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 Formulary Chapter 6: Endocrine system - Full Chapter
Notes:

 

 

 

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06.06  Expand sub section  Drugs affecting bone metabolism
Calcitriol
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Second Choice
Amber Initiation
 
 
Disodium Pamidronate
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Formulary
Red
 
Link  MHRA: Bisphosphonates: atypical femoral fractures
 
Alendronic Acid
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Formulary
Green



 
Link  MHRA: Bisphosphonates: atypical femoral fractures
Link  NICE TA464: Bisphosphonates for treating osteoporosis
Link  TA160: Alendronate, etidronate, risedronate, raloxifene and strontium ranelate for the primary prevention of osteoporotic fragility fractures in postmenopausal women (amended)
Link  TA161: Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women (amended)
 
CALCITONIN
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Formulary
Red

CALCITONIN (SALMON)/SALCATONIN - Red

CALCITONIN SALMON/ CALCITONIN - Red

 
 
Ibandronic acid
(Injection)
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Formulary
Red
 
Link  MHRA: Bisphosphonates: atypical femoral fractures
 
Ibandronic acid
(150mg tabs )
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Formulary
Amber Recommended
 
Link  MHRA: Bisphosphonates: atypical femoral fractures
 
Ibandronic acid
(50mg tabs)
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Formulary

Dudley

Black 

Sandwell

Amber SC

ESCA Sandwell only

Walsall

 Green

Wolverhampton 

Red

 

 
Link  ESCA: Ibandronic acid 50mg-Sandwell only
Link  MHRA: Bisphosphonates: atypical femoral fractures
 
PAMIDRONATE DISODIUM
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Formulary
Red
 
 
RISEDRONATE SODIUM 30mg
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Formulary
Green
 
 
ROMOSOZUMAB
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Formulary
Red

Evenity - Red

 
Link  NICE TA 791: Romosozumab for treating severe osteoporosis
 
Sodium Clodronate (Calsteon®, Loron 520® )
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Formulary

 

Dudley 

Black

Sandwell

Amber SC

ESCA- Sandwell

Walsall

 Black

Wolverhampton

Red


 

 
Link  ESCA: Sodium clodronate-Sandwell only
Link  MHRA: Bisphosphonates: atypical femoral fractures
 
Teriparatide
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Formulary
Red
High Cost Medicine

Red - Forsteo

Red - Movymia

Red - Terrosa

 
Link  NICE TA161: Osteoporosis - secondary prevention (including Teriparatide)
 
Zoledronic acid
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Formulary
Red

Red - Aclasta

Red - Zometa

 
Link  MHRA: Bisphosphonates: atypical femoral fractures
Link  NICE TA464: Bisphosphonates for treating osteoporosis
 
06.06  Expand sub section  Osteoporosis
06.06.01  Expand sub section  Calcitonin and parathyroid hormone
Calcitonin (salmon) / Salcatonin
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Formulary
Red

Injection

Nasal spray

For hospital use only

 
Link  NICE TA161: Osteoporosis - secondary prevention (including strontium ranelate)
 
06.06.02  Expand sub section  Bisphosphonates and other drugs affecting bone metabolism
06.06.02  Expand sub section  Bisphosphonates to top
Alendronic acid (Binosto®)
(effervescent tablets)
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Third Choice
Green
High Cost Medicine
 
Link  MHRA: Bisphosphonates: atypical femoral fractures
Link  NICE TA464:Bisphosphonates for treating osteoporosis
 
Etidronate disodium
(tablets)
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Formulary
Green

In line with NICE

 
Link  MHRA; Bisphosphonates: atypical femoral fractures
Link  NICE TA160: Alendronate, etidronate, risedronate, raloxifene and strontium ranelate for the primary prevention of osteoporotic fragility fractures in postmenopausal women
Link  NICE TA161: Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women
 
06.06.02  Expand sub section  Denosumab
Denosumab (Prolia®)
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Formulary

 

Dudley 

Amber Initiation

Sandwell

Amber SC

ESCA-Denosumab-Sandwell only

Walsall

Red

Wolverhampton 

Amber Recommended with RiCaD 

Wolverhampton only

 
Link  ESCA: Denosumab (Prolia)-Sandwell only
Link  NICE TA204: Denosumab for the prevention of osteoporotic fractures in postmenopausal women
 
Denosumab (Xgeva®)
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Formulary
Red
For specialist use only in line with NICE TA265
 
Link  NICE TA265: Bone metastases from solid tumours - denosumab: guidance (TA265 )
 
06.06.02  Expand sub section  Strontium renelate
Strontium ranelate
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Formulary
Amber Initiation
 
 
 ....
 Non Formulary Items
Alendronic Acid
(Oral solution)

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Non Formulary
Black

Removed from formulary in Decemeber 2016, replaced by effervescent tablets

ALENDRONIC ACID

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Non Formulary
Black

ALENDRONIC ACID / Fosamax Once Week - Black 

ALENDRONIC ACID/COLECALCIFEROL - Black 

ALENDRONIC ACID/COLECALCIFEROL / Bentexo - Black

ALENDRONIC ACID/COLECALCIFEROL / Fosavance - Black

Alendronic Acid  (Fosamax®)

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Non Formulary
Alendronic Acid  (Fosamax® Once Weekly)

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Non Formulary
Alendronic Acid with colecalciferol  (Fosavance®)

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Non Formulary
CALCITRIOL  (Rocaltrol®)

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Non Formulary
Black
Disodium Eitdronate  (Didronel PMO®)

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Non Formulary
Disodium Etidronate  (Didronel®)

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Non Formulary
Black
PARATHYROID HORMONE

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Non Formulary
Black

Preotact - BLACK 

RISEDRONATE 5MG

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Non Formulary
Black
Risedronate Sodium  (Actonel®)

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Non Formulary
Black

Actonel - Black

RISEDRONATE/CALCIUM CARBONATE/COLECALCIFEROL - Black

RISEDRONATE/CALCIUM CARBONATE/COLECALCIFEROL / Actonel Combi - Black

 

Link  UKMI Q&A: Can oral bisphosphonates be given to people with renal impairment to treat osteoporosis?
Link  MHRA: Bisphosphonates: atypical femoral fractures
Link  NICE TA464: Bisphosphonates for treating osteoporosis
Link  TA 161: Alendronate, etidronate, risedronate, raloxifene, strontium ranelate and teriparatide for the secondary prevention of osteoporotic fragility fractures in postmenopausal women (amended)
Link  TA160: Alendronate, etidronate, risedronate, raloxifene and strontium ranelate for the primary prevention of osteoporotic fragility fractures in postmenopausal women (amended)
Tiludronic Acid  (Skelid®)

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Non Formulary
  
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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