2. Cardiovascular system - guidance

To access BNF Formulary section click on the link under BNF Section/s

To access the Guidance Document click on the highlighted text under the Title column

Use documents past their review date with Caution

BNF Section/s	Title	Issuing Body	Version	Date of Issue/Review	Update Due
2.3.2.3	Andexanet alfa - Andexanet alfa for reversing anticoagulation from apixaban or rivaroxaban - TA697	NICE		12 May 2021
2.3.2, 2.3.2.2, 2.3.2.5 Apixaban, Edoxaban, Rivaroxaban and Dabigatran	Anticoagulant prescribing - Click here for K&M Anticoagulant position statement and risk mitigation principles. NHSE updated the Commissioning recommendations for national procurement for direct-acting oral anticoagulant(s) (DOACs) on the 6th of September 2024. This document will be reviewed ASAP, via the normal ICB governance process, to reflect the current NHSE recommendations.	Kent and Medway ICB		Apr 2024	Review in process !
2.3.2.2	Apixaban - Apixaban for the prevention of venous thromboembolism after total hip or knee replacement in adults TA245	NICE		Jan 2012	-
2.3.2 & 2.3.2.2	Atrial fibrillation - Atrial fibrillation: diagnosis and management NG196	NICE		Jun 2021	-
2.6	Bempedoic Acid/Ezetimibe - BEMPEDOIC ACID WITH EZETIMIBE (Nilemdo and Nustendi) for treating primary hypercholesterolemia or mixed dyslipidaemia. Implementation guidance for Nice TA694	Kent and Medway CCG		Sep 2021	Sep 2022 !
2.3.2.5	Dabigatran etexilate -Dabigatran etexilate for the prevention of venous thromboembolism after hip or knee replacement surgery in adults - TA157	NICE		Sept 2008	-
2.3.2.5	Dabigatran etexilate - Dabigatran etexilate for the prevention of stroke and systemic embolism in atrial fibrillation TA249	NICE		Jul 2021	-
2.5.3	Dapagliflozin & Empagliflozin - K&M Implementation of NICE TA’s – SGLT2 inhibitors (Dapagliflozin & Empagliflozin) in the treatment of chronic heart failure	Kent and Medway ICB		Aug 2023	Aug 2025
2.5.3	Dapagliflozin - Dapagliflozin for treating chronic heart failure with reduced ejection fraction TA679	NICE		Feb 2021	-
2.5.3	Dapagliflozin - Dapagliflozin for treating chronic heart failure with preserved or mildly reduced ejection fraction TA902	NICE		Jun 2023	-
2.5.3 6.3.1.4	Dapagliflozin - Dapagliflozin for treating chronic kidney disease TA775	NICE		Mar 2022	-
2.3.2.2	DOAC - Direct-acting oral anticoagulants (DOACs): paediatric formulations; reminder of dose adjustments in patients with renal impairment	MHRA Drug Safety Update		May 2023	-
2.3.2.2	DOAC Monitoring - DOAC Monitoring Recommendations for Non-Valvular Atrial Fibrillation (NVAF) in Primary Care This document is under review. In the meantime please refer to DOACs (Direct Oral Anticoagulants) monitoring – SPS - Specialist Pharmacy Service – The first stop for professional medicines advice and Anticoagulation - oral \| Health topics A to Z \| CKS \| NICE for advice on DOAC monitoring, also noting manufacturer’s SmPC Home - electronic medicines compendium (emc), and to the MHRA on calculating renal function using creatinine clearance for dosing DOACs (MHRA Click here)	Kent and Medway CCG		Dec 2021	Dec 2023 !
2.5.3	Empagliflozin - Empagliflozin for treating chronic heart failure with reduced ejection fraction TA773	NICE		Mar 2022	-
2.5.3	Empagliflozin - Empagliflozin for treating chronic heart failure with preserved or mildly reduced ejection fraction TA929	NICE		Nov 2023
2.5.3	Empagliflozin - Empagliflozin for treating chronic kidney disease TA942	NICE		Dec 2023
2.3.1	Epoprostenol	*High-Cost Drugs*
2.5.1 6.3.1.4	Finerenone - Finerenone for treating chronic kidney disease in type 2 diabetes TA877	NICE		Mar 2023
2.6	Icosapent - Icosapent ethyl with statin therapy for reducing the risk of cardiovascular events in people with raised triglycerides TA805	NICE		13 July 2022
2.6	Inclisiran - Inclisiran for treating primary hypercholesterolaemia or mixed dyslipidaemia TA733	NICE		Oct 2021	2024
2.6	Inclisiran - Kent & Medway ICB Position Statement Prescribing Inclisiran (Leqvio®) for the treatment of primary hypercholesterolaemia or mixed dyslipidaemia in Kent and Medway	Kent and Medway ICB		Jul 2023	Jul 2025
2.6	Lipid Management - Summary of National Guidance for Lipid Management for Primary and Secondary Prevention of CVD	NICE /National Guidance		Mar 2024	-
2.4.1.4	Metolazone - MHRA Xaqua (metolazone) 5mg tablets: exercise caution when switching patients between metolazone preparations	MHRA Drug Safety Update		Jan 2023	-
2.4.1.4	Metolazone - Metolazone (Xaqua) prescribing position statement	Kent and Medway ICB	1.1	Jun 2024	Jun 2026
2.4.1.4	Metolazone - Metolazone (Xaqua) Patient Information	Kent and Medway ICB		Jun 2024	Jun 2026
2.3.2.2	Rivaroxaban - Rivaroxaban for the prevention of venous thromboembolism after total hip or total knee replacement in adults - TA170	NICE		Apr 2009	-
2.3.2.2	Rivaroxaban - Rivaroxaban for the treatment of deep vein thrombosis and prevention of recurrent deep vein thrombosis and pulmonary embolism (PE) TA261	NICE		Jul 2012	-
2.5.2	Sacubitril + Valsartan - Sacubitril + Valsartan prescribing Guidance	MCH/Medway & Swale CCG		Sep 2016	-
2.5.3 6.3.1.4	SGLT2 - SGLT2 inhibitors for Chronic Kidney Disease (CKD) in Adults	Kent and Medway ICB		Jun 2024	Jun 2026
2.3.2.6	Warfarin - Guidance for switching from Warfarin to DOACs -	Kent and Medway CCG	1	Jun 2020	-

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