University Hospitals Birmingham NHS Foundation Trust

Chapters

Status Drug name NICE TAs Comments
Status: Green Alogliptin (Vipidia®)

1st line choice

Status: Green Canagliflozin
Status: Amber Continous glucose monitoring system (Dexcom ONE®)
Status: Green Dapagliflozin

For treating Type 2 diabetes in line with NICE 

Status: Green Dapagliflozin (Forxiga®)
Status: Amber Dapagliflozin#Amber
Status: Red Dapagliflozin#Red

Specialist centres only for treating Type 1 diabetes

Status: Green Dulaglutide (Trulicity®)

Not for monotherapy. Not in combination with insulin.

Status: Green Empagliflozin
Status: Amber Empagliflozin (Jardiance®)
Status: Amber Empaglifozin#Amber
Status: Green Empaglifozin#Green
Status: Green Ertugliflozin (Steglatro®)
Status: Green Exenatide prolonged release injection (Bydureon®)
Status: Amber Flash glucose monitoring system  (FreeStyle Libre 2®, FreeStyle Libre®)
Status: Amber Glibenclamide tablets

For patients who do not want to move to insulin but not responding to metformin

Status: Green Glicazide M/R tablets

2nd line option

Status: Green Glicazide tablets
Status: Green Glimepiride tablets
Status: Green Glucagon hypokit
Status: Green Glucose 40% oral gel
Status: Green Insulin actrapid® injection (10ml)

Prescribe by brand name

Status: Amber Insulin aspart (Fiasp®)

Prescribe by brand name. For specialist use in pregnancy.

Status: Green Insulin aspart (Novorapid®) injection

Prescribe by brand name

Status: Amber Insulin degludec 100 units/ml (Tresiba®)

Amber for type 1 diabetes- specialist initiation. RICaD. Red for Type 2 diabetes.                                        

Status: Red Insulin degludec 100 units/ml (Tresiba®)#red

Amber for type 1 diabetes- specialist initiation. RICaD. Red for Type 2 diabetes.     

Status: Green Insulin detemir (Levemir®)

Prescribe by brand name

Status: Amber Insulin glargene 300 units/ml (Toujeo®)

Specialist initiation. For patients who require more than 80 units of insulin glargine per day and who are troubled by nocturnal hypos. Transfer to Primary Care should not happen until specialists can demonstrate reduction in nocturnal hypos (e.g. after 3–4 months). RICaD.

Status: Green Insulin glargine (lantus®)

Extremely high relative cost. Prescribe by brand name.

Status: Green Insulin glargine 100 units/ml (Abasalgar®)

Prescribe by brand name. First line for new patients initiated on insulin glargine 100 units/ml.

Status: Green Insulin glulisine (Apidra)

Prescribe by brand name

Status: Green Insulin humalog® mix 25

Prescribe by brand name

Status: Green Insulin humalog® mix 50

Prescribe by brand name

Status: Green Insulin humulin I® injection

Prescribe by brand name

Status: Green Insulin humulin S® injection

Prescribe by brand name

Status: Green Insulin humulin® M3 injection

Prescribe by brand name

Status: Green Insulin hypurin® bovine isophane injection

For existing patients only

Status: Green Insulin hypurin® bovine lente injection

For existing patients only

Status: Green Insulin hypurin® bovine neutral injection

For existing patients only

Status: Green Insulin hypurin® bovine protamine zinc injection

For existing patients only

Status: Green Insulin hypurin® porcine 30/70 injection

For existing patients only

Status: Green Insulin hypurin® porcine isophane injection

For existing patients only

Status: Green Insulin hypurin® porcine neutral inj (10ml)

For existing patients only

Status: Green Insulin insulatard® injection

Prescribe by brand name

Status: Green Insulin insuman® basal

Prescribe by brand name

Status: Green Insulin insuman® comb 15 injection

Prescribe by brand name

Status: Green Insulin insuman® comb 25 injection

Prescribe by brand name

Status: Green Insulin insuman® comb 50 injection

Prescribe by brand name

Status: Green Insulin insuman® rapid injection

Prescribe by brand name

Status: Green Insulin lispro 100 units/ml (Humalog®) injection

Prescribe by brand name

Status: Green Insulin novomix® 30 injection

Prescribe by brand name

Status: Red IV fluids

Hospital only

Status: Green Linagliptin tablets
Status: Red Liraglutide (Saxenda®) (GLP1s should all be prescribed by brand name)

The use of Liraglutide for this indication is restricted to prescribing in secondary care by a specialist multidisciplinary Tier 3 weight management service with a commercial agreement in place.

Prescribe by brand (Saxenda®) to avoid patients inadvertently receiving a different product licensed for type 2 diabetes.

Status: Green Liraglutide (Victoza®) injection (GLP1s should all be prescribed by brand name)

THIS IS FOR DIABETES ONLY. Prescribe by brand (Victoza®) to avoid patients inadvertently receiving a different product licensed for obesity.

1.8 mg is non-formulary.

Status: Green Lixisenatide (Lyxumia®)

1st line choice GLP1 for co-prescribing with insulin. RICaD.

Status: Green Metformin liquid
Status: Green Metformin M/R tablets

2nd line - only for patients intolerant of slowly titrated standard release metformin. Sukkarto SR 500mg and 1000mg.

Status: Green Metformin tablets
Status: Green Pioglitazone tablets
Status: Green Repaglinide tablets
Status: Red Semaglutide (Wegovy®)

The use of semaglutide for this indication is restricted to prescribing in secondary care by a specialist multidisciplinary Tier 3 weight management service with a commercial agreement in place.

Prescribe by brand (Wegovy®) to avoid patients inadvertently receiving a different product licensed for type 2 diabetes.

The Wegovy® brand of semaglutide is not commercially available yet.

Status: Green Semaglutide solution for injection (Ozempic®)
Status: Green Semaglutide tablets (Rybelsus®) (GLP1s should all be prescribed by brand name)
Status: Green Sitagliptin tablets
Status: Red Soluble insulin

Hospital only

Status: Green Tirzepatide (Mounjaro®)
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