2.6 Hyperlipidaemia
| First line drugs | Second line drugs | Specialist drugs | Secondary care drugs |
Traffic light status (TLS) explained:
- Green: Routine prescribing within licensed indication
- Amber 1: specialist recommendation followed by GP initiation and continuation
- Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
- Amber 3: specialist initiation and stabilisation followed by GP continuation
- Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
- Red: Hospital or specialist prescribing only
Lipid-regulating drugs
National guideline
Bile acid sequestrants
Colestipol hydrochloride (Amber 2)
- Colestid® granules for oral suspension 5g
Colestyramine
- Powder, sugar free 4g sachet
Colesevelam (Amber 3)
- Cholestagel® 625mg Tablets
Notes:
- For patients with proven Bile Acid Malabsorption (BAM) and have either failed or are intolerant of colestyramine.
- Off-label use.
- The patient will be reviewed within 1 month to assess efficacy and the medication stopped if there is no improvement in symptoms or it is not tolerated
Cholesterol Absorption inhibitors
Ezetimibe
- Tablets 10mg
Note:
- Use as per NICE TA385 Ezetimibe for treating primary heterozygous-familial and non-familial hypercholesterolaemia (February 2016)
Fibrates
Bezafibrate
- Tablets 200mg
- Tablets, modified release 400mg
Fenofibrate (Amber 1)
- Capsules 67mg, 200mg, 267mg
- Tablets 160mg
Statins
Atorvastatin
- Tablets 10mg, 20mg, 40mg, 80mg
Pravastatin
- Tablets 10mg, 20mg, 40mg
Rosuvastatin (Amber 2)
- Crestor® Tablets 5mg, 10mg, 20mg, 40mg
Note:
Restricted for 4th line use in familial hypercholesterolaemia and secondary prevention where target levels have not been met with other statins.
Simvastatin
- Tablets 10mg, 20mg, 40mg, 80mg
PCSK9 Inhibitors
Alirocumab
- Praluent® 75mg solution for injection in pre-filled pen, pre-filled syringe
- Praluent® 150mg solution for injection in pre-filled pen
Note:
- Use as per NICE TA393: Alirocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia (June 2016)
Evolocumab
- Repatha® 140mg/mL solution for injection; Prefilled syringe 1x1mL, Prefilled SureClick pen 2x1mL
Note:
- Use as per NICE TA394: Evolocumab for treating primary hypercholesterolaemia and mixed dyslipidaemia (June 2016)
Traffic light status (TLS) explained:
- Green: Routine prescribing within licensed indication
- Amber 1: specialist recommendation followed by GP initiation and continuation
- Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
- Amber 3: specialist initiation and stabilisation followed by GP continuation
- Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
- Red: Hospital or specialist prescribing only
Return to Chapter: 2. Cardiovascular system
Last updated by: Sheila Wood on 08-07-2019 11:21
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BNF
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NICE
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Summary of product characteristics
