Recent Decisions

1st October 2024
Roc Total Sunblock® removed from the Joint Formulary (no longer available). Replaced with Anthelios® as the recommended preparation and Uvistat® as an alternative (section 13.8.1).

29th August 2024
Lebrikizumab added as a 'red' drug for severe atopic dermatitis, as per NICE TA986 (section 13.5.3.2).
Ivacaftor–tezacaftor–elexacaftor (Kaftrio®), Lumacaftor–ivacaftor (Orkambi®), and Tezacaftor–ivacaftor (Symkevi®) added as 'red' drugs for cystic fibrosis, as per NICE TA988 (section 3.12).
Etranacogene dezaparvovec added as a 'red' drug for severe heamophilia B, as per NICE TA989 (section 9.1.3.5).
Tenecteplase added as a 'red' drug for stroke thrombolysis, as per NICE TA990 (section 2.10.1).
Abaloparatide added as a 'red' drug for post-menopause osteoporosis, as per NICE TA991 (section 6.6.1).
Burosumab added as a 'red' drug for X-linked hypophosphataemia, as per NICE TA993 (section 6.6.1.1).

2nd August 2024
Valproate entries switched to generic (chapter 4). Specialists must clearly communicate if patients are required to remain on a particular brand.
Atogepant classified as 'yellow' (section 4.7.5.2).
Recommendation to prescribe immediate release venlafaxine over modified release removed, and recommendation to use MR tablets over MR capsules removed (section 4.3.4).
Letrozole added as a 'yellow' drug for infertility (section 6.5.1.1).

11th July 2024
Valupak Vitamin D3 1,000iu added as the preparation of choice in Primary Care (section 9.5.4.2)

1st July 2024
Voxeletor added as a 'red' drug for treating haemolytic anaemia caused by sickle cell disease, as per NICE TA981 (section 9.1.3.4)
Tafamidis added as a 'red' drug for treating transthyretin amyloidosis with cardiomyopathy, as per NICE TA984 (section 2.14)

26th June 2024
SunSense range of sunscreen preparations removed as no longer available (section 13.8.1)

24th June 2024
Orabase® paste removed as this is no longer available (section 12.3.1)

20th June 2024
Dry Eye Guideline updated (section 11.8.1)

4th June 2024
Atogepant added (RAG status to be agreed) for prevention of migraine, as per NICE TA973 (section 4.7.5.2)
Setmelanotide added as a 'red' drug for obesity and hyperphagia in Bardet-Biedl syndrome, as per NICE HST31 (section 4.5)

13th May 2024
Ritlecitinib added as a 'red' drug for severe alopecia areata, as per NICE TA958 (section 13.4)

9th May 2024
Desitrend® specified as the brand of choice for levetiracetam granules (section 4.8.1.3)
Otigo® ear drops (lidocaine hydrochloride 40mg/g, phenazone 10mg/g) added (section 12.1.2)

25th April 2024
Dapagliflozin and empagliflozin reclassified from 'amber' to 'yellow' when used for heart failure (section 2.14)

19th March 2024
Diabetic macular oedema added as an indication for fluocinolone intravitreal implant, as per NICE TA953 (section 11.4.2)
Etrasimod added as a 'red' drug for ulcerative colitis, as per NICE TA956 (section 1.5.3.1

18th March 2024
Klean-Prep® removed as discontinued (section 1.6.5)

29th February 2024
Cytisine added as a 'green' drug for smoking cessation (section 4.10.2)
Prescribing guidance for daridorexant added (section 4.1.1.3)

16th February 2024
Ceyesto® and Slenyto® added as 'amber' drugs (section 4.1.1.2)

6th February 2024
Sebelipase alfa added as a 'red' drug, as per NICE HST30 (section 9.3)

2nd February 2024
Semaglutide tablets reclassified from 'amber' to 'green' while injections unavailable (section 6.1.2.6)
Tirzepatide classified as a 'green' drug (section 6.1.2.6)

19th January 2024
Insupen Original needles replaced Omnican needles (section 6.1.1.1)

10th January 2024
Gynest® replaced with generic Estriol 0.01% cream (section 7.2.1)

5th January 2024
Hidradenitis suppurativa added as an indication for secukinumab, as per NICE TA935 (section 13.14)
Targeted-release budesonide added as a 'red' drug for primary IgA nephropathy, as per NICE TA937 (section 8.2.2)
Chronic kidney disease added as an indication for empagliflozin, as per NICE TA942 (section 6.1.2.5)
Velmanase alfa added as a 'red' drug for alpha-mannosidosis, as per NICE HST29 (section 9.3)

5th December 2023
Caphosol added as a 'red' drug for prevention of mucositis secondary to Radiotherapy (section 12.3.1)

1st December 2023
Multiple Sclerosis section added - all 'red' drugs (section 8.2.1).

24th November 2023
New 'yellow' category added to the Joint Formulary. 'Yellow' drugs should only be initiated / advised by a Specialist, but ongoing prescribing may be transferred to Primary Care. Unlike 'amber' drugs, a Shared Care Guideline is not required.

30th October 2023
Sitagliptin moved to first-line DDP4 inhibitor, alogliptin moved to second-line (section 6.1.2.4)

9th October 2023
Mavacamten added as a 'red' drug (section 2.14)
Bimekizumab added as a 'red' drug (section 10.1.3.5)
Pegunigalsidase alfa added as a 'red' drug (section 9.3)
Birch bark extract (Filsuvez® gel) added as a 'red' drug (section 13.14)

27th September 2023
Aerobika® added as an 'amber' device (section 3.7.2)
Ciprofloxacin 0.2% ear drops re-classified from 'red' to 'green' (section 12.1.1.1)

25th September 2023
Lixisenatide removed following product withdrawal (section 6.1.2.6)
Mefenamic acid added as a 'green' drug for dysmenorrhoea / menorrhagia (section 10.1.1.1)

29th August 2023
Rimegepant added as an 'amber' drug for migraine prevention, as per NICE TA906 (section 4.7.5.2)
Cipaglucosidase alfa added as a 'red' drug for treating late-onset Pompe disease, as per NICE TA912 (section 9.3)

30th June 2023
Chronic heart failure with preserved or mildly impaired ejection fraction added as an indication for dapagliflozin 'amber' (section 2.14)
Crohn's disease added as an indication for upadacitinib 'red' (section 1.5.3.1)
Deucravacitinib added as a 'red' drug for psoriasis (section 13.5.3.2)

28th June 2023
Magnesium citrate (4mmol / 93mg) tablets added as a green drug (section 9.2.4)

6th June 2023
Cangrelor added as a 'red' drug for primary PCI where oral route unavailable (section 2.9)

30th May 2023
Tezepelumab added as a 'red' drug for severe asthma, as per NICE TA880 (section 3.4.1.3)
Risankizumab added as a 'red' drug for Crohn's disease, as per NICE TA888 (section 1.5.3.1)
Difelikefalin added as a 'red' drug for pruritus in patients having haemodialysis (section 4.12.3)

10th May 2023
Dexcom ONE continuous glucose monitoring system added (section 6.1.6.2)

5th May 2023
Fusion Allergy® nasal spray (ectoin 2%) added as a red drug for allergic rhinitis - red classification until listed in Drug Tariff (section 12.2.1.4)

26th April 2023
Trifarotene cream (Aklief®) added as a 'green' drug for papulopustular acne (section13.6.2)

3rd April 2023
Semaglutide (Wegovy®) added as a 'red' drug for obesity, as per NICE TA875 (section 4.5)

29th March 2023
Finerenone added as a 'red' drug pending shared care guideline, as per NICE TA877 (section 2.2.3)
Relugolix–estradiol–norethisterone acetate classified as 'amber without shared care guideline' (section 6.7.2.1)
Somatrogon classified as 'red' (section 6.5.1.4)
Feraccru® (ferric maltol) added as a 'red' drug (section 9.1.1.1)

16th March 2023
Normacol® (sterculia) removed as discontinued (section 1.6.1)

10th March 2023
Phyllocontin® (aminophylline tablets) removed as discontinued (section 3.1.3)
Famotidine has replaced ranitidine as the H2-receptor antagonist of choice while ranitidine unavailable (section 1.3.1)

3rd March 2023
Somatrogon added for growth disturbance as per NICE TA863 (Formulary classification pending - section 6.5.1.4)
Non-radiographic axial spondyloarthritis added as an indictation for upadacitinib as per NICE TA861 (section 10.1.3.5)
Eptinezumab added as a 'red' drug for preventing migraine as per NICE TA871 (section 4.7.5.2)
Cannabidiol indication extended to include treating seizures caused by tuberous sclerosis complex, as per NICE TA873 (section 4.8.1.3)
Vutrisiran added as a 'red' drug for treating hereditary transthyretin-related amyloidosis, as per NICE TA868 (section 4.12.2)

31st January 2023
Lofexidine moved from 'amber' to 'red' (section 4.10.3)

9th January 2023
Chronic immune thrombocytopenia added as an indication for avatrombopag, as per NICE TA853 (section 9.1.4)
Upadacitinib added as a 'red' drug for severe ulcerative colitis, as per NICE TA856 (section 1.5.3.1)

21st December 2022
Amisulpride switched from 'amber' to 'green' (section 4.2.1)
Cariprazine switched from 'red' to 'amber' (section 4.2.1)
Paliperidone palmitate long acting injection switched from 'red' to 'amber' (section 4.2.2)
Migril® removed as no longer available (section 4.7.5.1)

16th December 2022
Tapentadol MR switched from 'red' to 'amber' (section 4.7.3)

1st November 2022
Relugolix–estradiol–norethisterone acetate added for uterine fibroids as per NICE TA832 (section 6.7.2.1) - awaiting RAG classification.
Fostamatinib added as a 'red' drug for refractory chronic immune thrombocytopenia (section 9.1.4)

26th October 2022
Gloucestershire Wound Management Formulary updated (section 17)

6th October 2022
Naloxone (Prenoxad®) 2mg/2ml injection has been added as a 'red' drug to be issued to those at risk of opioid overdose (or their carers) who have demonstrated an awareness and understanding of the naloxone supply and related training programme (section 4.10.3)
Actimorph® orodispersible tablets added as an immediate-release morphine alternative to Oramorph® (section 4.7.3)
Adaflex® added as the immediate-release melatonin preparation of choice (section 4.1.1)

5th October 2022
Ozanimod added as a 'red' drug for ulcerative colitis, as per NICE TA828 (section 1.5.3.1)

4th October 2022
Guanfacine switched from 'red' to 'amber' with Shared Care Guideline (section 4.4)
Brivarecetam switched from 'red' to 'amber' (section 4.8.1.3)
Isocarboxazid, moclobemide, and phenelzine switched from 'red' to 'amber' with Shared Care Guideline (section 4.3.2)
Ankylosing spondylitis added as an indication for upadacitinib, as per NICE TA829 (section 10.1.3.5)
Avacopan added as a 'red' drug for granulomatosis with polyangiitis or microscopic polyangiitis, as per NICE TA825 (section 10.1.3.5)

9th September 2022
Faricimab added as a 'red' drug for wetAMD and diabetic macular oedema as per NICE TA799 & 800 (section 11.8.2)
Risankizumab added as a 'red' drug for psoriatic arthritis as per NICE TA803 (section 10.1.3.5)
Teduglutide added as a 'red' drug for short bowel syndrome as per NICE TA804 (section 1.4.2)
Icosapent ethyl added as a 'green' drug for reducing cardiovascular events in people with raised triglycerides as per NICE TA805 (section 2.12.4)
Roxadustat added as a 'red' drug for anaemia in chronic kidney disease as per NICE TA807 (section 9.1.3.1)
Fenfluramine added as a 'red' drug for Dravet Syndrome as per NICE TA808 (section 4.8.1.3)
Abrocitinib, tralokinumab, and upadacitinib added as 'red' drugs for atopic dermatitis as per NICE TA814 (section 13.5.3.2)
Guselkumab added as a 'red' drug for psoriatic arthritis as per NICE TA815 (section 10.1.3.5)
Brolucizumab added as a 'red' drug for diabetic macular oedema as per NICE TA820 (section 11.8.2)
Avalglucosidase alfa added as a 'red' drug for Pompe Disease as per NICE TA821 (section 9.7)
Elosulfase alfa added as a 'red' drug for mucopolysaccharidosis type 4A as per HST19 (section 9.6)
Setmelanotide added as a 'red' drug for obesity caused by LEPR or POMC deficiency as per HST21 (section 6.7.5)

8th September 2022
Sodium zirconium cyclosilicate switched from 'red' to 'amber' with Shared Care Guideline (section 9.2.6.2)
Sodium picosulfate oral solution added (section 1.6.2)

7th September 2022
Tirbanibulin switched from 'red' to 'green' (section 13.8.2)
Paracoxib added as an 'amber' drug for Palliative care use (section 10.1.1.1)

5th July 2022
Pridinol added as a 'red' drug for central and peripheral muscle spasms: lumbar pain, torticollis, general muscle pain, in adults where diazepam is not suitable (section 10.2.2)
Stiripentol added as a 'red' drug for severe myoclonic epilepsy in infancy (SMEI, Dravet's syndrome) where seizures are not adequately controlled with clobazam and valproate (section 4.1.8.3).

24th June 2022
Link to Primary Care Oral Nutritional Supplements added (section 9.4.2)

1st June 2022
Romosozumab added as a 'red' drug for severe osteoporosis, as per NICE TA791 (section 6.6.1.1)
Filgotinib added as a 'red' drug for ulcerative colitis, as per NICE TA792 (section

16th May 2022
Blood Glucose Testing Strips updated (section 6.1.6.2)

8th April 2022
Oral anticoagulant section updated (section 2.8.2 and 2.8.3). Edoxaban is now the DOAC of choice for non-valvular AF (NVAF).

31st March 2022
Avatrombopag added as a 'red' drug for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure, as per NICE TA626 (section 9.1.4)
Chronic kidney disease added as an indication for dapagliflozin, as per NICE TA775 (section 6.1.2.5)

30th March 2022
Tirbanibulin added as a 'red' drug (pending primary care review) for actinic keratosis (section 13.8.2)
Luforbec® 100/6 MDI added to replace Fostair®100/6 MDI (sections 3.2.3.1 & 3.2.3.1)

29th March 2022
FreeStyle Libre Sensor added for restricted use in line with Gloucestershire Prescribing Guidance (section 6.1.6.2)

25th March 2022
Semaglutide tablets added as an 'amber' drug where subcutaneous GLP1 agonists are unsuitable (section 6.1.2.6)

7th February 2022
Bempedoic acid reclassified as a 'green' drug (from amber) as per the Gloucestershire Secondary Prevention Lipid Mangagement Pathway (section 2.12.4)

31st January 2022
Antipsychotics section updated (sections 4.2.1 & 4.2.2)

28th January 2022
Opicapone re-classified from 'red' to 'amber' (section 4.9.1.4)

19th January 2022
Brivaracetam added as a 'red' drug for epilepsy (section 4.8.1.3)

5th January 2022
Solriamfetol added as an 'amber' drug for narcolepsy, as per NICE TA758 (section 4.4)
Dupilumab added as a 'red' drug for severe asthma, as per NICE TA751 (section 3.4.1.3)
Cenobamate added as a 'red' drug for focal onset seizures, as per NICE TA753 (section 4.8.1.3)
Risdiplam added as a 'red' drug for spinal muscular atrophy, as per NICE TA755 (section 10.2.1)
Onasemnogene abeparvovec added as a 'red' drug for spinal muscular atrophy, as per NICE HST15 (section 10.2.1)
Givosiran added as a 'red' drug for acute hepatic porphyria, as per NICE HST16 (section 9.3.1)

3rd December 2021
Crizanlizumab added as a 'red' drug for preventing sickle cell crises, as per NICE TA743 (section 9.1.3.4)
Mexiletine added as a 'red' drug for treating symptoms of myotonia in non-dystrophic myotonic disorders, as per NICE TA748 (section 4.12.1)

10th November 2021
Inclisiran added as a treatment for primary hypercholesterolaemia or mixed dyslipidaemia in patients with a history of CVD and an LDL-C persistently 2.6mmol/l or more despite maximum tolerated lipid-lowering therapy, as per NICE TA733 (section 2.12.4)
Secukinumab psoriasis indication expanded to include children and young people, as per NICE TA734 (section 13.5.3.2)
Tofacitinib indication expanded to include juvenile idiopathic arthritis, as per NICE TA735 (section 10.1.3.5)
Berotralstat added as a 'red' drug for prevention of recurrent attacks of hereditary angioedema, as per NICE TA738 (section 3.4.2.2)
Apalutamide added as a 'red' drug for prostate cancer, as per NICE TA740 and NICE TA741 (section 8.3.4.3)

14th October 2021
Nordimet® (methotrexate pre-filled pen) added as an alternative to Metoject® for children with needle phobia (section 10.1.3.4)

5th October 2021
Erectile dysfunction guideline uploaded to section 7.5.1)

1st October 2021
Saprpterin added as a 'red' drug for treating hyperphenylalaninaemia in phenylketonuria, as per NICE TA729 (section 9.4.1)

29th September 2021
Accu-Check Instant blood glucose test strips added for use in Paediatrics (section 6.1.6.2)
4SURE Smart Duo blood glucose / ketones meter added for use in Type 1 Diabetes where blood ketone monitoring is required as part of 'sick day rules' (section 6.1.6.3)

16th September 2021
Liraglutide added as an 'amber' drug for T2DM in children aged 10 years or over (section 6.1.2.6)

6th September 2021
Psoriatic arthritis added as an indication for guselkumab, as per NICE TA711 (section 10.1.3.5)
Enzlutamide added as a 'red' drug for treating hormone-sensitive metastatic prostate cancer, as per NICE TA712 (section 8.3.4.3)
Moderate rheumatoid arthritis added as an indication for adalimumab, etanercept and infliximab, as per NICE TA715 (section 10.1.3.5)
Axial spondyloarthritis added as an indication for ixekizumab, as per NICE TA718 (section 10.1.3.5)
Non-radiographic axial spondyloarthritis added as an indication for secukinumab, as per NICE TA719 (section 10.1.3.5)
Abiraterone indications extended to include newly diagnosed high-risk hormone-sensitive metastatic prostate cancer, as per NICE TA721 (section 8.3.4.3)
Bimekizumab added as a 'red' drug for moderate to severe plaque psoriasis (section 13.5.3.2)

25th August 2021
Alfentanil injection added as an 'amber' drug restricted to Palliative Care where eGFR < 30 (section 4.7.3)
Idarucizumab injection added as a 'red' drug for the reversal of dabigatran in life-threatening bleeding (section 2.8.3)

5th July 2021
Sialanar® (glycopyrronium bromide oral solution) approved for symptomatic treatment of severe sialorrhoea (section 1.3.2)

28th June 2021
Volanesorsen added as a 'red' drug for familial chylomicronaemia syndrome, as per NICE HST13 (section 2.12.4)
Metreleptin added as a 'red' for treating lipodystrophy, as per NICE HST14 (section 6.7.4)
Bempedoic acid moved from 'red' to 'amber' (section 2.12.4)
Andexanet alfa added as a 'red' drug for reversal of apixaban or rivaroxaban in adults with life-threatening or uncontrolled G.I. bleeding, as per NICE TA697 (section 2.8.3)
Ravulizumab added as a 'red' drug for paroxysmal nocturnal haemoglobinuria, as per NICE TA698, and atypical haemolytic uraemic syndrome, as per NICE TA710 (section 9.1.3.3)
Jorveza® added as a 'red' drug for eosinophilic oesophagitis, as per NICE TA708 (section 1.5.2)

5th May 2021
Severe rheumatoid arthritis biologics pathway added (section 10.1.3.5)

30th April 2021
Anakinra added as a 'red' drug for Still's disease, as per NICE TA685 (section 10.1.3.5)
Bempedoic acid added as a 'red' drug for hypercholesterolaemia when statins are unsuitable and ezetimibe monotherapy is insufficient, as per NICE TA694 (section 2.12.4)

29th April 2021
Cortiment® (budesonide MR) has replaced Clipper® (beclometasone MR) as a 'red' drug for the treatment of acute flares of mild to moderate UC in patients who have a severe intolerance to systemic corticosteroids (section 1.5.2)

8th April 2021
Asthma and COPD inhaler guidelines updated (chapter 3)

30th March 2021
Semaglutide entry amended to specify injection (tablets have not yet been evaluated for Gloucestershire Joint Formulary - section 6.1.2.6)

DOAC entries updated to remove promotion of rivaroxaban over other DOACs (section 2.8.2)

16th March 2021
Baricitinib added as a 'red' drug for atopic dermatitis, as per NICE TA681 (section 13.5.3.2)
Erenumab added as a 'red' drug for migraine prevention, as per NICE TA682 (section 4.7.5.2)

4th March 2021
Bevacizumab (intravitreal injection) added as a 'red' drug for wet age-related macular degeneration (section 11.8.2)

26th February 2021
Upadacitinib added as a 'red' drug for rheumatoid arthritis, as per NICE TA665 (section 10.1.3.5)
Caplacizumab added as a 'red' drug for acute acquired thrombotic thrombocytopenic purpura, as per NICE TA667 (section 9.1.4)
Filgotinib added as a 'red' drug for rheumatoid arthritis, as per NICE TA676 (section 10.1.3.5)
Dapagliflozin added as an 'amber' drug for chronic heart failure with reduced ejection fraction, as per NICE TA679 (section 2.14)
Brolucizumab added as a 'red' drug for wet age-related macular degeneration, as per NICE TA672 (section 11.8.2)

4th February 2021
Sulfinpyrazone removed (no longer available) and replaced with benzbromarone as a 'red' drug for gout prophylaxis (section 10.1.4.2)

3rd February 2021
Section 9.2 (Fluids and Electrolytes) and 9.3 (Metabolic Disorders) added to the Joint Formulary
Solifenacin moved from second-line to first-line (alongside standard-release tolterodine) for urinary incontinence (section 7.4.2)

29th January 2021
Saxenda® (liraglutide) added as a 'red' drug for obesity, as per NICE TA664 (section 4.5)
Upadacitinib added as a 'red' drug for severe rheumatoid arthritis, as per NICE TA665 (section 10.1.3.5)
Caplacizumab added as a 'red' drug for acute acquired thrombotic thrombocytopenic purpura, as per NICE TA667 (section 9.1.4)

8th January 2021
Osteoporosis Guideline updated (section 6.6)

16th December 2020
Section 9.1 (Anaemias and some other blood disorders) added to the Joint Formulary

11th December 2020
Dry Eye Syndromes Guideline / Formulary updated (section 11.8.1)

3rd December 2020
Asilone removed as discontinued (section 1.1.1)
Tripotassium dicitratobismuthate removed as discontinued (section 1.3.3)

1st December 2020
Cilodex® (ciprofloxacin 0.3% and dexamethasone 0.1%) ear drops added for acute otitis externa to replace the off-label use of eyedrops (section 12.1.1.2)

27th November 2020
Pramipexole added as an 'amber' drug with preference to prescribe the MR version as Pipexus® (section 4.9.1.1)

Sativex® oromucosal spray added as a 'red' drug (section 10.2.2)

26th November 2020
Naldemedine for opioid induce constipation added, as per NICE TA651 (section 1.6.6)
Galcanezumab for migraine prevention added as a 'red' drug, as per NICE TA659 (section 4.7.5.2)

9th November 2020
Perioperative guidance regarding metformin updated (section 6.1.2.2)

30th October 2020
Gloucestershire Continence and Urology Products Formulary and Continence Passport uploaded.

9th October 2020
Vagifem® removed as the Formulary choice of estradiol 10mcg vaginal tablet now alternative options (e.g. Vagirux®) are more cost effective (section 7.2.1)

2nd September 2020
Mydriasert (tropicamide / phenylephrine ophthalmic insert) added as a 'red' drug (section 11.5.2)

21st July 2020
Rivastigmine patches switched from 'amber' to 'green' (section 4.11)

20th July 2020
Verkazia® (ciclosporin 1mg/ml) eye drops added as a 'red' drug for the treatment of severe vernal keratoconjunctivitis (VKC) in children from 4 years of age and adolescents (section 11.8.3)

3rd July 2020
Chloroprocaine (Ampres®) added as a 'red' drug (section 15.2.3)

1st July 2020
Fremanezumab added as a 'red' drug for migraine prevention as per NICE TA631 (section 4.7.5.2)
Ulcerative colitis added as an indication for ustekinumab as per NICE TA633 (section 1.5.3.1)
Voretigene neparvovec added as a 'red' drug for inherited retinal dystrophies caused by RPE65 gene mutations, as per NICE HST11 (section 11.8.3)

27th May 2020
Ulipristal acetate 5mg (Esmya®) removed following MHRA recall (section 6.4.1.6)

6th March 2020
Pentosan polysulfate sodium added as a 'red' drug for bladder pain syndrome, as per NICE TA610 (section 7.4.3)
Cannabidiol (Epydiolex®) added as a 'red' drug for Dravet and Lennox-Gastaut syndromes, as per NICE TA614 and NICE TA615 (section 4.8.1.3)
Sotagliflozin added as an 'amber' drug for type 1 diabetes in combination with insulin, as per NICE TA622 (section 6.1.2.5)

25th February 2020
Methyl-5-aminolevulinate cream (Metvix®) added as a 'red' drug for Dermatology use (section 13.8.2)

4th February 2020
Eslicarbazepine as an 'amber' drug for the treatment of epilepsy (section 4.8.1.3)

27th January 2020
Ingenol mebutate (Picato®) gel removed. Marketing Authorisation suspended pending investigations regarding safety (section 13.8.2)

27th December 2019
Retigabine removed (discontinued) section 4.8.1.3

19th December 2019
Over active bladder Formulary updated as follows (section 7.4.2)
Solifenacin has replaced tolterodine MR as a second-line option (first-line where compliance significantly improved by once-daily administration)
Oxybutynin tablets, tolterodine MR, and trospium MR have been removed.
Penthrox® added as a 'red' drug for use in ED only (section 15.1.2)
Mydrane® added as a 'red' drug restricted for patients where mydriasis is inadequate with topical therapy prior to cataract surgery (section 11.5)

29th November 2019
GlucoRx Safety Pen Needles added for use by district / community nurse use (section 6.1.1.1)

28th November 2019
Olopatadine eye drops added as a second-line option when OTC sodium cromoglicate is ineffective (section 11.4.3)
Ketofall® eye drops added as a third-line option when OTC sodium cromoglicate is ineffective and the patient has a documented preservative allergy (section 11.4.3)
Escitalopram added as a second-line SSRI option when citalopram is not tolerated (section 4.3.3)
Eplerenone switched from amber to green as a second-line option for heart failure patients when spironolactone is not tolerated (section 2.2.3)
Bunov® has replaced Butec® as the weekly buprenorphine transdermal patch of choice (section 4.7.3)

15th November 2019
Fencino®, Mezolar® and Matrifen® specified as the lower cost fentanyl patches of choice where a patch is definitely required (section 4.7.3)

8th November 2019
Chronic sialorrhoea added as an indication for Xeomin (botulinum neurotoxin type A) as per NICE TA605 (section 4.9.3.1)
Lanadelumab added for preventing recurrent attacks of hereditary angioedema, as per NICE TA606 (section 3.4.2.2)
Prevention of atherothrombotic events in people with coronary or peripheral artery disease added as an indication for rivaroxaban, as per NICE TA607 (section 2.8.2)

6th November 2019
Testavan® 20mg/g transdermal gel has replaced Tostran® 2% gel as the transdermal testosterone of choice (section 6.4.2.1)

19th September 2019
Risankizumab added for moderate to severe plaque psoriasis, as per NICE TA596 (section 13.5.3.2)

16th September 2019
Hydrocortisone 10mg tablets to be prescribed as Hydventia brand (section 6.3.1)

6th September 2019
Emollient Formulary updated (section 13.2)
Psoriasis biologics pathway added (section 13.5.3.2)
Inflammatory Bowel Disease (IBD) biologics pathway added (section 1.5.3.1)

28th August 2019
Loteprednol 0.5% eye drops approved as a 'red' drug for restricted use in post-operative patients (section 11.4.1)

13th August 2019
Aliskiren removed following publication of NHS Clinical Commissioners document: Items which should not routinely be prescribed in primary care: Guidance for CCGs Version 2, June 2019

31st May 2019
Psoriasis added as an indication for certolizumab as per NICE TA574 (section 13.5.3.2)
Tildrakizumab added as an option for the treatment of psoriasis as per NICE TA575 (section 13.5.3.2)

29th May 2019
Insulin Formulary updated (section 6.1.1)
Summary of changes:

• Semglee® has replaced Abasaglar® as the long-acting analogue insulin of choice (pre-filled pens only)
• Insulin Lispro Sanofi® has replaced Apidra® as the short-acting insulin of choice
• Insuman Comb 25® has replaced Humulin M3® as the biphasic human insulin of choice
• Insuman Basal® has replaced Humulin I® as the long-acting human insulin of choice

3rd May 2019
Wound Management Formulary added

5th April 2019
Opicapone added as a 'red' drug second-line to entacapone (section 4.9.1.4)
Guanfacine added as a 'red' drug second-line to atomoxetine (section 4.4)

1st April 2019
Ertugliflozin (SGLT2 inhibitor) added, as per NICE TA572 (section 6.1.2.5)

19th March 2019
SLS requirements for erectile dysfunction updated and generic tadalafil added for PRN use only (section 7.5.1)
Benralizumab added as a 'red' drug for severe eosinophilic asthma, as per NICE TA565 (section 3.4.1.3)

7th March 2019
Lubiprostone removed following manufacturer's discontinuation (section 1.6.7).

31st January 2019
Semaglutide added a the weekly GLP-1 agonist of choice (section 6.1.2.6)
Kyleena® added to replace Jaydess® as the low-dose levonorgestrel IUS of choice (section 7.3.5)

29th January 2019
Donepezil, galantamine, rivastigmine capsules, and memantine switched from 'amber' to 'green' drugs (section 4.11)

28th December 2018
Insulin Lispro Sanofi® added to the list of 'alternative' insulin preparations on the Insulin Formulary

30th November 2018
Flexitol® skin and heel balm (urea 12.5% and 25% respectively) added as an alternative to salicylic 2% ointment where a cream base would be better tolerated, and first-line ahead of unlicensed salicylic acid 5% and 10% preparations (section 13.2.4.5)

29th November 2018
Psoriatic arthritis added as an indication for tofacitinib as per NICE TA543 (section 10.1.3.5)
Ulcerative colitis added as an indication for tofacitinib as per NICE TA547 (section 1.5.3.1)

23rd October 2018
Combisal added to replace Sereflo and AirFluSal as the fluticasone/salmeterol MDI of choice (section 3.2.3.1)

15th October 2018
Naloxegol switched from 'red' to 'green' . Prucalopride and lubiprostone switched from 'amber' to 'green' (section 1.6).

10th September 2018
Xaggitin XL specified as the preferred brand of methylphenidate MR (section 4.4)

17th August 2018
Ixekizumab added as a 'red' drug for psoriatic arthritis, as per NICE TA537 (section 10.1.3.5)
Dupilumab added as a 'red' drug for atopic dermatitis, as per NICE TA534 (section 13.5.3.2)

25th July 2018
Noqdirna® (desmopressin oral lyophilisate) added for idiopathic nocturnal polyuria (section 6.5.2.1)

11th July 2018
Guselkumab added as a 'red' drug for psoriasis, as per NICE TA521 (section 13.5.3.2)

29th June 2018
Primary Care Antibiotic Guidelines updated (chapter 5)
Erectile Dysfunction section re-worded regarding generically available phosphodiesterase type-5 inhibitors (section 7.5.1)

27th June 2018
Asthma inhaler guideline updated (chapter 3)
COPD inhaler guideline updated (chapter 3)

18th June 2018
Teriparatide switched from 'amber' to 'red', section 6.6.1.

5th June 2018
Fluphenazine decanoate removed due to manufacturer discontinuing production, section 4.2.2

18th April 2018
Giant cell arteritis added as an indication for tocilizumab, as per NICE TA518, section 10.1.3.5

3rd April 2018
Acarizax® oral lyophysilate added as a 'red' drug for the treatment of house dust mite allergy, section 3.4.1.3

27th March 2018
Renacet® (Calcium acetate) tablets added as an 'amber' drug for use as a phosphate binder in renal impairment, section 9.6.2

21st March 2018
Brodalumab added as a 'red' drug for moderate to severe plaque psoriasis, as per NICE TA511, section 13.5.3.2

10th January 2018
Non-radiographic axial spondyloarthritis added as an indication for golimumab, as per NICE TA497, section 10.1.3.5

8th January 2018
Mecysteine removed as no longer available (section 3.7)