Tablets 62.5 micrograms, 125 micrograms, 250 micrograms
Liquid 50 micrograms/1mL

Injection 500 micrograms/2mL 

Oral digoxin is the preferred route. Intravenous digoxin should only be used when oral route is unavailable. Digoxin has a narrow therapeutic index and can cause toxicity.

Intravenous infusion 40mg

Congestive cardiac failure.
ICU use only.

ICU use only.

Tablets 2.5mg and 1.5mg MR
First line diuretic for hypertension

Tablets 2.5mg, 5mg

Tablets 2.5mg, 5mg

Treatment of patients with chronic heart failure with resistant volume overload

Must be prescribed by brand

Use the licensed preparation for new patients

Tablets 20mg, 40mg, 500mg
Liquid 20mg/5mL, 40mg/5mL, 50mg/5mL

First line treatment

 Furosemide 500mg tablets in East Lancashire

Tablets 1mg, 5mg

 Second line treatment - Only if poor response to furosemide

Injection 

Tablets 25mg, 50mg, 100mg

Heart failure

Tablets 25mg, 50mg

Heart failure

Please see chapter 06.01.05

Intravenous infusion 10%, 15%, 20%

injection 

Ventricular arrythmias where other options have failed.
Cardiology/ICU use only.

Tablets 400mg

On advice of cardiology only

Tablets 100mg, 200mg

On advice of cardiology only

Capsules 100mg, Tablets 250mg prolonged-release

On advice of cardiology only

Tablets 50mg, 100mg

On advice of cardiology only

Tablets 150mg, 300mg

Requires specialist supervision

Injection 150mg/3mL
Injection 300mg/10mL pre-filled syringe

50mg, 100mg, 200mg (as hydrochloride)

Treatment of documented ventricular arrhythmias which, in the judgement of the physician, are considered as life-threatening.
For use by specialists in treating arrhythmias only.

Ventricular arrhythmias

For cardiology/ICU use only

Tablets 1.25mg, 2.5mg, 3.75mg, 5mg, 7.5mg, 10mg

First line

Tablets 3.125mg, 6.25mg, 12.5mg, 25mg

Second line for heart failure

Tablets 100mg, 200mg

Tablets 50mg

Not first line. Use when beta blocker with a short half life is required.

Tablets 10mg, 40mg, 80mg
M/R capsules 80mg, 160mg

Not recommended for cardiac indications

Tablets 5mg

Not first line.
Note that strengths other than 5mg are significantly more expensive.

Tablets 40mg, 80mg

For arrhythmias.
On advice of cardiology only

Injection 100mg/10mL
Infusion 2.5g in 250mL

Tablets 25mg, 50mg

Hypertension

Tablets 25mg, 50mg

Heart failure

Initiated in hospital or under specialist supervision.

Tablets 20mg

Tertiary centre only.
Sildenafil and bosentan are licensed for use in pulmonary arterial hypertension (PAH). Treatment of this condition is commissioned nationally through a small number of PAH centres based in hospitals across the UK.
All patients should be referred to one of these centres, who carry out all prescribing of these therapies.

Injection 50mg vials

  unlicensed

For specialist use only.

Tablets 125mg, 250mg, 500mg

Tablets 200micrograms, 300micrograms, 400micrograms

Reserved for use in resistant hypertension, in line with NG 136

Tablets 25 microgram 

Clonidine is considered less suitable for prescribing in hypertension

 Vasomotor symptoms (VMS) associated with menopause

Tablets 1mg, 2mg, 4mg

Doxazosin MR do not prescribe 

Capsules 10mg

Injection

 unlicensed

For theatre/ICU use only.

Tablets 5mg, 10mg

Tablets 10mg, 25mg

Capsules 1.25mg, 2.5mg, 5mg, 10mg

First line

Tablets 2.5mg, 5mg, 10mg, 20mg

First line

Tablets 2mg, 4mg, 8mg

Not first line

Perindopril ARGININE is considered ‘Not suitable for prescribing’ across the ICB.

Tablets 2.5mg, 5mg, 10mg, 20mg

Restricted to use in post natal women when used in line with NG133

Tablets 12.5mg, 25mg, 50mg, 100mg

First line

Tablets 2mg, 4mg, 8mg, 16mg, 32mg

First line

Tablets 75mg, 150mg, 300mg

film-coated tablets
24.3 mg sacubitril and 25.7 mg valsartan (as sacubitril valsartan sodium salt complex).
48.6 mg sacubitril and 51.4 mg valsartan (as sacubitril valsartan sodium salt complex).
97.2 mg sacubitril and 102.8 mg valsartan (as sacubitril valsartan sodium salt complex).

Entresto® tablets and granules contain sacubitril and valsartan in the form x/y where x and y are the strength in milligrams of sacubitril and valsartan respectively. Doses in BNF Publications are expressed as the total of both drug strengths.

tablets and capsules

Existing patients only

Tablets 10mg, 20mg
M/R tablets 60mg
LA capsules 25mg, 50mg

Aerosol spray 400micrograms/dose
Patches 5mg/24h, 10mg/24h

Patches should only be considered in patients unable to comply with or tolerate oral isosorbide mononitrate.

Infusion

Tablets 5mg, 10mg

First line dihydropyridine

M/R tablets 2.5mg, 5mg, 10mg 

Tablets 10mg, 20mg

A second line dihydropyridine calcium channel blocker when amlodipine is not tolerated (e.g. where patients develop significant ankle oedema)

A second line dihydropyridine calcium channel blocker when amlodipine is not tolerated (e.g. where patients develop significant ankle oedema).

For existing patients only

Tablets 30mg
Intravenous infusion 10mg/50mL

Prevention and treatment of ischaemia following subarachnoid haemorrhage

For use only within licensed indications following aneurysmal subarachnoid haemorrhage.

Tablets 40mg, 80mg, 120mg
M/R tablets 120mg, 240mg
Liquid 40mg/5mL

Prescribe diltiazem modified-release preperations by brand name. Different hospital Trusts may stock different brands. Follow local Trust policy regarding brand switches.

Injection 10mg/10mL

Specialist use only

Tablets 10mg, 20mg

Alternative following first line anti-anginal agents as per CG126 Stable angina: management

M/R tablets 375mg, 500mg, 750mg

Restricted to use in line with NICE CG126 Stable angina: management

Tablets 5mg, 7.5mg

Capsules 100mg

Raynauds

Specialist use only

Pulmonary hypertension

For use by specialist centres only.
NHSE commissioned

Tablets 25mg

Digital ulceration

Unlicensed indication - Specialist initiation only

Injection 500micrograms

 Restricted drug - specialist initiation only.
  Unlicensed use.
NHSE commissioned for digital ulcers and pulmonary arterial hypertension

Infusion

Injection

 unlicensed

Tablets 2.5mg, 5mg

Postural hypotension

For theatre/ICU use only

50mg/50ml vials for infusion

250mg/2.5ml concentrate vials for infusion

Injection 1000units/1mL, 10 000units/10mL, 20 000units/20mL

Refer to local guidance

Care when prescribing/selecting strength of syringes - Different strengths available. 

Refer to local guidance

Due to the differences in injectable device, all enoxaparin prescribing should be by brand name.
Switching between brands should be as a last resort after full training in the use of the new device has taken place.
Care when prescribing/selecting strength of syringes - Different strengths available.

Refer to local guidance

Care when prescribing/selecting strength of syringes - Different strengths available

Anticoagulation where standard options are contra-indicated.
Use only following haematologist advice.

Flush 50units/5mL

Arterial line patency. ICU use only.

Specialist use.
NHSE commissioned drug for digital ulcers and pulmonary arterial hypertension.

Infusion 250mg

Injection 1.5mg in 0.3mL, 2.5mg in 0.5mL, 5mg in 0.4mL, 7.5mg in 0.6mL, 10mg in 0.8mL

tablets 15mg, 30mg, 60mg
 
Edoxaban for preventing stroke and systemic embolism in people with non-valvular atrial fibrillation (NICE TA355)

Edoxaban for treating and for preventing deep vein thrombosis and pulmonary embolism (NICE TA354)   ( East Lancashire only, for this indication)

Tablets 2.5mg, 10mg, 15mg, 20mg

  Rivaroxaban for the prevention of stroke and systemic embolism in people with atrial fibrillation (NICE TA256)
 
Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults (NICE TA 170)

Rivaroxaban for preventing adverse outcomes after acute management of acute coronary syndrome (NICE TA335) ( East Lancashire only, for this indication)

Rivaroxaban for the treatment of deep vein thrombosis and prevention of recurrent deep vein thrombosis and pulmonary embolism (NICE TA261)  ( East Lancashire only, for this indication)

Rivaroxaban for treating pulmonary embolism and preventing recurrent venous thromboembolism (NICE TA287)  ( East Lancashire only, for this indication)

 *10mg tablets* Treatment of DVT and PE, and extended prevention of recurrent DVT and PE in adults

Tablets 2.5mg, 5mg

  Apixaban for preventing stroke and systemic embolism in people with non-valvular atrial fibrillation (NICE TA275)

Apixaban for the prevention of venous thromboembolism after total hip or knee replacement in adults (NICE TA245)

Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism (NICE TA341)

Capsules 110mg, 150mg

Dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation (NICE TA249)

Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee replacement surgery in adults (NICE TA157)

  Dabigatran etexilate for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism (NICE TA327)   ( East Lancashire only, for this indication)

Tablets 2.5mg

Prevention of cardiac events in patients with coronary (CAD) or peripheral artery Disease (PAD)

  East Lancashire only

Tablets 1mg, 3mg, 5mg

Treatment of venous thromboembolism

Prevention of stroke and systemic embolism in non-valvular atrial fibrillation

Tablets 1mg

Second line vitamin K antagonist

Powder for solution for infusion 200mg

Solution for injection/infusion 2.5 g/50 mL

Rapid reversal of anticoagulant effects of dabigatran  

Injection 50mg/5mL

Dispersible tablets 75mg, 300mg

The use of enteric coated aspirin 75mg is not recommended

Tablets 25mg, 100mg
M/R capsules 200mg

Tablets 5mg, 10mg

Tablets 60mg, 90mg

Acute ischaemic stroke (NICE TA264)

Follow local policy

Follow local policy

Injection 

Acute myocardial infarction - TA52

Acute ischaemic stroke - TA990

Follow local policy

Injection

Follow local policy

Tablets 10mg, 20mg, 40mg, 80mg

First line

Tablets 10mg, 20mg, 40mg

Tablets 5mg, 10mg, 20mg

Tablets 10mg, 20mg, 40mg

Pravastatin is restricted to use in patients who cannot tolerate other statins.

Powder 4g/sachet

Lipids

Tablets 625 mg

Cardiovascular Disease prevention in hyperlipidaemia when the patient is intolerant of all other options.

Tablets 10mg

Tablets 200mg
M/R tablets 400mg

Capsules (micronised) 200mg, 267mg
Tablets (micronised) 160mg

Pre-filled pen 75mg, 150mg

Pre-filled pen 140mg

primary hypercholesterolaemia or mixed dyslipidaemia in adults as per NICE TA394

Prevention of cardiac events in patients with CHD and a history of ACS, in combination with a statin

Tablets 180mg

As monotherapy for patients intolerant to ezetimibe

Tablets 180mg/10mg

Soft capsules 998 mg 

Pre-filled syringe 284mg/1.5ml

3%, 1%, 0.5%, 0.2% Solution for Injection