REMEDY : BNSSG referral pathways & Joint Formulary
Covid -19 Specific information
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Advice & Guidance for GPs
Advice & Guidance Services Advice and Guidance Best Practice Triage Service (RAS) on e-Referral
Biochemistry
Alkaline Phosophatase Clinical Biochemistry in Primary Care Creatinine Kinase Hyperkalaemia Hyperlipidaemia Hypomagnesaemia Lipid Advice & Guidance Service
Breast
Advice & Guidance Service Axillary masses Breast Implants (non-cancer) Breast Pain Breast Surgery Breastfeeding Family History of Breast Cancer Male Breast Symptoms Mastitis and Breast Abscess Nipple conditions
Cancer Screening
Bowel Cancer Screening Breast Cancer Screening Cervical Cancer Screening Pancreatic Cancer Surveillance Programme Targeted Lung Health Check (TLHC) program
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Advice & Guidance Service Cancer and Severe Mental Illness (SMI) LD & Cancer Living with and beyond cancer (LWBC) Nutrition in cancer Physio for NBT Cancer patients Post cancer - Digital Remote Monitoring and Personalised Stratified Follow Up Rehab / prehab Toxicity Risk Assessment Tool
Cardiology
Advice & Guidance Service Angina Arrhythmia Atrial Fibrillation and Flutter Cardiac Rehabilitation Cardiac Rhythm Analysis Coronary Artery Calcification ECG - Open Access ECHO - requesting Heart Failure Hypertension Inherited Cardiac Conditions NT Pro BNP Testing Pacemakers Postural Orthostatic Tachycardia Syndrome (PoTS) Rapid Access Chest Pain Clinics Syncope and TLOC (non-traumatic) Thoracic Aorta Disease
Care of the Elderly
Active Ageing - South Glos Advice and guidance - Care of the Elderly Assistive Technology Service Falls & Balance Fracture Liaison Service Frailty Hearing Services Live Longer Better Movement Disorders NHS@home - Frailty pathway Rapid Assessment Clinic For Older People
Community Therapy
Community Therapy
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Acute Assessment COVID Medicine Delivery Unit (CMDU) COVID Oximetry @ Home Virtual Ward COVID Testing Long COVID TeamNet and Latest updates
Dementia
Dementia - Assessment & referral Dementia Prescribing Mental Capacity & Best Interest Decisions
Dermatology
Acne vulgaris Actinic Keratosis Advice & Guidance and guidelines Alopecia Basal Cell Carcinoma Benign Skin Lesions Bowens Disease Community Dermatology Service Cosmetic skin treatments Eczema Hidradenitis Suppurativa Hyperhidrosis Leg Ulcer Mole Mapping/Surveillance Pityriasis Rosea Pityriasis Versicolor Polymorphic Light Eruption Pruritis Psoriasis Rosacea Scabies Seborrhoeic Dermatitis Skin Camouflage Tinea Tissue Viability/Wound Care Service Unusual Appearance - Outlook Urticaria Vulval Skin Care Warts and Verrucas
Diabetes
Community Diabetes Specialist Service Diabetes & Nutrition Diabetes Advice and Guidance Diabetes Foot Care Diabetes Mellitus - Guidelines Diabetes self-management Diabetes Structured Education Diabetic Eye Screening Monogenic Diabetes Neuropathic Pain (Diabetic) Non-diabetic Hyperglycaemia and the National Diabetes Prevention Program Pregnancy and diabetes Rapid Access Diabetes Clinic Type 2 diabetes management Type 2 Path to Remission Programme
Dietetics & Nutrition
Advice & Guidance Service Local Services Malnutrition & Oral Nutritional Supplements Vitamin D Deficiency Weight management
Drug and Alcohol Misuse
Alcohol Misuse Opiate Dependence Non-opiate drug dependence Bristol Drug and Alcohol Service North Somerset Drug & Alcohol Service South Gloucestershire Drug & Alcohol Service Bristol Shared Care Breaking Free (Bristol & South Glos)
DVT and PE
DVT and SVT Pathway Pulmonary Embolus (suspected) Secondary Care DVT Services Unprovoked DVT
Enablement
Bristol Centre for Enablement Wheelchair Services
End of Life Care and Hospice
Bereavement support Death Certification and Medical Examiner End of Life Care End of life care - community support ReSPECT Plus SR1 Form (formerly DS1500) St Peters Hospice Weston Hospice
Endocrinology
Adrenal incidentaloma Adrenal insufficiency Advice and Guidance (Endocrinology) Endocrinology Services - UHBW and NBT Gynaecomastia Hirsutism Hyperprolactinaemia Hyperthyroidism Hyponatraemia Hypothyroidism Male hypogonadism Polyuria Primary hyperparathyroidism (PHPTH) Secondary hypertension Sub Clinical hyperthyroidism Sub Clinical hypothyroidism Thyroid Disease and pregnancy Thyroid eye disease
ENT
Advice & Guidance Service Anosmia Audiology (adult) Dizziness and Vertigo Ear wax and microsuction ENT HOT Clinic Epistaxis Hearing Problems Middle ear problems Moulded Ear Plugs Nasal Treatment Neck Lumps (including Goitre) Otitis Externa Rhinosinusitis & Nasal Polyps Snoring Speech & Language Tinnitus Tonsils Uvula
Fertility
Advice & Guidance Service Infertility Semen Analysis
Gastroenterology and Colorectal Surgery
Advice & Guidance Services Anaemia (Gastroenterology) Anal FIssure Barrett's oesophagus Coeliac Disease Colon Polyps Community Gastroenterology Clinic - InHealth Constipation in Adults Dyspepsia and Reflux Endoscopy Eosinophilic Oesophagitis Faecal Calprotectin FIT (Faecal Immunochemical Test) Gallstones (and polyps) Haemorrhoids and anal lesions Hiccups Inflammatory Bowel Disease (Confirmed) Inflammatory Bowel Disease (suspected) Irritable Bowel Syndrome Microscopic Colitis Pancreatitis (Acute) Pancreatitis (Chronic) and PEI Rectal Bleeding Stoma care Upper GI Bleed Urgent Gastroenterology Services
Gender Identity Genetics
Alpha 1 Antitrypsin Deficiency (AATD) Family History of Breast/Ovarian Cancer Family History of Colorectal Cancer Genetic Haemochromatosis Genetics - general Monogenic Diabetes
Gynaecology
Advice & Guidance Service Abnormal vaginal bleeding Cervical Conditions Dyspareunia Early Pregnancy Assessment Clinic Emergency Gynaecology Endometriosis Female Cosmetic Surgery Female Genital Mutilation Female Genitalia Surgery Female Urinary Incontinence Fibroids Hyperemesis Gravidarum Menopause Menstrual Disorders Mesh Complications Open Access Gynae Imaging Ovarian Conditions PCOS Pelvic Inflammatory Disease Pelvic Organ Prolapse Persistent Pelvic Pain (women) Premature Ovarian Insufficiency Recurrent Miscarriage Termination of Pregnancy Vaginal Discharge Vulval Skin Conditions
Haematology
Advice & Guidance Service Anaemia Blood Transfusions & Iron infusions Genetic Haemochromatosis Guidelines for Primary Care Leucocytosis (including neutrophilia and lymphocytosis) Lymphadenopathy (adults) Macrocytosis Polycythaemia Sickle Cell & Thalassaemia Vitamin B12 Warfarin monitoring
Hepatology
Advice & Guidance Hepatology Service Genetic Haemochromatosis Liver disease Viral Hepatitis Urgent Hepatology Service
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Imaging - see Radiology
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Learning Disabilities
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Max Fax and Dental
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Home > Formulary : Adult > Chapters > 2. Cardiovascular System >

BNSSG Adult Joint Formulary

2.5 Heart Failure

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Last edited: 24-10-2024

First line drugs Second line drugs Specialist drugs Secondary care drugs

 

See BNSSG Primary Care Heart Failure Treatment Guidance, Practical Guidance on how to use Heart Failure medications, Traffic Light: How to monitor renal function and potassium rises in stable heart failure patients - guidelines available here

Angiotensin Receptor Neprilysin Inhibitor

Sacubitril / Valsartan (Entresto) (TLS Amber 1 month) (SCP Click here)

 

Aldosterone Antagonists

Specific indications:

Spironolactone (TLS Blue)

  • Heart Failure
  • Hypertension (Step 4)
  • Oedema in liver cirrhosis
  • Conn's Syndrome

Eplerenone (TLS Amber Specialist Recommended) 

  • In addition to standard optimal therapy, to reduce the risk of cardiovascular mortality and morbidity in adult patients with NYHA class II (chronic) heart failure and left ventricular dysfunction (LEVF ≤30%)

 

Sodium Glucose Co-transporter 2 Inhibitors

See Endocrine System Guidelines page for the 'Advice on the use of SGLT-2 inhibitors in Type 2 Diabetes, Heart Failure and Chronic Kidney Disease' aide memoire

Dapagliflozin (TLS Amber Specialist Recommended)

Empagliflozin (TLS Amber Specialist Recommended)

 

Phosphodiesterase Type-3 Inhibitors

Enoximone (TLS Red)

Milrinone (TLS Red)

Calcium Sensitiser

Levosimendan (TLS Red)

  • under advice of consultant intensivist only

Selective Sinus Node If Inhibitors

Ivabradine (TLS Amber 3 months) (SCP click here)

  • NICE TA267 Ivabradine for treating chronic heart failure

Other

Vericiguat (TLS Red)

  • For the treatment of symptomatic chronic heart failure with reduced ejection fraction who are stabilised after a recent decompensation event requiring IV therapy. This treatment is reserved for patients who are on optimised standard therapy with a recent decompensation who have exhausted all other options under the care of the secondary care cardiology team

 

2.5.2 Cardiomyopathy

Obstructive Hypertrophic Cardiomyopathy

Mavacamten (TLS Red)

  • NICE TA913 Mavacamten for treating symptomatic obstructive hypertrophic cardiomyopathy

 

Transthyretin Amyloidosis Cardiomyopathy

Tafamidis (TLS Red)

  • NICE TA984 Tafamidis for treating transthyretin amyloidosis with cardiomyopathy

 

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