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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 4 - Central nervous system 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
04.05 Drugs used in the treatment of obesity
FSRH GLP-1 agonists and contraception Patient information leaflet Injectable weight loss drugs, contraception and HRT from the Primary Care Women’s Health Society MHRA GLP-1 medicines for weight loss and diabetes: what you need to know NICE guideline [NG246]: Overweight and obesity management

Liraglutide (Saxenda®)
(6mg/ml Solution for injection in pre-filled pen)

RED
Restricted Drug Restricted

Pre-filled pen - contains 18 mg liraglutide in 3 ml.

PRESCRIBE BY BRAND

Adults:

To be used in accordance with the following NICE TA(s)

NB - Prescribed in secondary care by a multidisciplinary tier 3 weight management service. No GP prescribing.

GPs can refer patients to the Luton & Dunstable Tier 3 service using the referral form below. 

Treatment should be discontinued after 12 weeks on the 3.0 mg/day dose if patients have not lost at least 5% of their initial body weight.

 

April 2023: Approved for use in paediatrics from age 12 for management of obesity, under guidance of tertiary centre.

 

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Entry reviewed: May 2025

BNF BNFc SPC
MHRA DSU Nov 2023 Ozempic▼(semaglutide) and Saxenda (liraglutide): vigilance required due to potentially harmful falsified products Specialist Weight Management Obesity/Bariatric Service Referral Form MHRA DSU GLP-1 receptor agonists: reports of diabetic ketoacidosis when concomitant insulin was rapidly reduced or discontinued MHRA DSU: GLP-1 receptor agonists and dual GLP-1/GIP receptor agonists: strengthened warnings on acute pancreatitis, including necrotising and fatal cases NICE TA 664 Liraglutide for managing overweight and obesity

Semaglutide (Wegovy®)
(0.25mg, 0.5mg, 1mg, 1.7mg & 2.4mg solution for injection in pre-filled pen)

RED
Restricted Drug Restricted

To be used in accordance with the following NICE TA(s):

NB - to be used for a maximum of 2 years, and within a specialist weight management service providing multidisciplinary management of overweight or obesity (including but not limited to tiers 3 and 4). No GP prescribing.

PRESCRIBE BY BRAND

 

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Entry reviewed May 2025 

BNF BNFc SPC
MHRA DSU: GLP-1 receptor agonists and dual GLP-1/GIP receptor agonists: strengthened warnings on acute pancreatitis, including necrotising and fatal cases MHRA DSU: Semaglutide (Wegovy, Ozempic and Rybelsus): risk of Non-arteritic Anterior Ischemic Optic Neuropathy (NAION) NICE TA875: Semaglutide for managing overweight and obesity

Tirzepatide (Mounjaro®)
(Overweight and obesity)

GREEN
Restricted Drug Restricted

GENERAL PRACTICE OR SECONDARY CARE SHOULD NOT PRESCRIBE TIRZEPATIDE TO ANY PATIENT FOR THE MANAGEMENT OF OVERWEIGHT AND OBESITY UNLESS THEY MEET THE ELIGIBIITY CRITERIA BELOW

  • Tirzepatide should only be offered to individuals who meet the national agreed eligibility criteria.
  • For 2026/2027, eligible patients must meet the following criteria:
    • BMI of 35kg/m2 or more (reduced by 2.5kg/m2 for people with South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds) AND at least 4 of the following 5 qualifying co-morbidities:
      • Established atherosclerotic cardiovascular disease.
      • Hypertension requiring treatment
      • Dyslipidaemia treated with lipid-lowering therapy, or with low-density lipoprotein (LDL) ≥ 4.1 mmol/L, or high-density lipoprotein (HDL) <1.0 mmol/L for men or HDL<1.3 mmol/L for women, or fasting (where possible) triglycerides ≥1.7 mmol/L.
      • Obstructive sleep apnoea (sleep clinic confirmed) meeting criteria for continuous positive airways pressure.
      • Established type 2 diabetes mellitus.

 

For BLMK area, the local BSOP provider is XYLA.

 

  • STOPPING CRITERIA: 
    • In line with NICE recommendations, if less than 5% of the initial weight has been lost after 6 months on the highest tolerated dose of tirzepatide, a decision should be made to discontinue treatment.
    • Where a patient declines to participate in BSOP or does not complete the BSOP programme, tirzepatide should be discontinued.

FOR TREATMENT OF TYPE 2 DIABETES

  • See monograph in endocrine chapter for use of tirzepatide in the management of type 2 diabetes. 
BNF SPC
MHRA DSU: GLP-1 receptor agonists and dual GLP-1/GIP receptor agonists: strengthened warnings on acute pancreatitis, including necrotising and fatal cases NICE TA1026: Tirzepatide for managing overweight and obesity
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.