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Herefordshire & Worcestershire
Medicines and Prescribing Committee
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 Formulary Chapter 6: Endocrine system - Full Chapter
06.01.02.03  Expand sub section  Other antidiabetic drugs
06.01.02.03  Expand sub section  Alpha glucosidase inhibitors
06.01.02.03  Expand sub section  DPP4 inhibitors (gliptins)
06.01.02.03  Expand sub section  SGLT2 inhibitors
06.01.02.03  Expand sub section  GLP1 agonists to top
Semaglutide S/C injection
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First Choice

Green  SEMAGLUTIDE SHOULD BE THE PRODUCT OF CHOICE WHEN A ONCE WEEKLY GLP-1 AGONIST IS TO BE USED.


Amber  When administration is with insulin: In line with NICE NG28, diabetes specialist initiation advice/recommendation should be sought when initiating GLP1 agonists in combination with insulin.  In line with the SPC, caution should be exercised when considering use in patients with diabetic retinopathy treated with insulin.

 
Lixisenatide S/C injection
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First Choice

 Green LIXISENATIDE SHOULD BE THE PRODUCT OF CHOICE WHEN A DAILY   GLP-1 AGONIST IS TO BE USED.


 Amber When administration is with insulin: In line with NICE NG28, diabetes specialist initiation advice/recommendation should be sought when initiating GLP1 agonists in combination with insulin.

 
Dulaglutide S/C injection
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Formulary

 


Green


Amber  When administration is with insulin: In line with NICE NG28, diabetes specialist initiation advice/recommendation should be sought when initiating GLP1 agonists in combination with insulin.

 
 
Exenatide 2mg prolonged release (S/C injection)
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Formulary

 


Green


Amber  When administration is with insulin: In line with NICE NG28, diabetes specialist initiation advice/recommendation should be sought when initiating GLP1 agonists in combination with insulin.


 

 
 
Liraglutide S/C injection
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Formulary

1.8mg dose not recommended.


Green


Amber  When administration is with insulin: In line with NICE NG28, diabetes specialist initiation advice/recommendation should be sought when initiating GLP1 agonists in combination with insulin.

 
 
Semaglutide oral tabletsBlack Triangle (Rybelsus®)
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Formulary

Rybelsus is a tablet for once-daily oral use but has special administration directions:



  • It must be taken on an empty stomach at any time of the day.

  • Patients are required to wait at least 30 minutes before eating/drinking or taking other oral medicinal products. Waiting less than 30 minutes decreases absorption.

  • It should be swallowed whole with a sip of water (up to half a glass of water equivalent to 120 ml).


Green  For patients where a GLP1 analogue is indicated but an oral preparation is more suitable.


Amber  When administration is with insulin: In line with NICE NG28, diabetes specialist initiation advice/recommendation should be sought when initiating GLP1 agonists in combination with insulin. 


All patients should be reviewed within 6 months of initiation to assess effectiveness.

 
 
06.01.02.03  Expand sub section  Meglitinides
06.01.02.03  Expand sub section  Other
06.01.02.03  Expand sub section  Thiazolidinediones
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
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
CCG
CCG

Traffic Light Status Information

Status Description

Red

Secondary care only, not to be prescribed in primary care.   

Amber 2

Specialist initiation with shared care guidance Medicines which should be initiated in secondary care by the specialist with follow-on prescription and monitoring according to a specific Shared Care (SC) Guideline. Prescribing may be continued in primary care in line with a shared care guideline   

Amber with Shared Care

Specialist initiation with shared care guidance Medicines which should be initiated in secondary care by the specialist with follow-on prescription and monitoring according to a specific Shared Care (SC) Guideline. Prescribing may be continued in primary care in line with a shared care guideline   

Amber

Considered suitable for primary care prescribing following specialist initiation/recommendation.  

Green

Considered appropriate for prescribing in both secondary and primary care. Suitable for initiation in primary care.   

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