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 Formulary Chapter 6: Endocrine system - Full Chapter
Notes:

 

 

 

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06.04  Expand sub section  Sex hormones
Estradiol/Medroxyprogesterone
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Second Choice
Green
 
 
Estradiol/Norethisterone
(Oral presentations)
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Second Choice
Green

 

2nd line to patches 

https://pcwhf.co.uk/wp-content/uploads/2021/02/Prescribing-HRT-3.pdf 

 
 
Femoston Conti ®
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Second Choice
Green
 
 
Femoston Sequential ®
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Second Choice
Green
 
 
Clonidine Hydrochloride
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Formulary
Green
 
 
Estradiol 10mg (Vagifem®, Vagirux®)
(Pessary)
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Formulary
Green

Pessary 

  • Vagifem
  • Vagirux
 
 
Estradiol 1mg /2mg
(Tablets)
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Formulary
Green
 
 
Estradiol hemihydrate (lenzetto 153 mg/spray ®)
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Formulary
Green

 

 

 
 
Estradiol/dydrogesterone
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Formulary
Green
 
 
ESTRIOL 0.01% Cream
( 0.01% Cream)
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Formulary
Green
 
 
EVOREL SEQUI PATCH
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Formulary
Green
 
 
NORETHISTERONE
(5mg Tabs)
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Formulary
Green
 
 
Progynova TS patch
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Formulary
Green
 
 
Sandrena gel
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Formulary
Green
 
 
Tibolone (Livial®)
(Tablets)
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Formulary
Green
 
 
Trisequens ®
(Tablets)
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Formulary
Green
 
 
Oestrogel®
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Formulary
Green
 
 
06.04.01  Expand sub section  Female sex hormones and their modulators
06.04.01.01  Expand sub section  Oestrogens and HRT
Evorel Conti®
(Patch)
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First Choice
Green
 
Evorel Sequi®
(Patch)
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First Choice
Green
 
Evorel®
(Patch)
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First Choice
Green
 
Femseven Conti®
(Patch)
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Second Choice
Green
 
 
Femseven Sequi®
(Patch)
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Second Choice
Green

 

 2nd line to Evorel Sequi®

 
 
COMBINED CYCLICAL HRT
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Formulary
Green

BRANDS

  • Elleste-Duet
  • Prempak-C
 
 
Elleste Solo
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Formulary
Green
 
 
Elleste-Duet Conti®
(Tablets)
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Formulary
Green
 
 
Clinorette®
(Tablets)
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Formulary
Green
 
 
Estraderm MX®
(Patches)
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Formulary
Green
 
 
Estradot®
(Patches)
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Formulary
Green
 
 
Estriol® 0.01%
(Cream)
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Formulary
Green
 
 
Femseven ®
(Patch)
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Formulary
Green
 
 
Kliofem®
(Tablets)
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Formulary
Green
 
 
Kliovance®
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Formulary
Green
 
 
Lubion®
(Injection)
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Formulary
Red

Fertility use only

 
 
Novofem®
(Tablets)
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Formulary
Green
 
 
Ovestin ®
(Cream)
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Formulary
Green
 
 
Premarin®
(Tablets)
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Formulary
Green
 
 
Premique® low dose
(Tablets)
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Formulary
Green
 
 
Tridestra®
(Tablets)
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Formulary
Green
 
 
Zumenon®
(Tablets)
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Formulary
Green
 
 
Indivina®
(Tablets)
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Formulary
Green
 
 
Premique® modified release
(Tablets)
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Formulary
Green
 
 
Progynova®
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Formulary
Green

Progynova® 1mg and 2mg tablets

 
 
Climanor®
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Formulary
Green
 
 
06.04.01.01  Expand sub section  Hormone replacement therapy
06.04.01.01  Expand sub section  Ethinylestradiol to top
Ethinylestradiol
(Tablets)
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Formulary
Red
 
 
06.04.01.01  Expand sub section  Raloxifene
Raloxifene
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Formulary
Green
 
Link  NICE TA 160 Raloxifene for the primary prevention of osteoporotic fragility fractures in postmenopausal women
 
06.04.01.01  Expand sub section  Oestrogen only tablets
06.04.01.01  Expand sub section  Oestrogens and progestogen sequential combined therapy
06.04.01.01  Expand sub section  Continuous combined therapy
06.04.01.01  Expand sub section  Gonadomimetic to top
06.04.01.01  Expand sub section  Selective oestrogen modulator
06.04.01.02  Expand sub section  Progestogens
Medroxyprogesterone Acetate (Climanor®)
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Formulary
Green
 
 
Medroxyprogesterone Acetate (Depo -Provera®)
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Formulary
Green
 
 
Medroxyprogesterone Acetate (Provera®)
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Formulary
Green
 
 
Medroxyprogesterone Acetate (Sayana press®)
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Formulary
Green

Suitable for self injection in patients who have had appropriate tranining

 
 
Progesterone
(Pessary)
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Formulary
Amber Initiation

    BRANDS

  • Cyclogest pessary 
  • Lutigest pessary 
 
 
Progesterone (micronised) (Utrogestan ®)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
 
06.04.02  Expand sub section  Male sex hormones and antagonists
Testosterone  (Sustanon 250®)
(Injection)
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Formulary
Amber Recommended
 
 
Testosterone gel
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Formulary
Amber Initiation
 
 
Testosterone Propionate
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Formulary
Red
 
 
Testosterone undecanoate (Nebido®)
(Injection)
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Formulary
Amber Recommended
 
 
06.04.02  Expand sub section  Anti-androgens
Finasteride
(5mg Tablets)
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Formulary
Green
 
 
Dutasteride (Avodart®)
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Formulary
Amber Recommended
 
 
Cyproterone acetate
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Formulary
Amber Recommended

BRANDS

  • Androcur

 

 

 
 
06.04.02  Expand sub section  Dutasteride and finasteride to top
06.04.03  Expand sub section  Anabolic steroids
06.04.04  Expand sub section  Gender dysphoria
 ....
 Non Formulary Items
Bazedoxifene/Conjugated Oestrogens  (Duavive®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
Link  BMS- guidance on HRT prescribing
Climagest

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Non Formulary
Black
Climaval®

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Non Formulary
Black
Clonidine
(Oral Solution)

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Non Formulary
Black
Cyclo-Progynova®

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Non Formulary
Black
Dienogest

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Non Formulary
Black

  BRANDS

  • Zalkya
Dydrogesterone  (Duphaston®)

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Non Formulary
Dysrogesterone  (Duphaston® HRT)

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Non Formulary
Black
Estradiol with progesterone continuous tablets for HRT  (Angeliq®)

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Non Formulary
ESTRADIOL/PROGESTERONE  (Bijuve®)

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Non Formulary
Black
FINASTERIDE
(1mg Tablet)

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Non Formulary
Black

 

BNF states - Finasteride is not prescribable in NHS primary care for the treatment of androgenetic alopecia in men.

Hormonin®

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
Mesterolone  (Pro-Viron®)

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Non Formulary
Norethisterone  (Micronor®HRT)

View adult BNF View SPC online View childrens BNF
Non Formulary
NORISTERAT INJECTION

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Non Formulary
Black
Nuvelle Continous tablets

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Non Formulary
Black
OESTROGENS FOR HRT  (Bedol®)

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Non Formulary
Black

https://thebms.org.uk/publications/tools-for-clinicians/

 

OXANDROLONE 2.5 MG

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Non Formulary
Black
Primolut N®

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Non Formulary
Black
PROGESTERONE

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Non Formulary
Black

   BRANDS

  • Crinone vaginal gel 
Progesterone Injection  (Gestone®)

View adult BNF View SPC online View childrens BNF
Non Formulary
TESTOSTERONE ENANTATE

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Non Formulary
Black
TESTOSTERONE IMPLANTS

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Non Formulary
Black
TRISEQUENS S

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Non Formulary
Black
ULIPRISTAL ACETATE

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Non Formulary
Black
Ulipristal acetate  (Esmya®)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

MHRA March 2020 Esmya (ulipristal acetate): suspension of the licence due to risk of serious liver injury

July 2018 - Traffic light status amended to RED in light of EMA update

Esmya: new measures to minimise risk of rare but serious liver injury

The only indication approved for use by the APC is
pre-operative treatment of moderate to severe symptoms of uterine fibroids (1 course).

Link  EMA June 2018: Esmya: new measures to minimise risk of rare but serious liver injury
Link  MHRA February 2018: Esmya (ulipristal acetate) for uterine fibroids: do not initiate or re-start treatment; monitor liver function in current and recent users
Utrogestan® Vaginal Capsules

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
  
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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