Dorset Formulary


	Dorset The Dorset Formulary has been developed in associations with NHS Dorset Clinical Commissioning Group Dorset County Hospital NHS Foundation Trust Dorset Healthcare University NHS Foundation Trust University Hospitals Dorset NHS Foundation Trust

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Formulary Chapter 2: Cardiovascular system - Full Chapter

Notes:

Chapter review date:

Details...

02.08.02

Oral anticoagulants

See bottom of section for commissioning statements and guidance covering multiple oral anticoagulants

Warfarin

Formulary

Indicated for prophylaxis of embolisation in rheumatic heart disease and atrial fibrillation;prophylaxis after insertion of prosthetic heart valve; prophylaxis and treatment of venous thrombosis and pulmonary embolism

RBCH and DCHFT: 5mg tablets not stocked.

Primary Care management of high INR July 2017

Apixaban (Eliquis^®)

Formulary

In accordance with NICE TA for prevention of VTE in patients undergoing hip or knee replacement surgery, as per licensed indications.

- Note routine 1st line option at RBCH and DCH is LMWH

For prevention of stroke or systemic embolism in patients with AF within NICE TA and local guidance, as per licensed indications.

For the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism in accordance with NICE TA.

NICE TA 245:Apixaban for the prevention of venous thromboembolism after total hip or knee replacement in adults

NICE TA 275: Apixaban for preventing stroke and systemic embolism in people with nonvalvular atrial fibrillation

NICE TA 341: Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism

Dabigatran (Pradaxa®)

Formulary

In accordance with NICE TA for prevention of VTE in patients undergoing hip or knee replacement surgery, as per licensed indications.
- Note routine 1st line option at RBCH and DCH is LMWH

For prevention of stroke or systemic embolism in patients with AF within NICE TA and local guidance, as per licensed indications.

For the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism in accordance with NICE TA.

NICE TA 157: Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee replacement surgery in adults

NICE TA 249: Dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation

NICE TA 327:Dabigatran etexilate for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism

Edoxaban (Lixiana®)

Formulary

For prevention of stroke or systemic embolism in patients with AF within NICE TA and local guidance, as per licensed indications.

For the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism in accordance with NICE TA.

NICE TA 354: Edoxaban for treating and for preventing deep vein thrombosis and pulmonary embolism

NICE TA 355: Edoxaban for preventing stroke and systemic embolism in people with non-valvular atrial fibrillation

Rivaroxaban (Xarelto^®)

Formulary

Prophylaxis in Superficial Thrombosis - refer to Anticoagulation policy. 6 week course Unlicensed

In accordance with NICE TA for prevention of VTE in patients undergoing hip or knee replacement surgery, as per licensed indications.
- Note routine 1st line option at RBCH and DCH is LMWH

Rivaroxaban for preventing adverse outcomes after acute management of acute coronary syndrome. As per NICE TA335.
- For initiation by Consultant Cardiologist only. See shared care guideline for further details.

For prevention of stroke or systemic embolism in patients with AF within NICE TA and local guidance, as per licensed indications.

For the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism in accordance with NICE TA.

In Coronary artery disease or peripheral artery disease. In line with NICE TA607

Commissioning statement for the use of rivaroxaban for preventing adverse outcomes after acute management of acute coronary syndrome

Shared care guideline for the use of rivaroxaban for preventing adverse outcomes after acute management of acute coronary syndrome

Commissioning statement on Rivaroxaban for preventing atherothrombotic events in people with coronary artery diease or peripheral artery disease December 19

NICE TA 170: Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults

NICE TA 256: Rivaroxaban for the prevention of stroke and systemic embolism in people with atrial fibrillation

NICE TA 261: Rivaroxaban for the treatment of deep vein thrombosis and prevention of recurrent deep vein thrombosis and pulmonary embolism

NICE TA 287:Rivaroxaban for treating pulmonary embolism and preventing recurrent venous thromboembolism

NICE TA 335: Rivaroxaban for preventing adverse outcomes after acute management of acute coronary syndrome

NICE TA607 Rivaroxaban for preventing atherothrombotic events in people with coronary or peripheral artery disease

CoaguChek®

Formulary

Testing strips

Added March 2020

Review September 2020

Acenocoumarol (Sinthrome^®)

Formulary

Tablets.

Specialist initiation in patients intolerant of warfarin (where other oral agents are not indicated).

Phenindione

Formulary

Tablets.

Specialist initiation.

DCHFT Policy for prevention of venous thromboembolism (VTE) for adults

DCHFT Venous thromboembolism guideline

DCHFT: Emergency reversal of anticoagulation guideline

UHD Anticoagulation Guideline (September 2020)

UHD Guideline for the Management of Non Massive Pulmonary Embolism (August 2020)

UHD Massive PE Guideline V1 (November 2019)

UHD Reducing the Risk and Management of VTE in Pregnancy (August 2020)

UHD VTE prevention guidelines (August 2020)

Direct Acting Oral Anticoagulants (DOACs) in Renal Impairment : Practice Guide To Dosing Issues

DCHFT Electronic (Publisher) version of Direct Oral Anticoagulant (DOAC) Alert Card

Medicines Q&A Can small volume intramuscular injections be given to patients taking oral anticoagulants?

Medicines Q&A Warfarin and PPI interactions

NICE Venous thromboembolism: diagnosis and anticoagulation treatment visual summary link July 2020

RBCH Electronic (publisher) version of Direct Oral Anticoagulant (DOAC) Alert Card

RBH & PFT DOAC Initiation form 2019

Response to NHS E guidance on supply of additional direct oral anticoagulants (DOACs) during COVID-19 July 2020

Stopping DOACs before procedures (2018)

02.08.02

Atrial Fibrillation

02.08.02

VTE Prophylaxis

....

Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to children's BNF
	Link to SPCs

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	CCG

Traffic Light Status Information

Status	Description
	May be initiated, stabilised and maintained in primary, secondary or tertiary care
	Amber drug - without shared care
	Amber drug - with shared care guideline
	For secondary or tertiary care initiation and long-term maintenance of prescribing
	Not recommended