netFormulary Isle of Wight NHS
Formulary  
 Search
 Formulary Chapter 2: Cardiovascular system - Full Chapter
Chapter Links...
 Details...
02.12  Expand sub section  Lipid-regulating drugs
02.12  Expand sub section  Bile acid sequestrants
02.12  Expand sub section  Ezetimibe
02.12  Expand sub section  Fibrates
02.12  Expand sub section  Statins to top
 note 

Statins are an effective treatment for lowering LDL cholesterol and ofer primary and secondary cardiovascular protection.

Following failure or side effects with one statin a different statin should be tried.

People on low intensity statins or low doses of other statins should have doses and options optimised before trying other options.

Statins are contraindicated in pregnancy. Women planning a pregnancy taking a statin should be advised to stop statin 3 months before conceiving and not to restart until they finished breast feeding.

 

Atorvastatin
View adult BNF View SPC online View childrens BNF
First Choice
Green

HIGH INTENSITY STATIN at doses 20mg, 40mg & 80mg

Medium intensity statin at dose of 10mg

First line choice

Aim for >40% reduction in non-HDL cholesterol after 3 months

Primary prevention starting dose for individuals who have 10% or higher QRISK2 score. 20mg

Secondary prevention in people with cardiovascular disease

Exceptions apply for this dose

80mg

Measure LFT's within 3 months of starting and at 12months.

Creatine kinase should be checked if complaints of unexplainable muscle pains and weakness. This does not need to be measured routinely in people who are asymptomatic and on a statin

 
Rosuvastatin
(Prescribe generically)
View adult BNF View SPC online View childrens BNF
Second Choice
Green

HIGH INTENSITY STATIN - At doses 10mg, 20mg or 40mg

Medium intensity statin at 5mg dose

Second line choice

Aim for >40% reduction in non-HDL cholesterol after 3 months

Primary prevention starting dose for individuals who have 10% or higher QRISK2 score. 10mg

Secondary prevention in people with cardiovascular disease

Exceptions apply for this dose

40mg

Measure LFT's within 3 months of starting and at 12months.

Creatine kinase should be checked if complaints of unexplainable muscle pains and weakness. This does not need to be measured routinely in people who are asymptomatic and on a statin

 
   
Simvastatin
View adult BNF View SPC online View childrens BNF
Second Choice
Green

High intensity statin at dose of 80mg

( MHRA - 80mg dose is associated with increased risk of myopathy.)

Medium intensity statin at doses of 20mg and 40mg

Low intensity at dose of 10mg

Patients who are stable on low/medium intensity statins should be encouraged to switch to a high intensity statin or dose for optimal prevention.

 

 
   
Fluvastatin
View adult BNF View SPC online View childrens BNF
Third Choice
Green

Medium intensity statin at 80mg dose

Low intensity statin at dose of 20mg and 40mg.

Lower intensity statins may be preferred in patients with intolerance or side effects

Individuals should be encouraged to try a higher intensity statin after discussion of risk and benefits.

 

 

 
   
Pravastatin
View adult BNF View SPC online View childrens BNF
Fourth Choice
Green

LOW INTENSITY STATIN:

Use of higher intensity statins are advised for optimal outcomes. Low intensity statin may be preferred in patients who have intolerance or side effects.

Change to higher intensity statin should be encourage at medication reviews following discussion of potential risks and benefits.

 
   
02.12  Expand sub section  Nicotinic acid group
02.12  Expand sub section  Omega-3 fatty acid compounds
02.12  Expand sub section  PCSK9 inhibitors
 ....
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

Drugs that may be initiated, stabilised and maintained by primary, secondary or tertiary care Secondary and tertiary care prescribing may be continued by primary care. [this does not indicate first/second line choice]  

Green Hospital

Items used by the Hospital but would not normally be continued into primary care. Primary care prescribers can change to GREEN first or second.   

Green plus

Initiation of drugs by primary care following written advice from secondary/ tertiary care advice.  

Yellow

Drugs that may be continued in primary care following initiation and stabilisation in secondary/tertiary care  

Amber

Items requiring a shared care agreement. These items should be initiated and stabilised by secondary or tertiary care. The GP should only be asked to take over prescribing through a formal shared care agreement. Secondary care will be expected to continue prescribing until the agreement is made.  

Red

Hospital/ Trust ONLY. These are items the secondary and tertiary care are responsible for prescribing and will need to continue to prescribe for long term maintenance. These items will NOT be prescribed in primary care. But primary care should be informed the patient is receiving these items. This will include NHSE funded items requiring repatriation.  

GP - Black

Items covered by NHSE ‘Should not prescribe in primary care list’ – See CCG policy on Drugs of limited clinical value  

GP - Grey

Grey List: Items covered by NHSE ‘Should not prescribe in primary care list’ that are not to be routinely prescribed but may be suitable in a defined population – See CCG policy on Drugs of limited clinical value  

netFormulary