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 Formulary Chapter 6: Endocrine system - Full Chapter
Notes:

 

 

 

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06.01.02.03  Expand sub section  Other antidiabetic drugs
06.01.02.03  Expand sub section  DPP-4 inhibitors
06.01.02.03  Expand sub section  Alpha glucosidase inhibitors
06.01.02.03  Expand sub section  GLP-1 mimetics
06.01.02.03  Expand sub section  DPP4 inhibitors (gliptins) to top
06.01.02.03  Expand sub section  SGLT2 inhibitors
06.01.02.03  Expand sub section  GLP1 agonists
06.01.02.03  Expand sub section  Meglitinides
06.01.02.03  Expand sub section  SGL2 inhibitors
Canagliflozin
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Formulary
Green

For treating Type 2 diabetes  in line with NICE, and chronic kidney disease.

Do not use SGLT2-inhibitors in patients with T1DM, regardless of CKD and/or heart failure status due to risk of DKA (diabetic ketoacidosis) 

 
Link  MHRA Alert: SGLT2 inhibitors: monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness
Link  MHRA Alert: SGLT2 inhibitors: reports of Fourniers gangrene (necrotising fasciitis of the genitalia or perineum) (Feb 2019)
Link  MHRA: Canagliflozin (Invokana, Vokanamet): signal of increased risk of lower extremity amputations observed in trial in high cardiovascular risk patients
Link  MHRA: SGLT2 inhibitors (canagliflozin, dapagliflozin, empagliflozin): risk of diabetic ketoacidosis
Link  NICE TA315: Canagliflozin in combination therapy for treating type 2 diabetes
Link  NICE TA390: Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes
 
Dapagliflozin
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Formulary

 

  for treating Type 2 diabetes and chronic kidney disease in line with NICE 

Do not use SGLT2-inhibitors in patients with T1DM, regardless of CKD and/or heart failure status due to risk of DKA (diabetic ketoacidosis)

Amber Recommended Treatment of all grades of symptomatic heart failure 

 

SGLT2 inhibitors: updated advice on the risk of diabetic ketoacidosis

MHRA: SGLT2 inhibitors: updated advice on increased risk of lower-limb amputation (mainly toes)

 
Link  MHRA Alert: SGLT2 inhibitors: monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness
Link  NICE TA775: Dapagliflozin for treating chronic kidney disease
Link  NICE TA679: Dapagliflozin for treating chronic heart failure with reduced ejection fraction
Link  MHRA Alert: SGLT2 inhibitors: reports of Fourniers gangrene (necrotising fasciitis of the genitalia or perineum) (Feb 2019)
Link  NICE TA288: Dapagliflozin in combination therapy for treating type 2 diabetes
Link  NICE TA390: Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes
Link  NICE TA418: Dapagliflozin in triple therapy for treating type 2 diabetes
 
Empagliflozin
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Formulary

 Green For treating type 2 diabetes
Do not use SGLT2-inhibitors in patients with T1DM, regardless of CKD and/or heart failure status due to risk of DKA (diabetic ketoacidosis)

Amber Recommended treatment of all grades of symptomatic heart failure

SGLT2 inhibitors: updated advice on the risk of diabetic ketoacidosis

MHRA: SGLT2 inhibitors: updated advice on increased risk of lower-limb amputation (mainly toes)

 
Link  MHRA Alert: SGLT2 inhibitors: monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness
Link  MHRA Alert: SGLT2 inhibitors: reports of Fourniers gangrene (necrotising fasciitis of the genitalia or perineum) (Feb 2019)
Link  MHRA: SGLT2 inhibitors (canagliflozin, dapagliflozin, empagliflozin): risk of diabetic ketoacidosis
Link  NICE TA773: Empagliflozin for treating chronic heart failure with reduced ejection fraction
Link  NICE TA336: Empagliflozin in combination therapy for treating type 2 diabetes
Link  NICE TA390: Canagliflozin, dapagliflozin and empagliflozin as monotherapies for treating type 2 diabetes
 
Empagliflozin/Linagliptin
View adult BNF View SPC online View childrens BNF
Formulary
Green

 

 

 

 
 
ErtugliflozinBlack Triangle
View adult BNF View SPC online View childrens BNF
Formulary
Green

In line with NICE


Do not use SGLT2-inhibitors in patients with T1DM,
regardless of CKD and/or heart failure status due to risk
of DKA (diabetic ketoacidosis)

 

 
Link  MHRA Alert: SGLT2 inhibitors: monitor ketones in blood during treatment interruption for surgical procedures or acute serious medical illness
Link  NICE TA583: Ertugliflozin with metformin and a dipeptidyl peptidase-4 inhibitor for treating type 2 diabetes
Link  MHRA Alert: SGLT2 inhibitors: reports of Fourniers gangrene (necrotising fasciitis of the genitalia or perineum) (Feb 2019)
Link  NICE TA572: Ertugliflozin as monotherapy or with metformin for treating type 2 diabetes
 
06.01.02.03  Expand sub section  Other to top
06.01.02.03  Expand sub section  Thiazolidinediones
 ....
Key
Restricted Drug Restricted Drug
Unlicensed Drug Unlicensed
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
ICB
ICB
Green Low Carbon

Low carbon footprint

Amber Medium Carbon

Medium carbon footprint

Red High carbon footprint

High carbon footprint

Status Description

Green

Medicines which are suitable for initiation and maintenance prescribing by primary and secondary care clinicians. These medicines should be initiated and prescribed within their licensed indications  

Amber Initiation

Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry.  

Amber SC

Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry.  

Amber Recommended

Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a specialist.  

Red

Medicines for initiation and maintenance prescribing by Specialists (hospital or GPs with Special Interest) only  

Grey

Positive NICE TA and /or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information.  

Black

Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use.  

Multiple

Check Notes as varies across the area  

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