|Therapeutic Area||Formulary Choices||Cost for 28|
(unless otherwise stated)
|Rationale for decision / comments|
|Other Antianginal Drugs|
|Potassium Channel Activator||Nicorandil||10mg tablets: £4.12 (60)|
20mg tablets: £5.52 (60)
|Where Nicorandil has been added for symptom control pending angioplasty or CABG, strong consideration should be given to cautious withdrawal after successful completion of and recovery from the procedure.
Nicorandil is associated with oral, anal, gi & para-stomal ulceration & delayed wound healing. Addition of a PPI is ineffective to promote healing – cessation of the drug is needed.
Also see MHRA alert Jan 16: risk of ulcer complications with Nicorandil
|Sinus Node Regulator||Ivabradine||5mg tablets: £5.41 (56)|
7.5mg tablets: £5.59 (56)
| GREEN for medical management of Stable angina: in line with NICE CG126 See guide on previous page
AMBER for management of heart failure see Prescribing Guidelines for Heart Failure.
• QT prolongation may be exacerbated by heart rate reduction. The use of ivabradine with other drugs which prolong QT interval eg citalopram, diltiazem, should be avoided.
• If the combination appears necessary, close cardiac monitoring is needed.
• Hypokalaemia and hypomagnesaemia can increase the risk of arrhythmia especially in patients with long QT interval, whether congenital or substance-induced eg with potassium-depleting diuretics (thiazide diuretics and loop diuretics). Caution & careful monitoring is needed.
|Other||Ranolazine||375mg P/R tablets: £48.98 (60)|
500mg P/R tablets: £48.98 (60)
750mg P/R tablets: £48.98 (60)
|Included for medical management of stable angina: in line with NICE CG126 See guide on previous page.