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
7. Obstetrics, gynaecology, renal and urinary-tract disorders

7.5. Drugs used in Chronic Kidney Disease

7.5.1. Mineralocorticoid Receptor Antagonists

Total Formulary
Specialist and GP
FINERENONE (KERENDIA) (tablets)

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7.5.2. Sodium-glucose co-transporter 2 (SGLT2) inhibitors

Total Formulary
DAPAGLIFLOZIN (FORXIGA)

Restrictions:

Chronic Kidney Disease:

  • Restricted to initiation by clinicians, either in primary or secondary care, experienced in the treatment of chronic kidney disease (CKD) for use in patients with an estimated glomerular filtration rate of ≥25 to ≤75 mL/min/1.73m2 at treatment initiation, who are receiving an angiotensin converting enzyme inhibitor or angiotensin receptor blocker (unless these are not tolerated or contraindicated), and have a urine albumin-creatinine ratio of at least 23mg/mmol and/or type 2 diabetes mellitus.

For use in chronic heart failure, see section 2.5.6

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EMPAGLIFLOZIN (JARDIANCE)

Restrictions:

Chronic Kidney Disease:

Restricted to initiation by clinicians, either in primary or secondary care, experienced in the treatment of chronic kidney disease (CKD) for use in patients having individually optimised standard care (including angiotensin converting enzyme inhibitors or angiotensin II receptor blockers, unless these are contraindicated or not tolerated), and either, at the start of treatment:

  • an estimated glomerular filtration rate (eGFR) of 20 mL/min/1.73m2 up to 45 mL/min/1.73m2, or
  • an eGFR of 45 mL/min/1.73m2 up to 90 mL/min/1.73m2 and either:
    • A urine albumin-to-creatinine ratio (uACR) of 22.6 mg/mmol or more, or
    • Type 2 Diabetes Mellitus (T2DM).

For use in chronic heart failure, see section 2.5.6

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7.5.3. Cation exchange compound

Total Formulary
Specialist and GP
PATIROMER (VELTASSA) (oral suspension)

Restrictions:

Restricted to specialist initiation in patients with hyperkalaemia (serum potassium >6.0mmol/L) with chronic kidney disease (CKD) stage 3b to 5 and/or heart failure who would otherwise need to downtitrate or discontinue their renin-angiotensin-aldosterone system inhibitor (RAASi) therapy to maintain a clinically acceptable serum potassium level.

Prescribing Notes:

Please refer to section 9.2.1.1 for treatment of acute, life-threatening hyperkalaemia.

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Specialist and GP
SODIUM ZIRCONIUM CYCLOSILICATE (LOKELMA)

Restrictions:

Restricted to specialist initiation in patients with hyperkalaemia (serum potassium >6.0mmol/L) with chronic kidney disease (CKD) stage 3b to 5 and/or heart failure who would otherwise need to down-titrate or discontinue their renin-angiotensin-aldosterone system inhibitor (RAASi) therapy to maintain a clinically acceptable serum potassium level. 

Prescribing Notes:

Please refer to section 9.2.1.1 for treatment of acute, life-threatening hyperkalaemia.

BNF Link