LLR APC meeting Minutes June 2025(356 KB) - LMSG/LLR APC minutes
Date added: 3rd Jul 2025
| Drug Name | Classification | Clinical Indication | Comments |
|---|---|---|---|
| AMILORIDE (UPDATED) | Orange | Oedema in heart failure, reduction of hypokalaemia induced by diuretics and adjunct to other diuretics in hypertension in children |
In line with SCA: Paediatric Cardiology Medications |
| APIXABAN (NEW) | Red | Primary thromboprophylaxis in children over 2 years and adults with a Fontan circulation | |
| ASPIRIN (NEW) | Orange | Antiplatelet, used either as mono-therapy or dual-therapy with clopidogrel in children |
In line with SCA: Paediatric Cardiology Medications |
| ATENOLOL (NEW) | Orange | Hypertension & arrhythmias in children |
In line with SCA: Paediatric Cardiology Medications |
| BARICITINIB (NEW) | Red | For use in monogenic interferonopathies (adults and children 2 years and over) | |
| CAPTOPRIL (UPDATED) | Orange | For the treatment of Heart failure, Hypertension and Aortic stenosis/regurgitation in children |
In line with SCA: Paediatric Cardiology Medications |
| CARVEDILOL (NEW) | Orange | Heart failure in children |
In line with SCA: Paediatric Cardiology Medications |
| CLONIDINE ORAL (NEW) | Yellow | For Tic Disorders including: Chronic Motor Tic Disorder, Chronic Vocal Tic Disorder, Transient Tic Disorder and Tourette Syndrome. Off-label indication | |
| CLOPIDOGREL (NEW) | Orange | Antiplatelet, used either as mono-therapy or dual-therapy with aspirin in children |
In line with SCA: Paediatric Cardiology Medications |
| COAL TAR PREPARATIONS (NEW) | Green | Psoriasis |
Many formulations available, encourage self-care, if required prescribe generically: Coal Tar extract 2% shampoo |
| COAL TAR SOLUTION 12%w/w, SALICYLIC ACID 25w/w & SULFUR4%w/w (Generic cocois ointment) (NEW) | Green | Psoriasis | |
| DALTEPARIN | Green | Thromboprophylaxis and Treatment of DVT & PE |
This remains a second-line option for patients who are not suitable for enoxaparin |
| DALTEPARIN | Green | Low INR |
This remains a second-line option for patients who are not suitable for enoxaparin In line with Warfarin Guidelines for Primary Care |
| DAPAGLIFLOZIN / METFORMIN (Xigduo®) (UPDATED) | Do not prescribe | Type 2 diabetes |
Not accepted locally for use. Use individual components. |
| DIGOXIN (NEW) | Orange | Heart failure and supraventricular arrhythmias in children |
In line with SCA: Paediatric Cardiology Medications |
| DITHRANOL IN LASSAR’S PASTE (Can be made as; 0.1%w/w, 0.5%w/w, 1%w/w, 2%w/w, 4%w/w, 10%w/w and 15%w/w) (NEW) | Green | Psoriasis |
Dithranol is no longer available in ready-made applications. It is only available as a special order to be made by a pharmacist. It’s use should be restricted to patients where other preparations have been ineffective or unsuitable Treatment with dithranol should start with the lowest strength (0.1%) cream and gradually increase over about four weeks to the highest tolerated strength that produces the optimum therapeutic effect |
| DOXEPIN (NEW) | Do not prescribe | Depression |
Not accepted locally for use in depressive illness. Existing patients should be reviewed to an alternative. |
| ENALAPRIL (UPDATED) | Orange | Heart failure and hypertension in infants and children |
In line with SCA: Paediatric Cardiology Medications |
| ENOXAPARIN | Green | Low INR used in line with primary care warfarin guidance |
Prescribe by brand name INHIXA® as different brands have different injection techniques. |
| FLECAINIDE (NEW) | Orange | Arrhythmias in children |
In line with SCA: Paediatric Cardiology Medications |
| FUROSEMIDE (UPDATED) | Orange | Oedema in heart failure and hypertension in children |
In line with SCA: Paediatric Cardiology Medications |
| GUSELKUMAB (Tremfya) (NEW) | Grey | For treatment of adult patients with moderate to severely active Crohn's disease or Ulcerative Colitis | |
| LABETOLOL (NEW) | Orange | Hypertension in children |
In line with SCA: Paediatric Cardiology Medications |
| LISINOPRIL (UPDATED) | Orange | Hypertension, heart failure & aortic stenosis/regurgitation in children |
In line with SCA: Paediatric Cardiology Medications |
| LOSARTAN (UPDATED) | Orange | Hypertension and connective tissue disorders in children |
In line with SCA: Paediatric Cardiology Medications |
| MACITENTAN (Opsumit) (NEW) | Grey | For long-term treatment of pulmonary arterial hypertension in paediatric patients aged 2 years to less than 18 years with WHO Functional Class II to III | |
| MARSTACIMAB (Hympavzi®) (NEW) | Red | For treating severe haemophilia B in people 12 years and over without anti-factor antibodies |
TA supports use in haemophilia B only In line with NICE TA 1073 |
| METHYLPHENIDATE (Focusim XL) (NEW) | Do not prescribe | ADHD |
DNP (for this brand) |
| METOPROLOL (NEW) | Orange | Hypertension & Arrhythmias in children |
In line with SCA: Paediatric Cardiology Medications |
| MOLNUPIRAVIR (NEW) | Red | For Covid-19 |
In line with |
| MULTIVITAMIN AND MINERAL SUPPLEMENT (Forceval) (NEW) | Green |
Restricted for for use in gastric bypass / BPD/DS bariatric surgery on the recommendation of a dietician Restricted for for use in line with the out of hours enteral feeding tube guidelines only Restricted for micronutrient supplementation for patients with intestinal failure |
|
| NEPAFENAC (Nevanac®) | Red | Pain and inflammation post cataract surgery and Cystoid Macular Oedema in Uveitic Patients | |
| OCTEROTIDE (UPDATED) | Yellow | Vomiting in palliative care, initiation by specialist palliative care team only | |
| OCTEROTIDE (UPDATED) | Red |
Multiple indications see Formulary |
|
| PARECOXIB | Red | Single intra-operative dose for the management of acute postoperative pain. |
Only to be given to patients for whom per rectal diclofenac is not appropriate. |
| PROPRANOLOL (NEW) | Orange | Hypertension, arrhythmias & Tetralogy of Fallot in children |
In line with SCA: Paediatric Cardiology Medications |
| RELUGOLIX–ESTRADIOL–NORETHISTERONE (Ryeqo ®) (NEW) | Yellow | For treating symptoms of endometriosis |
Initial 6 month prescription via specialist team before being transferred. DEXA scan arranged by secondary care at 1 year. In line with NICE TA 1057 |
| RELUGOLIX–ESTRADIOL–NORETHISTERONE (Ryeqo ®) (UPDATED) | Yellow | For treating moderate to severe symptoms of uterine fibroids in adults of reproductive age. |
Initial 6 month prescription via specialist team before being transferred. DEXA scan arranged by secondary care at 1 year. In line with NICE TA832 |
| RIVAROXABAN (Xarelto) (NEW) | Red | Primary thromboprophylaxis in children over 2 years and adults with a Fontan circulation | |
| SOMAPACITAN (Sogroya®) (NEW) | Red | For treating severe growth hormone deficiency in people 3 to 17 years. |
In line with NICE TA 1066 |
| SPF 50+ SUNSCREEN PREPARATIONS (Anthelios) (NEW) | Green | Borderline Substance: only for patients with photosensitive disorder with widespread dysplastic lesions and/or a history of skin cancer |
Restricted Green. Patients should be encouraged to purchase sun screens OTC as per LLR Self-Care Guidelines |
| SPIRONOLACTONE (UPDATED) | Orange | Oedema in heart failure, hypertension and reduction of hypokalaemia induced by diuretics in children. |
In line with SCA: Paediatric Cardiology Medications |
| SUMATRIPTAN/NAPROXEN (Suvexx) (NEW) | Grey | Acute treatment of the headache phase of migraine attackes with or without aura in adults where treatment with a monoentity product has been insufficient | |
| TOBRAMYCIN inhalation | Red | Cystic fibrosis |
Available as nebuliser solution (Vantobra®, Bramitob®) and dry powder for inhalation (Tobi ® podhaler). |
| WARFARIN (NEW) | Orange | Anticoagulant in children |
In line with SCA: Paediatric Cardiology Medications |
Other Updates on this Website
Recent documents from LLR APC and TAS
SCA: Paediatric Cardiology Medications(264 KB)
Date added: 2nd Jul 2025
GP template Out Of Area Shared Care Request(127 KB) - Leicestershire traffic light system
Updated June 2025
Date added: 10th Dec 2021
GP template orange WRONG INDICATION(127 KB) - Leicestershire traffic light system
Updated June 2025
Date added: 10th Dec 2021
GP template GREY drug(125 KB) - Leicestershire traffic light system
Updated June 2025
Date added: 10th Dec 2021
GP template Do Not Prescribe Drug(125 KB) - Leicestershire traffic light system
Updated June 2025
Date added: 10th Dec 2021
LLR CCG’s High Cost Drugs List - Guidelines
Document retired June 2025
Date added: 24th Apr 2019
Warfarin Guidelines for Primary Care(725 KB) - Guidelines
Date added: 30th Jul 2018
GP template to decline RED drug prescribing request(125 KB) - Leicestershire traffic light system
Updated June 2025
Date added: 3rd Jun 2015
LLR Standards for Prescribing and Medicines Management at the Interface(425 KB) - Guidelines
Version 10 updated June 2025
Date added: 3rd Jun 2015
About the Leicester, Leicestershire and Rutland Area Prescribing Committee
In common with other local health communities, the Leicester, Leicestershire and Rutland Area Prescribing Committee (LLR APC) acknowledges the benefits of having a Leicestershire Health Community-wide strategy for the prescribing of specialist medicines and the managed entry of new drugs and related technologies.
Leicestershire Health Community comprises the Leicester, Leicestershire and Rutland Integrated Care Board, University Hospitals of Leicester (UHL) NHS Trust and Leicestershire Partnership NHS Trust (LPT), amongst which there is a total consensus on the need for this strategy, and the LLR APC has been in place since 2005. Learn more