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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
02.12 Lipid-regulating drugs
02.12 Bile acid sequestrants
02.12 Ezetimibe
02.12 Fibrates
02.12 Statins

MHRA DSU Sept 2023 Statins: very infrequent reports of myasthenia gravis

Using statins in liver impairment – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice

Atorvastatin tablet

GREEN
First Choice

10mg, 20mg, 40mg & 80mg available

Doses of 20mg and above are classified as "high intensity statins"

 

Entry reviewed: April 2022

BNF BNFc SPC

Rosuvastatin tablet

GREEN
Second Choice

5mg, 10mg, 20mg & 40mg available

Doses of 10mg and above are classified as "high intensity statins"

 

Entry reviewed: April 2022

BNF BNFc SPC

Simvastatin tablet

GREEN
Third Choice

10mg, 20mg & 40mg available

20mg and 40mg are classified as "medium intensity statins"

 

Entry reviewed: April 2022

BNF BNFc SPC

Rosuvastatin capsule

GREEN
Restricted Drug Restricted

Restriction: Licensed option for patients who are unable to swallow tablets or those with enteral feeding tubes

 

The capsules can be administered as intact capsule or its content can be sprinkled on soft food, for example apple sauce before oral administration (see SPC for instructions). Alternatively, the pellets can also be administered via nasogastric tubing (see SPC for instructions).

 

Entry reviewed: November 2023

BNF BNFc SPC
Non formulary items

Atorvastatin oral suspension 4mg/mL

 
Non Formulary

Expensive. If patients have dysphagia or enteral feeding tubes consider using rosuvastatin capsules as alternative

Entry reviewed: June 2022

BNF BNFc SPC

Pravastatin tablet

 
Non Formulary

10mg, 20mg & 40mg available

Assessed April 2022: In line with updated lipid management guidance NICE CG181, high intensity statins should be started where indicated. Pravastatin is low intensity and is therefore less favoured for initiation.

 

Entry reviewed: April 2022

BNF BNFc SPC
02.12 Nicotinic acid group
02.12 Omega-3 fatty acid compounds
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.