Greater Glasgow and Clyde Medicines
Key to symbols The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP The medicine should only be used and prescribed by a specialist Indicates the preferred choice within a class or group of medicines
The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP
The medicine should only be used and prescribed by a specialist
Indicates the preferred choice within a class or group of medicines
2. Cardiovascular system

2.3. Anti-arrhythmic drugs

2.3.2. Drugs for arrhythmias

Total Formulary
Specialist and GP
DRONEDARONE (tablets)

Restrictions: Restricted to patients for the prevention of recurrence of AF in patients in whom beta-blockers, class 1c drugs and amiodarone are contraindicated, ineffective or not tolerated and who do not have a diagnosis of heart failure.

Prescribing Notes:

In accordance with the marketing authorisation and BNF, dronedarone should only be initiated and monitored only under specialist supervision. In cases where GPs continue the prescribing, associated monitoring should continue to be the responsibility of the acute sector.

The European Medicines Agency’s (EMA) Committee for Medicinal Products for Human Use (CHMP) has recommended restricting the use of dronedarone (Multaq®) for maintaining heart rhythm in patients with paroxysmal or persistent atrial fibrillation for the maintenance of sinus rhythm after successful cardioversion. It has also recommended that due to an increased risk of liver, lung and cardiovascular adverse events, dronedarone should only be prescribed after alternative treatment options have been considered. The Committee also recommended a number of other risk minimisation measures to reduce the risk of injuries to liver, lung and cardiovascular system. Patients who are currently taking dronedarone are recommended to have their treatment evaluated by their doctor at their next scheduled appointment.

BNF Link

Specialist and GP
LIDOCAINE

Restrictions: Restricted to specialist use only.

BNF Link

Specialist and GP
SOTALOL

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist and GP
PROPAFENONE

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist and GP
FLECAINIDE

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist and GP
DISOPYRAMIDE

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist and GP
AMIODARONE

Restrictions: Restricted to specialist initiation.

BNF Link

Specialist Only
ADENOSINE

Restrictions: Restricted to specialist use only.

BNF Link

VERAPAMIL

Prescribing Notes:

Modified release preparations should be prescribed by brand name.

BNF Link