Safety lancets are considerably more expensive than standard lancets; they should only be prescribed for patients who are unable to self-test and require assistance from a healthcare worker to obtain a blood sample. They should not be prescribed for patients who self-test.

All dosing advice and labelling for dexamethasone formulations must now be expressed as dexamethasone base https://www.palliativedrugs.com/download/dexamethasone_injection_changes_V11_141218_aw_final.pdf

Risk of venous thromboembolism (VTE) for drospirenone-containing combined oral contraceptives (COCs), is higher than for levonorgestrel and those containing desogestrel or gestodene. The risk of VTE with drospirenone containing pills remains very small and, like other oral contraceptives, is less than that associated with pregnancy.

As per national recommendations for gestational diabetes

Due to be discontinued, it is anticipated stock will run until June 2025

Only to be prescribed for adults having insulin administered by a third party such as District Nursing teams and Care home staff.

Ertugliflozin as monotherapy or with metformin for treating type 2 diabetes as per NICE TA572

Advanced warning that Levemir products are due to be discontinued in 2026, advice is not to initiate any new patients on Levemir products.

Advanced warning that Levemir products are due to be discontinued in 2026, advice is not to initiate any new patients on Levemir products.

Relatively expensive compared to 5mg standard tablets

Discouraged - QIPP Workstream

Safety lancets are considerably more expensive than standard lancets; they should only be prescribed for patients who are unable to self-test and require assistance from a healthcare worker to obtain a blood sample. They should not be prescribed for patients who self-test.

Safety lancets are considerably more expensive than standard lancets; they should only be prescribed for patients who are unable to self-test and require assistance from a healthcare worker to obtain a blood sample. They should not be prescribed for patients who self-test.

Safety lancets are considerably more expensive than standard lancets; they should only be prescribed for patients who are unable to self-test and require assistance from a healthcare worker to obtain a blood sample. They should not be prescribed for patients who self-test.

Safety lancets are considerably more expensive than standard lancets; they should only be prescribed for patients who are unable to self-test and require assistance from a healthcare worker to obtain a blood sample. They should not be prescribed for patients who self-test.

Not included in national recommendations, not for new initiations.

for patients with significant swallowing difficulties unable to take ANY medicine in a solid dose formulation. The strict administration requirements for Binosto are the same as for the standard alendronate. Binosto is considerably more expensive than the preferred standard alendronate formulation.

May only be initiated in primary care for people with type 2 diabetes and no heart failure.

May only be initiated in primary care for people with type 2 diabetes and no heart failure.

Discouraged - very expensive compared to standard tablets

May be initiated in primary care for people with type 2 diabetes and no heart failure and for use in the management of CKD as per NICE TA775. Dapagliflozin remains as specialist recommended in the treatment of chronic heart failure (with or without T2D) in line with NICE TA679. Please note - a starting dose of 5mg is only to be used in cases of severe hepatic impairment, this may be increased to 10mg if well tolerated.

May be initiated in primary care for people with type 2 diabetes and no heart failure and for use in the management of CKD as per NICE TA775. Dapagliflozin remains as specialist recommended in the treatment of chronic heart failure (with or without T2D) in line with NICE TA679. Please note - a starting dose of 5mg is only to be used in cases of severe hepatic impairment, this may be increased to 10mg if well tolerated.

May be initiated in primary care for people with type 2 diabetes and no heart failure and for the managment of CKD in line with NICE TA 942. Empagliflozin remains as specialist recommended in the treatment of chronic heart failure (with or without T2D) - in line with NICE TA773 and TA929

May be initiated in primary care for people with type 2 diabetes and no heart failure and for the managment of CKD in line with NICE TA 942. Empagliflozin remains as specialist recommended in the treatment of chronic heart failure (with or without T2D) - in line with NICE TA773 and TA929

Fiasp (Fast acting insulin aspart) for patients 1 year and over under the care of the paediatric diabetes service, who are either unpredictable eaters or have problematic post-meal glucose rise, not managed with dietetic input and assessed as competent to try Fiasp by the dietician.

Fiasp (Fast acting insulin aspart) for patients 1 year and over under the care of the paediatric diabetes service, who are either unpredictable eaters or have problematic post-meal glucose rise, not managed with dietetic input and assessed as competent to try Fiasp by the dietician.

Fiasp (Fast acting insulin aspart) for patients 1 year and over under the care of the paediatric diabetes service, who are either unpredictable eaters or have problematic post-meal glucose rise, not managed with dietetic input and assessed as competent to try Fiasp by the dietician.

Approved for use in the treatment of type 1 diabetes mellitus in adults, adolescents and children from the age of one year, who are under the care of the paediatric diabetes service

Insulin degludec (Tresiba) - approved for use in the treatment of type 1 diabetes mellitus in adults, adolescents and children from the age of one year, who are under the care of the paediatric diabetes service.

Insulin degludec (Tresiba) - approved for use in the treatment of type 1 diabetes mellitus in adults, adolescents and children from the age of one year, who are under the care of the paediatric diabetes service.

Xultophy, a combination of liraglutide/insulin degludec, is accepted onto the formulary for patients intolerant of at least two GLP-1 agonists and who may also be on insulin. Prescribing of Xultophy will be undertaken by the Diabetes Team for the first month and guidance on how Xultophy will be titrated up (and any existing insulin titrated down) will be provided by the Diabetes Team. Patients on Xultophy will be supervised by the Team for about 12 months.

To be prescribed via specialist weight management service only

NICE TA358 Tolvaptan is recommended as an option for the treatment of autosomal dominant polycystic kidney disease in adults when specified criteria are met (October 2015) Hyponatraemia secondary to SIADH in patients requiring cancer chemotherapy. Commissioned by NHS England

NICE TA358 Tolvaptan is recommended as an option for the treatment of autosomal dominant polycystic kidney disease in adults when specified criteria are met (October 2015) Hyponatraemia secondary to SIADH in patients requiring cancer chemotherapy. Commissioned by NHS England

For type 1 pump patients only. Not for initiation in primary care

For type 1 paediatric patients who are unable to use a separate ketone meter.

All children who attend school should be prescribed BD Autoshield needles to minimise the risk of needle stick injuries. These needles should be added to repeat prescriptions in ADDITION to universal needles, as the Autoshield is required only for school use, not home use.

Dulaglutide (Trulicity) is only to be prescribed for patients already on treatment. Please do not initiate new patients on this medication.

Dulaglutide (Trulicity) is only to be prescribed for patients already on treatment. Please do not initiate new patients on this medication.