netFormulary Shropshire and Telford Local Health Economy NHS
NHS Shropshire CCG
NHS Telford & Wrekin CCG
Shrewsbury and Telford Hospitals NHS Trust
Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust
Shropshire Community Health NHS Trust
 
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 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.03.02  Expand sub section  Drugs for arrhythmias
02.03.02  Expand sub section  Supraventricular arrhythmias
02.03.02  Expand sub section  Supraventricular and ventricular arrhythmias
Amiodarone
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Amiodarone must not be initiated in primary care. It must be initiated by a specialist and only continued under a shared care arrangement for patients where other treatments cannot be used, have failed or is in line with NICE Guidance CG180. It may also be suitable in patients prior and post cardioversion or in specific patients who also have heart failure or left ventricular impairment.

Amiodarone has an important place in the treatment of severe cardiac rhythm disorders where other treatments either cannot be used or have failed. It has potential major toxicity and its use requires monitoring both clinically and via laboratory testing.

NICE clinical guideline on Atrial Fibrillation (AF) CG 180 puts greater emphasis on rate rather than rhythm control and has clarified the place of amiodarone in the treatment pathway

NICE have issued the following “Do not do” recommendation:

Do not offer amiodarone for long-term rate control.  

 
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Disopyramide
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Flecainide
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Propafenone
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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
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
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 first-line drugs for implementation in Primary Care  

Amber

These medicines are considered suitable for prescribing in Primary Care following specialist (consultant or GPwSI) initiation or recommendation. Some of these medicines may require on-going communication between the Secondary Care specialist and the Primary Care prescriber using Prescribing Information (PI) or through the use of an Effective Shared Care Agreement (ESCA) and this will be indicated in the text.  

Red

Drugs which require special consideration. These are drugs for use in Secondary Care ONLY or for Consultant Prescribing ONLY where indicated. They should not be prescribed in Primary Care.  

Black

Medicines classified in the BNF as 'not NHS' or are considered by the Area Prescribing Committee to be of low clinical value should not be prescribed  

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