| Formulary Chapter 6: Endocrine system - Full Chapter
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| Chapter Links... |
 NTAG Endocrine System Recommendations |
| Details... |
| 06.01.01.02 |
Intermediate- and long-acting insulins |
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Note: preloaded pens and Innolet® devices should only be used where cartridges are not suitable. |
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Isophane Insulin (Insulatard®)
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Formulary
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- Approved Insulatard® formulations include:
- 10ml vial;
- 5x3ml cartridges (for use with Novopen® and Novopenmate® devices);
- 5x3ml Innolet® pens.
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Isophane Insulin (Humulin® I)
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Formulary
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- Approved Humulin® I formulations include:
- 10ml vials;
- 5x3ml cartridges;
- 5x3ml pens.
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Insulin Glargine biosimilar Abasaglar®
(Long acting)
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Formulary
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- First choice long acting basal insulin in patients eligible for treatment in line with NICE and NTAG
- Approved Abasaglar® formulations include:
- 5x3ml cartridge
- 5x3ml Kwikpen®.
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NG17: Type 1 diabetes in adults: diagnosis and management
 NTAG: Abasaglar® Insulin Glargine Biosimilar 100 units/ml for the treatment of type 1 or type 2 diabetes mellitus.
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Insulin degludec (Tresiba®)
(Long acting)
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Formulary
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- 100 units/mL only
- Pre-filled pen and cartridges
- Approved for use in patients with Type 1 diabetes with
- Nocturnal/Severe Hypogycaemia (with or without hypoglycaemic unawareness) in patients who would otherwsie progress to insuling pump treatment as per NICE TA151); or
- Recurrent DKA episodes despite good compliance and who would otherwise progress to insulin pump therapy
- Paediatric patients who cannot tolerate glargine sting
- Paediatric patients with poor control on the high HbA1c pathway
- Patients or Parents/Carers with unpredictable lifestyles such as students or shift workers.
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Insulin Detemir (Levemir®)
(Long acting)
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Formulary
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- Alternative choice long acting basal insulin.
- Approved Levemir® formualtions include:
- 5x3ml cartridges;
- 5x3ml pens.
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Insulin Glargine (Lantus®)
(Long acting)
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Formulary
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- Alternative choice long acting basal insulin.
- Approved Lantus® formulations include:
- 10ml vials;
- 5x3ml cartridges;
- 5x3ml pens (Solostar® - in line with NICE).
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Insulin Glargine (Toujeo®)
(Long acting)
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Formulary
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- Alternative choice long acting basal insulin.
- Approved Toujeo® formulations include:
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| 06.01.01.02 |
Biphasic insulins |
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Biphasic Isophane Insulin (Humulin® M3)
(Conventional )
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Formulary
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- Approved Humulin®M3 formulations include:
- 10ml vials;
- 5x3ml cartridges;
- 5x3ml pens.
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Biphasic Insulin Aspart (NovoMix® 30)
(Analogue)
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Formulary
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- Approved NovoMix® 30 formulations include:
- 5x3ml cartridges (for use with Novopen® and Novopen® Penmate injection devices)
- 5x3ml Flexpen® pens.
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Biphasic Insulin Lispro (Humalog® Mix 25 amd Mix 50)
(Analogue)
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Formulary
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- Approved formulations of Humalog® Mix 25 and Mix 50 include:
- 5x3ml cartridges
- 5x3ml Kwikpen®
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
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Description |
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Drugs for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician and the drug should be supplied through the hospital throughout the duration of treatment.
In some very exceptional circumstances (e.g. due to distance from the hospital, storage, supply or mobility/transport problems) it may be appropriate for the GP to be asked to prescribe a Red drug. This should be negotiated on an individual patient basis and should only be done with the GP’s prior informed agreement where the roles of the GP and hospital services are clearly defined and agreed. The GP should not feel under pressure to prescribe in these circumstances.
For all RED drugs automatically added to the formulary in response to a positive NICE TA: Prescribers need to ensure that local Trust new drug governance procedures and pharmacy processes are followed before any prescribing. |
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Drugs initiated by hospital specialist, but where continuing treatment by GPs may be appropriate under a shared care arrangement.
The specialist should send the GP a copy of the shared care agreement to sign. The GP should sign the shared care agreement, or indicate they do not want to be part of such an agreement, and return a copy back to the specialist. Shared care guidelines are available or are being developed for most of the drugs listed as Amber.
If no shared care guideline is available, the hospital specialist should provide the patient’s GP with sufficient information and support to allow treatment to be continued and managed safely in primary care. |
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Drugs normally recommended or initiated by a specialist (hospital or GP with an extended role https://www.rcgp.org.uk/gpwer), but can be safely maintained in primary care with very little or no monitoring required. In some cases there may be a further restriction for use outlined - these will be defined in each case. Provision of additional information, or an information leaflet, may be appropriate in some cases to facilitate continuing treatment by GPs. |
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Drugs where prescribing by GPs is appropriate. Can be initiated and prescribed in all care settings, and if appropriate, discontinued without recourse to secondary care. |
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NOT APPROVED: Drugs that have been considered by NTAG or the NENC ICB Medicines Subcommittee (or other approved body) and are not approved for prescribing within the North East and North Cumbria. |
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UNDER REVIEW: drugs whose current formulary status or RAG status is currently under review. |
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NOT REVIEWED: Drugs that haven not been reviewed yet. This usually means that an application is in progress. These drugs are not normally considered appropriate for prescribing in the North East and North Cumbria until such time that a decision is taken on their formulary status. |
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