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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 2 - Cardiovascular system 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
Links:
Hypertension Resources For Health Professionals NICE guideline NG136 Hypertension in adults: diagnosis and management
02.08.01 Parenteral anticoagulants
JPC Bulletin 242 : Low Molecular Weight Heparins (LMWHs) and Fondaparinux – Prescribing Guidance (Feb 20) NICE NG158 : Venous thromboembolic diseases: diagnosis, management and thrombophilia testing NICE NG89: Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism
02.08.01 Heparin
02.08.01 Low molecular weight heparins
JPC Bulletin 242 : Low Molecular Weight Heparins (LMWHs) and Fondaparinux – Prescribing Guidance (Feb 20) NICE NG158 : Venous thromboembolic diseases: diagnosis, management and thrombophilia testing NICE NG89: Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism

Tinzaparin

 
First Choice

LMWH of choice - 1st line for treatment and prophylaxis of DVT and PE

Injection, prefilled syringes - 2500, 3500, 4500, 8000, 10000, 12000, 14000, 16000, 18000 units

20,000 units in 2ml vial

Mainly hospital only prescribing but GP's may prescribe for certain indications. Please refer to attached CCG guidelines.

BNF BNFc SPC
Bulletin 242: LMWH, fondaparinux and NOACs, Prescribing Guidance and Responsibilities

Dalteparin

RED
Restricted Drug Restricted

Paediatrics only and if recommended by GOSH

  •  10,000units in 4ml
  • 2500 units in 0.2ml
  • 5000 units in 0.2ml
  • 10,000 units in 1ml
  • 18,000 units in 0.72ml

 

NB: Fragmin (Dalteparin Sodium) 10,000IU/1 ml ampoule size is discontinued (Jan 2023)

BNF BNFc SPC

Enoxaparin
(Bedford site Obstetric patients)

SCG
Formulary

Shared Care guideline in place for Bedford site Obstetric patients

Also used for the treatment of ACS in renal patients.

 

  • Injection, prefilled syringes - 2000units (20mg), 4000units (40mg), 6000units (60mg), 8000units (80mg), 10,000units (100mg), 12,000units (120mg)
BNF BNFc SPC

Enoxaparin
(for L&D site Obstetric patients)

RED
Formulary

Hospital only prescribing for L&D site Obstetric patients (2nd-line after tinzaparin if allergic)

Also used for the treatment of ACS in renal patients.

  • Injection, prefilled syringes - 2000units (20mg), 4000units (40mg), 6000units (60mg), 8000units (80mg), 10,000units (100mg), 12,000units (120mg)
BNF BNFc SPC
02.08.01 Heparinoids
02.08.01 Hirudins
02.08.01 Heparin flushes
02.08.01 Epoprostenol
02.08.01 Fondaparinux
Classifications
GREEN
May be initiated in any care setting
Amber SPA
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Amber SPIS
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
SCG
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
RED
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
DNP
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
SELF
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.