsy
TOPOTECAN	Red
TRAMADOL	Green	Severe pain	Including SR tablets
TRAMADOL HYDROCHLORIDE / DEXKETOPROFEN (Skudexa®) (NEW)	Black	Pain
TRAMETINIB (Mekinist®)	Black	Melanoma	Not yet reviewed
TREOSULFAN	Red
TRICHLOROACETIC ACID (NEW)	Red	Resolution of cyst in enucleated socket
TRICLABENDAZOLE (NEW)	Red	Hepatic fascioliasis	Approved by the Antimicrobial Working Party
TRIENTINE	Red	Wilson's disease
TRIFLURIDINE / TIPIRACIL (Lonsurf®)	Black		Not yet reviewed
TRIFLURIDINE 1% eye drops	Red
TRIPLE BROMIDES	Black	Intractable epileptic seizures	Not approved by local committee
TRIPTORELIN	Amber Simple	Endometriosis, uterine fibroids
TRIPTORELIN	Amber Simple	Precocious puberty	GP Guidance
TRIPTORELIN	Green	Prostatic carcinoma	GP can give first injection to patients in whom anti-androgen treatment has been started by secondary care clinician. Local guidance
TROSPIUM (immediate release)	Green	Urinary frequency, urgency and incontinence
TROSPIUM XL	Black	Urinary incontinence
TYPICAL ORAL ANTIPSYCHOTICS	Green Conditional	See individual entries	If used for schizophrenia or psychoses to be initiated only after diagnosis and advice to use typical antipsychotic has been discussed with specialist (green for other licensed indications)
UBIQUINONE Q10	Black	Statin-induced myopathy	Not approved by local committee
ULIPRISTAL ACETATE (ellaOne®)	Green	Emergency contraception	To be taken from between 72 hours (3 days) to 120 hours (5 days) of unprotected sexual intercourse or contraceptive failure. Within the first 72 hours use Levonelle®. (Levonelle® 1500 is available on prescription. Levonelle One Step® can be sold to women over the age of 16 years)
ULIPRISTAL ACETATE (Esmya ®) (UPDATED)	Black	Uterine fibroids	In line with MHRA alert March 2020 regarding risks of liver injury.
UMECLIDINIUM / VILANTEROL inhaler (Anoro Ellipta®)	Black	COPD	Not yet reviewed
UMECLIDINIUM inhaler (Incruse Ellipta®)	Black	COPD	Not yet reviewed
UPADACITINIB (RINVOQ®) (NEW)	Black	Moderate to severe active rheumatoid arthritis, responded inadequately to, or who are intolerant to one or more DMARDs.	Not yet reviewed
UROFOLLITROPIN(Fostimon®)	Red	IVF
USTEKINUMAB	Red	Plaque psoriasis	Supported by NICE
USTEKINUMAB	Red	Crohns	In line with NICE TA 456
USTEKINUMAB	Red	Psoriatic arthritis	NICE TA 340
USTEKINUMAB	Red	Plaque psoriasis in children	In line with NICE TA 455
USTEKINUMAB (Stelara®) (NEW)	Red	Moderate to severe ulcerative colitis	In line with NICE TA633 Implementation date 17^th September 2020
USTEKINUMAB (Stelara®)	Red	Psoriasis
VALGANCICLOVIR (Valcyte®)	Red	Cytomegalovirus retinitis
VALPROATE SEMISODIUM (Depakote®)	Amber Simple	Mania in bipolar disorder
VALSARTAN / AMLODIPINE (Exforge®)	Black	Hypertension	Not approved by local committee
VANDETANIB	Red
VARENICLINE	Green	Smoking cessation	Alternative option to NRT or buproprion subject to patient using accredited smoking cessation services
VEDOLIZUMAB (UPDATED)	Red	Ulcerative colitis and Crohn's disese
VEMURAFENIB	Red
VENLAFAXINE	Green	Depression - low dose (<300mg)
VENLAFAXINE	Amber Full SCA	Treatment resistant depression - high dose (≥300mg)	Full SCA Request form
VILDAGLIPTIN	Black	Type 2 diabetes
VILDAGLIPTIN / METFORMIN (Eucreas®)	Black	Type 2 diabetes
VIMOVO® (esomeprazole +naproxen)	Black	Rheumatoid arthritis, osteoarthritis and ankylosing spondylitis
VINORELBINE	Red
VISMODEGIB	Red
VITAMIN A CAPSULES (Phebra ®) (NEW)	Amber Simple	Severe Vitamin A deficiency due to bariatric surgery or malabsorptive disorder
VITAMIN A IM INJECTION (NEW)	Red	Severe Vitamin A deficiency due to bariatric surgery or malabsorptive disorder where enteral routes are compromised
VONICOG ALFA (Veyvondi®) (NEW)	Black	Von Willebrand disease	Not yet reviewed
VORETIGENE NEPARVOVEC (Luxturna®) (NEW)	Black	Vision loss due to inherited retinal dystrophy caused by confirmed biallelic RPE65 mutations	Not yet reviewed
VORICONAZOLE	Red	All indications - High cost drug - use on microbiologist advice only
VORTIOXETINE	Amber Simple	Major depressive disorder	Third line option
VSL#3 (UPDATED)	Black	Probiotic
YASMIN®	Green	Contraception	NOTE: More expensive, with no evidence of significant advantages, compared to other similar OCs.
ZANAMIVIR SOLUTION FOR INFUSION (Dectova®) (NEW)	Red	Treatment of complicated and potentially life-threatening influenza
ZICONOTIDE	Black	Severe chronic pain (intrathecal)
ZIDOVUDINE	Red
ZOLENDRONIC ACID infusion	Red	Pagets disease & Osteoporosis
ZONISAMIDE	Amber Simple	Refractory epilepsy
ZOSTAVAX (Varicella zoster vaccine)	Black	Prevention of shingles and post-herpetic neuralgia. Live vaccine therefore NOT suitable for immunocompromised patients. Do not prescribe on FP10 (black through this route).	Available centrally from 1st Sept 2013 for those aged 70 and 79 years Public Health advice
ZUCLOPENTHIXOL ACETATE (Clopixol Acuphase®)	Red	Short-term management of acute psychosis or mania	Refer to Local Area Team letter May 2013
ZUCLOPENTHIXOL DECANOATE (Clopixol® Depot and Clopixol® Conc.)	Amber Full SCA	Schizophrenia	Full SCA Request form
ZUCLOPENTHIXOL ORAL	Green Conditional	Schizophrenia and other psychoses	If used for schizophrenia or psychoses to be initiated only after diagnosis and advice to use typical antipsychotic has been discussed with specialist

Traffic Light Classifications

Black

Drugs not recommended for use in the Leicestershire Health Community because of lack of evidence of clinical effectiveness, cost prioritization or concerns over safety.

All new drugs will be black until they have been through the appropriate approval process - then they will appear as a specific entry.

Red

Drugs which should be prescribed only by hospital specialists (clinical review by specialist as appropriate and annually as a minimum).

Amber Full SCA

Drugs which would initially be prescribed by a hospital specialist and then by a GP where full agreement to share the care of each specific patient has been reached under a LMSG Shared Care Agreement (SCA). Specific patient monitoring or intervention required.

Amber Simple

Drugs suitable to be initiated and prescribed in primary care only after specialist assessment and recommendation. A shared care agreement is not required.

Green Conditional

Drugs for which GPs are able to take full responsibility for prescribing and monitoring subject to specified conditions e.g. prescribing in line with agreed LMSG guidance or able to demonstrate suitable competence see comments under individual entries.

Green

Drugs for which GPs would normally take full responsibility for prescribing and monitoring. Drugs included in this list have been specifically considered by LMSG.