2.5.1. Vasodilator antihypertensive drugs
Restrictions:
Restricted to initiation and prescribing by specialists in the Scottish Pulmonary Vascular Unit or similar specialists.
Restrictions:
Restricted to initiation and prescribing by specialists in the Scottish Pulmonary Vascular Unit or similar specialists. Use in the reduction of the number of digital ulcers in patients with systemic sclerosis and ongoing digital ulcer disease and for pulmonary arterial hypertension WHO class II is non-Formulary.
Restrictions:
Iloprost nebules are restricted to use as an alternative in patients receiving other forms of prostacyclin treatment and to use by specialists in the Scottish Pulmonary Vascular Unit or similar specialists.
Restrictions:
Use as monotherapy or in combination is indicated for the long-term treatment of pulmonary arterial hypertension in adult patients of World Health Organisation Functional Class II to III is restricted to initiation and prescribing by specialists in the Scottish Pulmonary Vascular Unit or similar specialists.
Restrictions:
For Formulary indications and restrictions, see Prescribing Notes.
Prescribing Notes:
Chronic thromboembolic pulmonary hypertension (CTEPH): Treatment of adult patients with World Health Organisation (WHO) functional class II to III with inoperable CTEPH or persistent or recurrent CTEPH after surgical treatment to improve exercise capacity. It is restricted to initiation and prescribing only by specialists in the Scottish Pulmonary Vascular Unit for use in patients in whom a PDE5 inhibitor is inappropriate, not tolerated, or ineffective.
Pulmonary Arterial Hypertension (PAH): Restricted to use as a PAH-specific monotherapy as an alternative treatment option to endothelin receptor antagonist (ERA) monotherapy in adult patients with PAH of WHO FC II to III. It is restricted to initiation and prescribing by specialists in the Scottish Pulmonary Vascular Unit or by similar specialists.
Restrictions:
Use for pulmonary arterial hypertension (PAH) is restricted to use by specialists in the Scottish Pulmonary Vascular Unit for combination therapy in a sub-population of patients with PAH specifically those with WHO FC III who are insufficiently controlled with an ERA and a PDE-5 inhibitor and who would be considered for treatment with inhaled iloprost.
Restrictions:
Restricted to specialists working in the Scottish Pulmonary Vascular Unit or similar specialists and by physicians experienced in the management of pulmonary vascular disease.
Restrictions:
The treatment of adults with pulmonary arterial hypertension (PAH) classified as World Health Organisation functional class (WHO-FC) II and III, to improve exercise capacity is restricted to prescribing by specialists in the Scottish Pulmonary Vascular Unit or similar specialists.