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 Formulary Chapter 6: Endocrine system - Full Chapter
Notes:

Diabetes Guidelines

 Details...
06.01.01.02  Expand sub section  Intermediate- and long-acting insulins
 note 

In type 2 diabetes, long-acting insulin analogues (ie Lantus® glargine and Levemir® detemir) have few advantages over human NPH insulins (i.e. Insulatard®, Humulin I®, Insuman® Basal) but are more expensive. NICE guidance advises analogue insulins should be targeted for use in specific individual patients in which use of human NPH insulins may not be suitable.

Isophane Insulin (Humulin I)
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First Choice
Green

In T2DM NICE advises use of NPH insulin rather than insulin analogue first line 

 

3ml cartridge for Humapen® Savvio , 3ml; disposable pens Kwikpen®

 
Isophane Insulin (Insulatard)
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First Choice
Green

In T2DM NICE advises use of NPH insulin rather than insulin analogue first line 

May be used BD. 3ml Cartridge (Novopen®), Innolet® disposable device

 

 
Isophane Insulin (Insuman Basal)
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First Choice
Green

In T2DM NICE advises use of NPH insulin rather than insulin analogue first line 

3ml cartridge for Clikstar®, 3ml disposable pens Solostar®

 
Abasaglar Insulin biosimilar glargine
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Formulary
Green

Retained on formulary for existing patients & those who prefer pen cartridges - first line now Semglee® disposable pens

Abasaglar® 3ml cartridges, disposable pens 100 units/ml KwikPen®

 

 

 
   
Insulin degludec (Tresiba)
(100 units/ml)
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Formulary
Amber

Consultant initiation only – diabetes and paediatrics on an individual patient basis only, for patients who are "pre-pump" 

Long acting insulin analogue

 
   
Insulin degludec (Tresiba)
(200 units/ml)
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Restricted Drug Restricted
Amber

CAUTION: HIGH STRENGTH

Consultant initiation only – diabetes and paediatrics on an individual patient basis only, for patients who are "pre-pump" 

 
   
Insulin Detemir (Levemir)
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Formulary
Green

Long acting insulin analogue

3ml Cartridges (Novopen®), Disposable pens, (Flexpen®), Innolet® disposable injection device. May be used BD.

 
   
Insulin Glargine (Lantus)
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Formulary
Green

Semglee® disposable pens is first line biosimilar glargine.

Lantus® may be used for patients needing half unit doses.

Lantus® 10ml vial (hospital & insulin pumps only), 3ml cartridges, disposable pens (Solostar®)

 
   
Semglee Insulin Glargine
(biosimilar insulin glargine )
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Formulary
Green

First choice insulin glargine, long acting analogue

3ml pre-filled disposable pen (NB no cartridge product available)

 
   
06.01.01.02  Expand sub section  Biphasic insulins
Biphasic Isophane Insulin (Humulin M3)
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First Choice
Green

Use human isophane insulin first before analogues in type 2 diabetes in line with NICE NG28

3ml cartridges Humapen® Savvio disposable pens Kwikpen®

 
Biphasic Isophane Insulin (Insuman Comb)
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First Choice
Green

Use human isophane insulin first before analogues in Type 2 diabetes in line with NICE NG28

3ml cartridge for Clickstar® for omb 15 and 50, and also disposable pens Solostar® for Comb 25

 
Biphasic Insulin Aspart (NovoMix 30)
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Formulary
Green

3ml cartridges (Novopen®). 3ml disposable pens (Flexpen®)

 
   
Biphasic Insulin Lispro (Humalog Mix)
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Formulary
Green

Mix 25 and 50 - 3ml cartridges (Autopen® Classic or Humapen®), 3ml disposable pens (KwikPens®)

 
   
 ....
 Non Formulary Items
Biphasic Isophane Insulin  (Hypurin Porcine 30/70 Mix)

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Non Formulary
 
Biphasic Isophane Insulin  (Mixtard 30)

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Non Formulary
 
Insulin degludec and liraglutide  (Xultophy)

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Non Formulary
 
Insulin degludec with insulin aspart  (DegludecPlus)

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Non Formulary
 
Insulin Glargine  (Toujeo)

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Non Formulary
 
Insulin Zinc suspension  (HypurinBovine Lente)

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Non Formulary
 
Isophane Insulin  (Hypurin Bovine Isophane)

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Non Formulary
 
Isophane Insulin  (Hypurin Porcine Isophane)

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Non Formulary
 
Isophane Insulin  (Pork Insulatard)

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Non Formulary
 
Protamine Zinc Insulin  (Hypurin® Bovine Protamine Zinc)

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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

Suitable for use in primary care  

Amber

Specialist initiation. Shared care in place  

Red

Red do not use..  

Advice

Some formulations restricted  

Black

NICE "Do not do"  

Green 1

1st line option  

Green 2

2nd line option  

Green 3

3rd line option only  

Not Recomended / Black

Low Value Medicine not recommended for use - see NHSE guidelines  

OTC

This preparation should be bought over the counter for self-care  

Red Amber

Check product description for traffic light status  

Red Black

Low Value Medicine  

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