Local recommendations (Cardiovascular)

Diuretics

Recommendation Approval date Review date
Hydrochlorothiazide EKPG EKHUFT February 2019 February 2022
Metolazone (Xaqua®) Position Statement June 2024 June 2026
Metolazone (Xaqua®) Information for Patients June 2024 June 2026

Hypertension and Heart Failure

Recommendation Approval date Review date
EKPG Recommendation - Sacubitril Valsartan November 2016 November 2019
Sacubitril Valsartan GP letter June 2016 April 2021
Sacubitril valsartan GP summary June 2016 April 2021
Midodrine prescribing information sheet (V2) April 2016 April 2021
B195. Doxazosin MR 2.0 January 2018 January 2021
K&M Implementation of NICE TA’s – SGLT2 inhibitors (Dapagliflozin & Empagliflozin) in the treatment of chronic heart failure December 2023 December 2025

Nitrates, calcium-channel blockers, and other antianginal drugs

Recommendation Approval date Review date
Chronic Heart Failure -ECK Ivabradine NICE TA 267 July 2015 April 2021

Lipid modifying drugs

Recommendation Approval date Review date
Alirocumab & Evoculumab, GP update on Implementation of NICE TAs 393 & 394 November 2017 November 2020
EKPG Recommendation - Evolocumab and alirocumab for hypercholesterolaemia April 2017 April 2020
Implementation Guidance for NICE TA 694 - Bempedoic Acid September 2021 September 2022
Summary of national guidance for lipid management for primary and secondary prevention of CVD    
Kent & Medway ICB Position Statement for Prescribing Inclisiran July 2023 July 2025

Antithrombotic drugs

Recommendation Approval date Review date
LMWH Prescribing Pathways in East Kent February 2024 February 2026
Enoxaparin pre surgery EKPG recommendation July 2015 April 2021
Ticagrelor for the prevention of atherothrombotic events in adult patients with ACS, EKPG August 2013 April 2021
EKPG Recommendation - Argatroban for type 2 heparin-induced thrombocytopenia March 2017 March 2020
Factsheet - Inhixa (Enoxaparin) October 2020 October 2022

Kent and Medway DOAC Monitoring Recommendations for Non-Valvular Atrial Fibrillation (NVAF) in Primary Care . Version 4 (updated Sept 2021)

December 2021 December 2023

Kent and Medway ICB Position Statement and Risk Mitigation Principles for Anticoagulant Prescribing in nvAF

NHSE updated the Commissioning recommendations for national procurement for direct-acting oral anticoagulant(s) (DOACs) on the 6th of September 2024.
This document will be reviewed ASAP, via the normal ICB governance process, to reflect the current NHSE recommendations.

April 2024 April 2026

EKPG Recommendation - NOACs DVT PE Treatment

Document due for review. Since this document was published, a reversal agent for rivaroxaban and apixaban has become available.

August 2018 August 2021

General (Cardio)

Recommendation Approval date Review date
Rituximab for the treatment of immune thrombocytopenic purpura, EKPG Recommendation December 2015 April 2021
Dapagliflozin in CKD guide June 2022 June 2024