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Milton Keynes Formulary
Milton Keynes University Hospital NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes Clinical Commissioning Group
Milton Keynes Community Health Services
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 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.08.01  Expand sub section  Parenteral anticoagulants
Argatroban (Exembol)
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Formulary
Red

50mg/50mL solution for infusion vial

Hospital only use.

Note:

  • For anticoagulation for patients with Covid-19 vaccine-induced immune thrombocytopenia and thrombosis (VITT) only.
  • Use as per guidance on the management of VITT from the Expert Haematology Panel (EHP) and British Society of Haematology (BSH) (updated April 2021).
 
   
02.08.01  Expand sub section  Heparin
Heparin sodium
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Formulary
Red
  • 1000 units/mL; 1mL amp, 5mL amp, 5mL vial, 10mL amp, 20mL amp 
  • 5000 units/mL; 1mL amp, 5mL amp, 5mL vial 
  • 25,000 units/mL; 0.2mL amp, 1mL amp, 5mL vial
 
   
02.08.01  Expand sub section  Low molecular weight heparins
Dalteparin sodium (Fragmin)
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Formulary
Amber 1
  • Injection 2500 units in 0.2mL pre-filled syringe
  • Injection 5000 units in 0.2mL pre-filled syringe
  • Injection 7500 units in 0.3mL pre-filled syringe
  • Injection 10000 units in 0.4mL pre-filled syringe
  • Injection 12500 units in 0.5mL pre-filled syringe
  • Injection 15000 units in 0.6mL pre-filled syringe
  • Injection 18000 units in 0.72mL pre-filled syringe 
  • Injection 10000 units in 1mL pre-filled graduated syringe 

Note:

 Discharge supplies - Patients with GPs in MK are supplied 14 days of dalteparin on discharge and GP is expected to continue therapy.

 
   
Enoxaparin sodium (Inhixa)
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Restricted Drug Restricted
Amber 1

100 mg/mL (equivalent to 10,000 units anti-Factor Xa activity) solution in single dose pre-filled syringes

 

  • Injection 20mg in 0.2mL pre-filled syringe
  • Injection 40mg in 0.4mL pre-filled syringe
  • Injection 60mg in 0.6mL pre-filled syringe
  • Injection 80mg in 0.8mL pre-filled syringe
  • Injection 100mg in 1mL pre-filled syringe

 

Notes:

  • For use in Maternity patients only.

  • Discharge supplies - Patients with GPs in MK are supplied 14 days of enoxaparin on discharge and GP is expected to continue therapy.
 
Link  UKMI Q&A: LMWH to treat venous thromboembolism in patients with high body weight
   
Tinzaparin sodium (Innohep)
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Restricted Drug Restricted
Red

Approved for use at the Oxford Renal Unit Only 

  • Injection 10000 units in 0.5mL pre-filled syringe
  • Injection 14000 units in 0.7mL pre-filled syringe
  • Injection 18000 units in 0.9mL pre-filled syringe
  • 10000 international units in 1mL injection
  • 20000 international units in 1mL injection
 
   
02.08.01  Expand sub section  Heparinoids
02.08.01  Expand sub section  Hirudins to top
Bivalirudin (Angiox)
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Formulary
Red

Injection, powder for reconstitution 250mg vial

Notes:

  • Bivalirudin in combination with aspirin and clopidogrel is recommended for the treatment of adults with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
 
Link  MHRA Drug Safety Update: Risks associated with incorrect dose
Link  NICE CG 94:Unstable angina and NSTEMI
Link  NICE TAG 230 : Bivalirudin for the treatment of STEMI, 2011
   
02.08.01  Expand sub section  Heparin flushes
Heparin (flushes)
(Flush)
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Formulary
Red
  • 10 units/mL; 5mL amp for IV Flush 
  • 100 units/mL; 2mL amp for IV Flush

Notes:

  • Cannulae intended to be in place for less than 48 hours should be flushed with Sodium Chloride 0.9% solution.
  • Heparin flush solution should be reserved for cannulae to be in place for longer than 48 hours. 
 
Link  UKMI Q&A: Heparin vs saline flushes for maintenance of patency in intravascular catheters & cannulae
   
02.08.01  Expand sub section  Epoprostenol
Epoprostenol (Flolan)
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Restricted Drug Restricted
Red
High Cost Medicine

Consultant request only

Flolan® Infusion, powder for reconstitution 500 micrograms vial with diluent    

 
Link  MHRA: incompatibilities between Veletri and some administration devices
Link  NHSE policy for the treatment of pulmonary hypertension
   
02.08.01  Expand sub section  Fondaparinux
Fondaparinux sodium (Arixtra)
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Formulary
Red

Arixtra® Injection 2.5mg/0.5mL in pre-filled syringes

Notes:

  • For treatment of unstable angina or non-ST segment elevation myocardial infarction in adults for whom urgent (< 120 mins) invasive management (PCI) is not indicated.
  • For Hospital prescribing only and for a maximum of 8 days or till hospital discharge if that occurs earlier.
 
   
 ....
 Non Formulary Items
Bemiparin

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Non Formulary
 
Danaparoid  (Orgaran)

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Non Formulary
 
Enoxaparin  (BECAT )

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Non Formulary
 
Lepirudin

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Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Green

Routine prescribing within licensed indication  

Amber 1

Specialist recommendation followed by GP initiation and continuation  

Amber 2

Specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation   

Amber 3

Specialist initiation and stabilisation followed by GP continuation  

Amber SCG

Specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline  

Red

Hospital or specialist prescribing only  

Red Red

These medicines have been evaluated and rejected by MKPAG and are NOT approved for use within MK. They are not recommended for use because of lack of clinical effectiveness, cost effectiveness or safety.  

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