Not Recommended - Chapter 2 Cardiovascular system
Beta-adrenoceptor blocking drugs BNF section 2.4
(SMC No 214/05 - September 2006)
Nebivolol (Nebilet®) is not recommended for use within NHSScotland for the treatment of stable mild and moderate chronic heart failure.
Calcium-channel blockers BNF section 2.6.2
Lercanidipine (tablets) requested as an additional calcium channel blocker for the treatment of hypertension. The Group considered that there was relatively restricted information regarding an improved side-effect profile and although it was cheaper than amlodipine and felodipine this may not be the case long-term as both of these drugs are on the drug tariff. Lercanidipine was classified 2c - cost effective alternatives available. Not recommended for use in NHS Grampian. September 2004.
Other antianginal drugs BNF 2.6.3
(SMC No 319/06 - October 2006)
Ivabradine tablets (Procoralan®)t is not recommended for use in NHSScotland for the symptomatic treatment of chronic stable angina.
Peripheral vasodilators and related drugs BNF section 2.6.4
(Resubmission - SMC No 86/04 - November 2005)
Cilostazolt is not recommended for improvement of the maximal and pain-free walking distances in patients with intermittent claudication, who do not have rest pain and do not have evidence of peripheral tissue necrosis.
Low molecular weight heparins BNF section 2.8.1
(SMC No's 203/05 to 206/05 - October 2005).
Bemiparin injection for sub-cutaneous administration (Zibor®)t is not recommended for the:
- prevention of thromboembolic disease: general surgery (new chemical entity) SMC No 203/05.
- prevention of thromboembolic disease: orthopaedic surgery (new chemical entity) SMC No 204/05.
- prevention of clotting in the extracorporeal circuit during haemodialysis (new chemical entity) SMC No 205/05.
- treatment of venous thromboembolism (new indication) SMC No 206/05.
- treatment of acute deep vein thrombosis (DVT) SMC No 261/06
- treatment of acute pulmonary embolism (PE) SMC No 262/06
- prevention of venous thromboembolic events (VTE) in patients undergoing abdominal surgery who are judged to be at high risk of thromboembolic complications, such as those undergoing abdominal cancer surgery SMC No 287/06
Lipid-regulating drugs BNF section 2.12
Ezetimibe/simvastatin tablets (Inegy®)t. This combination does not comply with local statin guidance. Not recommended for use in NHS Grampian, cost-effective alternatives available. October 2005
Rosuvastatin tablets (Crestor®)t was requested as an additional statin on the formulary. As yet no outcome data for rosuvastatin are available and the evidence presented focussed on reduction in lipid levels rather than prevention of MI, stroke or kidney failure. The consensus was that there was no need for another statin on the formulary at present, and the current NHS Grampian statin guidance should remain as the standard treatment. Not recommended for use in NHS Grampian, cost-effective alternatives available. July 2006