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 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.03.02  Expand sub section  Drugs for arrhythmias
02.03.02  Expand sub section  Supraventricular arrhythmias
Adenosine (Adenocor)
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Formulary Injection
Infusion 
   
Dronedarone (Multaq)
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Restricted Drug Restricted
Green 3
Tablets

Restricted Item Cardiologist/stroke physician initiation only

Dronedarone should only be initiated as a second line treatment option for non-permanent atrial fibrillation after:
  • standard NICE first line options are either cautioned/contraindicated or have failed
  • and if
  • amiodarone use is cautioned/intolerated
  • It should only be used in clinically stable patients, and is not recommended for those with NYHA Class III/IV heart failure.

    Dronedarone is not recommended for patients with permanent AF.

    See attached guidance for more information. 
    Link  MHRA Safety Alert: Dronedarone cardiovascular, hepatic and pulmonary adverse events new restrictions and monitoring requirements
    Link  NICE TA197: Atrial fibrillation - dronedarone
       
    02.03.02  Expand sub section  Supraventricular and ventricular arrhythmias
     ....
    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
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    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

    Amber

    Drugs designated amber are suitable for shared care arrangements under a shared care protocol. Prescribing may be transferred from secondary to primary care once the patient is stabilised and agreed shared care arrangements have been established. Alternatively primary care may initiate under the supervision of secondary care if this option is given in the shared care document. It is recommended that shared care arrangements should be drawn up following local discussion and agreement by prescribing parties.   

    Black

    These products have been reviewed by the GM Joint Formulary Group and have been deemed not suitable for prescribing for adults in primary or secondary care within Greater Manchester. These decisions have been made on the basis of safety, efficacy and cost-effectiveness of the products.  

    Green

    Not used   

    Green 1

    Drugs designated green1 are suitable for initiation and ongoing prescribing within primary care.   

    Green 2

    Drugs designated green2 can be initiated by primary care following written or verbal advice from a specialist and then be subsequently safely prescribed in primary care with little or no monitoring required.  

    Green 3

    Drugs designated green3 are suitable for on-going prescribing within primary care after specialist initiation and an initial review (unless specified) in secondary care. Little or no monitoring is required.  

    Grey

    Not suitable for routine prescribing but may be suitable for a defined patient population. Whilst prescribers should think very carefully before prescribing or recommending any of the products on the grey list, there may be exceptional instances when the use of one of these products is necessary for a particular patient.   

    Red

    Drugs designated red are considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs should not be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy, this may include arranging for supply via a home care company.   

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