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 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.04  Expand sub section  Beta-adrenoceptor blocking drugs
Bisoprolol
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First Choice Tablets 
Carvedilol
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Formulary Tablets 
   
Labetalol
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Formulary Tablets
Injection
Infusion

Labetalol is a first line option for the management of hypertension in pregnancy (see NICE Guidance - Hypertension in Pregnancy).  
Link  NICE CG107: Hypertension in Pregnancy
   
Atenolol
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Formulary Tablets
Syrup
Injection  
   
Metoprolol
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Formulary Tablets (not a preferred GMMMG option)
Injection

 
   
Nebivolol (Nebilet«)
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Formulary Tablets

Highly cardio-selective. Can be considered in patients with severe COPD or asthma, when benefits of beta-blockade are thought to outweigh the respiratory risks, under specialist supervision with PEFR monitoring in hospital. Can also be tried in patients who develop wheeze with less cardioselective beta-blockers.

Usual to start at 1.25mg and uptitrate. This will involve the use of quarter of a 5mg tablet.  
   
Sotalol
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Formulary Tablets

Restricted Item Specialist initiation

Sotalol is an option for managing life-threatening arrhythmias.
 
   
Esmolol
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Formulary Intravenous Infusion

Restricted ItemáCardiologist/anaesthetist initiation only  
   
Propranolol
(For non-cardiovascular indications)
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Formulary Tablets
Modified Release Capsules
Liquid

 
   
 ....
 Non Formulary Items
Acebutolol  (Sectral®)

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Non Formulary
 
Atenolol and Co-amilozide  (Kalten«)

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Non Formulary
 
Atenolol and Nifedipine  (Beta-Adalat«)

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Non Formulary
 
Atenolol and Nifedipine  (Tenif«)

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Non Formulary
 
Celiprolol Hydrochloride

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Non Formulary
 
Co-flumactone

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Non Formulary
 
Co-tenidone (atenolol and chlortalidone)

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Non Formulary
 
Co-triamterzide

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Non Formulary
 
Frusene«

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Non Formulary
 
Kalspare«

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Non Formulary
 
Nadolol  (Corgard®)

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Non Formulary
 
Navispare«

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Non Formulary
 
Oxprenolol Hydrochloride

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Non Formulary
 
Oxprenolol Hydrochloride  (Slow-Trasicor®)

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Non Formulary
 
Oxprenolol Hydrochloride  (Trasicor®)

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Non Formulary
 
Oxprenolol Hydrochloride and Cyclopenthiazide  (Trasidrex«)

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Non Formulary
 
Pindolol

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Non Formulary
 
Pindolol and Clopamide  (Viskaldix«)

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Non Formulary
 
Timolol

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Non Formulary
 
Timolol Maleate and Bendroflumethiazide  (Prestim«)

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Non Formulary
 
Timolol Maleate and Co-amilozide  (Moducren«)

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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
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Link to adult BNF
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Link to children's BNF
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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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