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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 6 - Endocrine system 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
06.01.02.02 Biguanides

Metformin

GREEN
First Choice

500mg & 850mg Tablets

 

Do not prescribe 1 gram tablets - approx 40 times more expensive vs 500mg or 850mg

BNF BNFc SPC
MHRA DSU Metformin and reduced vitamin B12 levels: new advice for monitoring patients at risk

Metformin
(MR tablet)

GREEN
Formulary

500mg, 1000mg MR tablets

NB: 750mg tablets are high cost - restricted to use 2nd line only where immediate release is not suitable AND patient requires a dose of 750mg.

 

Entry reviewed: September 2023

BNF BNFc SPC
MHRA DSU Metformin and reduced vitamin B12 levels: new advice for monitoring patients at risk

Metformin
(Oral solution, sugar-free)

GREEN
Restricted Drug Restricted

Oral solution 500mg/5mL
Restricted - to patients who cannot swallow metformin hydrochloride tablets.

Also available as 850mg/5mL and 1g/5mL in primary care. These strengths are not routinely stocked at the L&D.

BNF BNFc SPC
MHRA DSU Metformin and reduced vitamin B12 levels: new advice for monitoring patients at risk

Metformin powder for oral solution sachets

GREEN
Restricted Drug Restricted

Cost effective alternative to liquid metformin where patient has difficulty swallowing tablets

Licensed from age 10

Each 500mg dose must be reconstituted in 150mL water - consider volume when prescribing (e.g. fluid restricted patients)

 

Entry reviewed: April 2023

BNF BNFc SPC
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.