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Blackburn with Darwen Primary Care Trust - About Us

Black Traffic Light Drugs (Not Recommended for Use)

These are medicines that have been reviewed and have been deemed less suitable for prescribing, and are therefore not recommended in primary or secondary care. This may be due to the lack of good clinical evidence, or due to the availability of more suitable alternatives.


These medicines are not included in the East Lancashire Joint Formulary and are not available within secondary care.


Template letters have been developed to aid GP's in the Blackburn with Darwen and East Lancashire PCT areas refer black lighted drugs back to the prescriber for review.


East Lancashire CCG Letter for referring back Black Lighted Drugs
East Lancashire CCG Letter for referring back Black Lighted Drugs - [90 KB] Template letter for referring black lighted drugs back to the prescriber for review.
Blackburn with Darwen CCG letter for referring back Black Lighted Drugs
Blackburn with Darwen CCG letter for referring back Black Lighted Drugs - [234 KB] Template letter for referring black lighted drugs back to the prescriber for review.



Generic Name 

Brand Name 

Indication / Comments


Actos® Actos® Generic prescribing only
Aflibercept Zaltrap® Aflibercept in combination with irinotecan and fluorouracil-based therapy is not recommended within its marketing authorisation for treating metastatic colorectal cancer that is resistant to or has progressed after an oxaliplatin-containing regimen
Agomelatine Valdoxan® Major depression

Alendronate and

Vitamin D

Fosavance®  Postmenopausal osteoporosis
Amifampridine Firdapse® NHS England Commissioned Drug
Amoxycillin (nebulised)   Not licensed for use via nebulised route for bronchiectasis or any other indication
  • Formulary
Anakinra Kineret® Rheumatoid arthritis (NICE TA72)
Apremilast Otezla Moderate to severe plaque psoriasis
Aprovel® Aprovel® Generic Prescribing Only
Aricept® Aricept® Generic Prescribing Only
Armour Thyroid Armour Thyroid Hypothyroidism
Asenapine  Sycrest® Schizophrenia/bipolar mania
Atorvastatin chewable tablets Lipitor chewable® hypercholesterolaemia
Azacitidine Vidaza® Not recommended  within its marketing authorisation, for treating acute myeloid leukaemia with more than 30% bone marrow blasts in people of 65 years or older who are not eligible for haematopoietic stem cell transplant.


Azelastine/ Fluticase Dymista® moderate to severe allergic rhinitis
Azilsartan Edarbi® Hypertension
Bendamustine Levact®

Non-Hodgkins lymphoma

(NICE TA206)


valerate Medicated


Betesil® Severe eczema; psoriasis
Bevacizumab Avastin® relapsed, platinum‑resistant epithelial ovarian, fallopian tube or primary peritoneal cancer - Appraisal terminated
Bevacizumab Avastin®

Combination non-oxiplatin chemotherapy of metastatic colorectal cancer, 2nd line

(NICE TA242)

Bevacizumab Avastin® Lung cancer, NSC (NICE TA148)
Bevacizumab Avastin® Renal cell carcinoma (NICE TA178)
Bevacizumab Avastin®

In combination with a taxane for metastatic breast cancer, 1st line (NICE TA214) 

Bevacizumab Avastin® Diabetic Macular Oedema
Bevacizumab Avastin® In combination with paclitaxel and carboplatin for 1st line treatment of advanced ovarian carcinoma (TA284) -not recommended by NICE
Bevacizumab Avastin® In combination with gemcitabine and carboplatin for treating  1st recurrence of platinum-sensitive advanced ovarian carcinoma TA285  not recommended by NICE
  • Formulary
Biatain-IBU®  Biatain-IBU®  Polyurethane foam film dressing
Botulinum Type A   uncomplicated chronic anal fissure
Brimonidine Mirvaso®

Facial erythema in rosacea

Bromfenac Yellox® Postoperative inflammation following cataract surgery
Budesonide oral capsules Entocort® 2nd line corticosteroid option in crohn's disease when conventional corticosteroid not tolerated
Buspirone  Buspar®  Anxiety (short term use)
Cabazitaxel Jevtana® Prostate Cancer
Canabis extract buccal spray Sativex®

Spasticity in multiple sclerosis(NICE CG186)

Existing patients to be referred for review in line with NICE recommendations

Canakinumab Ilaris®  Gout (NICE TAG281)
Cangrelor   reducing atherothrombotic events in people undergoing percutaneous coronary intervention or awaiting surgery requiring interruption of anti-platelet therapy.Appraisal terminated
Capsaicin 179 mg (8%) Patches  Qutenza® Peripheral neuropathic pain in non-diabetic patients
Carmustine implant Gliadel® Glioma, recurrent (NICE TA149)
Casodex® Casodex® Generic Prescribing Only
Cetuximab Erbitux®

Chemotherapy of metastatic colorectal cancer 2nd line

(NICE TA242)

Cetuximab Erbitux® Head & neck cancer, squamous cell carcinoma (NICE TA172)
Ciclesonide  Alvesco®  Prophylaxis of asthma
Cilostazol Pletal® 

Intermittent cludication

(NICE TA223)

Clarithromycin Straws  Clarosip®  Now discontinued 
Clarithromycin XL  Klaricid XL®  Respiratory tract infections
Co-aprovel® Co-aprovel® Generic Prescribing Only


Intestinal Gel

Duodopa®  Severe Parkinson's disease
Co-enzyme Q10/ Ubiquinone/ Ubidecarenone Co-enzyme Q10 Except for mitochondrial disorders 
Colesevelam Cholestagel®

Familial hypercholesterolaemia (combination or monotherapy)

Co-proxamol  e.g. Cosalgesic®  Distalgesic® Dolgesic®  Unlicensed and only available on named patient basis 
Cozaar® Cozaar® Generic Prescribing Only
Crizotinib Xalkori® Previously treated non-small-cell lung cancer associated with an anaplastic lymphoma kinase fusion gene - not recommended by NICE TAG296  
Dapoxetine Priligy®  premature ejaculation in men 18-64 years of age
Dasatinib Sprycel® 1st line -Chronic myeloid leukaemia (NICE TA251)
Dasatinib Sprycel® Chronic accelerated phase Philadelphia-chromosome-positive  myeloid leukaemia(NICE 241 & 251)
Decitabine Dacogen® Leukaemia, acute myeloid (NICE TA270)
Degludec with Liraglutide Xultophy® Type II diabetes mellitus
Denosumab Xgeva® Bone loss in non-metastatic prostate cancer (NICE TA194)
Desmopressin Nasal Spray Desmospray® Primary nocturnal enuresis (PNE) Formulary
Dexamethasone intravitreal implant Ozurdex® Repeat treatment for posterior uveitis
Dexibuprofen  Seractil®  Pain & inflammation
Diclofenac Gel Patch  Voltarol Gel Patch®  Pain & inflammation
Diclofenac tablets All brands NSAID
Dicycloverine Non-proprietary intestinal smooth muscle relaxant
Diovan® Diovan® Generic Prescribing Only
Dosulepin Prothiaden® Depressive illness

Diclofenac &


Arthrotec® Rheumatoid arthritis; osteoarthritis 
Disofrol® Disofrol® Intractable cough, unlicensed import from USA
E-Cigarettes E-Cigarettes substitute to smoking tobacco
Efalizumab Raptiva® Licence currently suspended.
Eltrompobag Revolade® severe aplastic anaemia refractory to immunosuppressive therapy - terminated appraisal
Entocort® Entocort® Prescribe as Budenofalk®
Erdosteine  Erdotin®  Acute exacerbations of chronic bronchitis
Eribulin Halaven® Treatment for locally advanced or metastatic breast cancer that has progressed after at least two chemotherpay regimens for advanced disease (NICE TA250)
Erlotinib Tarceva®

Maintenance monotherapy in advanced and metastatic for non-small-cell lung cancer

(NICE TA227)

Escitalopram  Cipralex® 

Black for Depression

Green for Generalised Anxiety  

Everolimus Certican® Everolimus is not recommended within its marketing authorisation for preventing organ rejection in people having a liver transplant
Everolimus Afinitor® in combination with exemetastane for treating advanced HER2-negative-hormone-receptor-positive breats cancer after endocrine therapy -Not recommended by NICE (TAG295)
Everolimus Afinitor®

Not for second line treatment of advanced renal cell carcinoma

(NICE TA219)

Ezetimibe &



Prescribe separately in line with NICE guidance

(NICE TA132)

Fampridine Fampyra® NHS England commissioned drug
Fentanyl Lozenge  Actiq®  Severe chronic pain
Fentanyl nasal spray Instanyl®  PecFent®  Severe chronic pain
Fentanyl sublingual Abstral® Effentora® Severe chronic pain
Fluconazole capsules & suspension Diflucan® Breast ductal thrush
Fludarabine, oral  Fludara® Leukaemia, lymphocytic, 1st line monotherapy (NICE TA119)
Fluocinolone Acetonide intravitreal implant Iluvien® Diabetic Macular Oedema (NICE TA271)
Fluorouracil 0.5% + salicylic acid 10% Actikerall® Actinic keratosis
Fluticasone & Formoterol inhaler Flutiform® Asthma
Fluticasone furoate/Vilanterol Relvar® Ellipta®  COPD in adults
Fluticasone furoate/Vilanterol Relvar® Ellipta®  Asthma in adults and children over 12 yaers
Fluticasone furoate Avamys® Nasal allergies
Forceval® Forceval® Black for all indications except: Malabsorption - RED, Gastric bypass surgery - Green
Fulvestrant Faslodex® Breast cancer, metastatic (NICE TA239)
Gamolenic Acid 

Efamast®  Epogam® 

Evening Primrose Oil® 

Dietary supplement  
Gefitinib Iressa® Lung cancer, NSC, 2nd line (NICE TA175)
Gefitinib Iressa®  Non-small-cell lung cancer that has progressed after prior chemotherapy.
Gemcitabine infusion Non-propietary gemcitabine in combination with carboplatin is not recommended within its marketing authorisations for treating the first recurrence of platinum‑sensitive ovarian cancer
Glucosamine  Alateris®  Glusartel® Osteoarthritis of the knee
Golimumab Simponi®

Black for Methotrexate naive patients with Rheumatoid Arthritis.

(NICE TA224)

Red as an option for Rheumatoid Arthritis (NICE TA225), Psoriatic Arthritis (NICE TA220) and Ankylosing Spondylitis (NICE TA233)

Golimumab Simponi® Moderate to severe active ulcerative colitis
Grass pollen extract Grazax®  Grass & tree pollen allergy
Heliox® Heliox® Not commissioned for vocal chord dysfunction  
Hyaluronic Acid  Durolane®, Euflexxa®, Fermathron®, Hyalgan® , Orthovisc®, Ostenil®, Ostenil Plus®, RenehaVis®, Suplasyn®, Synocrom®, Synopsis®, Synvisc®, SportVis® osteoarthritis (all joints)

  (update of CG59)

Hydrocortisone MR Plenadren® Treatment of adrenal insufficiency
Hydrogen peroxide 1% cream Crystacide® Skin infection, infected eczema
Icatibant Firazyr® Hereditary angioedema in patients with C1-esterase inhibitor deficiency
Idelalisib Zydelic® Treating follicular lymphoma that is refractory to 2 prior treatments (terminated appraisal)
Idrolax®  Idrolax®  Osmotic laxative
Imatinib Glivec® High dose for chronic or accelerated phase Philadelphia-chromosome-positive myeloid leukaemia (NICE241)
Imatanib, high dose Glivec® GIST, unresectable/ metastatic (NICE TA209)
Imiquimod 3.75% Zyclara® Actinic keratosis
Infliximab Remicade® Ulcerative colitis, sub-acute manifestations (NICE TA140)
Influenza Vaccine - Intadermal Intanza® 9 or 15 microgram / strain
  • MMB Decision - INTERFACE
Inositol Nicotinate Hexopal® 

Peripheral vascular disease

(NICE TA223)

Lapatinib Tyverb® In combination with an aromatase inhibitor for women who have been through the menopause and who have metastatic breast cancer that is hormone receptor and HER2 positive (as per NICE TA257)
Levocetirizine  Xyzal®  Antihistamine
Liothyronine 20mcg tablets   add  on treatment for refractory hypothyroidism despite adequate monotherapy with levothyroxine  
 Lipitor®  Lipitor®  Generic prescribing only
Loprazolam  Non-proprietary Hypnotic
Lormetazepam  Non-proprietary Hypnotic
Losartan and Hydrochlorothiazide  Cozaar Comp®  Hypertension
Losec® Losec® Generic Prescribing Only
Loxapine   Acute agitation and disturbed behaviours associated with schizophrenia and bipolar disorder (TA286)
Lumacaftor-ivacaftor Orkambi Cystic Fibrosis in people 12 years and older who are homozygous  for the F508del mutation as per NICE TAG 398




Lumiracoxib  Prexige® Now discontinued 


Vitalux Plus®

Dietary supplement
Melatonin  Circadin®  Primary insomnia in adults 
Methylnaltrexone   opioid-induced  bowel dysfunction in people with advanced illness receiving palliative care (TAG277)
Midazolam Epistatus® Unlicensed Special
Minocycline MR Acnamino® MR  Minocin MR®  Sebomin MR® Acne
Mirapexin® Mirapexin® Generic Prescribing Only
Modulen IBD®  Modulen IBD®  Food supplement
  • Formulary


Mugard®  Mugard®  Mucositis from cancer therapy
Mycophenolate sodium Myfortic® Renal transplantation in children & adolescents (NICE TA99)

Naproxen &


Vimovo® Pain & inflammation



Treatment of advanced ovarian cancer
  • Formulary
Nebulised Amoxycillin   Not licensed for use via nebulised route for bronchiectasis or any other indication
  •  Formulary
Necitumumab Portrazza Untreated advanced or metastatic squamous non-small-cell lung cancer - as per NICE TA411
Nicotine Strips NiQuitin Strips® Nicotine Replacement Therpay
Norfloxacin Utinor® Prophylaxis of spontaneous bacterial peritonitis  
Ofatumumab Arzerra® 

Chronic lymphocytic leukaemia

(NICE TA202)


Depot Injection

ZypAdhera® Schizophrenia
Omalizumab Xolair®

BLACK for children under 6

(NICE TA278) 

RED for adults and children over 6

(NICE TA278)

Oxycodone hydrochloride/naloxone hydrochloride  Targinact®  Restless Legs Syndrome
Oxycodone hydrochloride/naloxone hydrochloride Targinact® Severe pain
Omega-3 acid ethyl esters Omacor® Post Myocardial Infarction
  • Formulary
Paclitaxel  Abraxane®  Paclitaxel as albumin-bound nanoparticles in combination with gemcitabine for previously untreated metastatic pancreatic cancer





Breast cancer, early (NICE TA108)
Paclitaxel  Abraxane® Paclitaxel as albumin-bound nanoparticles with carboplatin for untreated non-small-cell lung cancer (terminated appraisal)


Paliperidone tablets Invega® Schizophrenia
Panitumumab Vectibix® Metastatic colon cancer (NICE TA240)
Panitumumab Vectibix® Monotherpay of metastatic colorectal cancer 2nd line (NICE TA242)
Pantoprazole  Protium®  Proton pump inhibitor
Paricalcitol Zemplar® Secondary hypoparathyroidism
Pegaptanib  Macugen® 

Age-related macular degeneration

(NICE TA155)

Pegloticase  Krystexxa® Gout (NICE TA291)
Pentoxifylline Trental® 

Peripheral vascular disease

(NICE TA223)

Perindopril Arginine  Coversyl® Use generic perindopril erbumine 
Pioglitazone15mg/Metformin 850mg Competact® Type 2 diabetes mellitus
Plavix®  Plavix®  Generic prescribing only - Plavix may be supplied against a generically written prescription.
Praxilene®  Praxilene®  Generic prescribing only
Prednisolone Soluble All brands Suppression of inflammation and allergic disorders
Prednisolone 5mg EC Deltacortril® Use non-EC tabs where possible, 2.5mg EC tabs remain Green
Prednisone Lodatra® Moderate to severe rheumatoid arthritis 
Pregabalin Lyrica® Generalised Anxiety disorder
Pregabalin  Lyrica®  Epilepsy only 
Progesterone Cream    Unlicensed 
Rabeprazole  Pariet®  Proton pump inhibitor
Ramucirumab Cyramzar® Advanced gastric cancer or gastro-oesophageal junction adenocarcinoma previously treated with chemotherapy
Ramucirumab Cyramzar® locally advanced or metastatic non-small-cell lung cancer , in combination with docetaxel, in adults whose disease has progressed after platinum-based chemotherapy.


Regorafenib Stivarga® Metastatic colorectal cancer after treatment for metastatic disease (terminated appraisal)
RESPeRATE ® RESPeRATE® Black for Adjunct treatment of Hypertension
Retapamulin  Altargo® Superficial bacterial infections
Risedronate Actonel® Osteoporosis, primary prevention (NICE TA160)
Rituximab MabThera® Pemphigus
Rituximab MabThera® Multi drug resistant, steroid dependent, frequently relapsing nephrotic syndrome
Rituximab MabThera® Resistant coeliac disease
Roflumilast Daxas®


(NICE TA244)

  • Guidelines


Crestor®  Primary hypercholesterolaemia
Salbutamol SR tablets Ventmax SR® Asthma
Salmeterol MDI Neovent® Asthma
Salmeterol MDI Sereflo® Asthma
Sea Water nasal drops Sterimar®  Nasal decongestant
Selenium Oral food supplement Post bariatric surgery - patient to purchase own
Sertindole Serdolect®  Schizophrenia
Silicone Gel Sheets Scarsil®, Silgel STC-SE®, Dermatix®, Ciltech®, NewGel®, Kelocote®, Advasil Conform®, Cica-Care® Hypertrophic and keloid scarring
Silk Garments

Dermasilk®, Dreamskin®,

Skinnies Silk TM

Eczema/atopic dermatitis


Simeprevir Olysio® Simeprevir in combination with sofosbuvir for treating genotype 1 or 4 chronic hepatitis C (terminated appraisal)
Simvastatin Suspension Rosemont brand Primary hypercholesterlaemia
Sipuleucel-T   Asymptomatic or minimally symptomatic metastatic hormone-relapsed prostate cancer (NICE TA332
Sirolimus Rapamune® Renal transplantation in children & adolescents (NICE TA99)
Sitagliptin & Metformin Janumet®

Type II Diabetes 

(prescribe drugs separately)

Sodium Chondroitin sulphate 2% bladder washout Uracyst® Painful bladder syndrome
Sodium Hyaluronate Injection Durolane®  Hyalgan®  Ostenil®

Black for OA of the knee

Red for all other indications

Sodium Oxybate Xyrem® Narcolepsy with cataplexy
Solifenacin 6mg/tamsulosin 400mcg MR Vesomni® Symptoms associated with benign prostatic hyperplasia
Sorafenib Nexavar® Renal cell carcinoma (NICE TA178)
Sorafenib Nexavar® Hepatocellular carcinoma, advanced & metastatic, 1st line (NICE TA189)

St Johns Wort 


Sunitinib Sutent® Renal cell carcinom (NICE TA178)







Renal transplantation in children & adolescents (NICE TA99)
Tadalafil Cialis® Benign prostatic hyperplasia (NICE TA273)
Tadalafil once daily Cialis® Post prostatectomy
Tadalafil 2.5, 5mg Cialis®

Erectile Dysfunction


Tamsulosin MR Tablets Flomaxtra XL® Benign prostatic hyperplasia
Tapentadol MR Palexia SR® Not recommended for use as a treatment option  for intractable neuropathic pain in non-palliative care patients
  • Formulary


  • Position Statement

Tapentadol MR  Palexia SR® Not recommended for use as a treatment for non-specific pain
Taurine Taurine Supplementation in Cystic Fibrosis Liver Disease  
Telbivudine  Sebivo®  Chronic Hepatits B 
Temsirolimus Torisel® Renal cell carcinoma (NICE TA178)
Temsirolimus Torisel® 

Mantle Cell Lymphoma

(NICE TA207)

Teriparatide Forsteo®

Black for treatment of osteoporosis in MEN at increased risk of fractures, Red for for  prevention of osteoporotic fragility fractures in postmenopausal women

(NICE TA160/161)

Testosterone gel Testim® Female sexual dysfunction post oophorectomy or primary ovariam failure
  • LMMG new medicine assessment

Testosterone Patches 



buccal tablets

Testosterone gel



Striant SR®



Hypoactive sexual desire in surgically induced menopause



buccal tablets 

Striant SR®  Hypogonadism

Testosterone Patches



buccal tablets

Testosterone gel



Striant SR®



Male low libido  
Tolvaptan Samsca® Hyponatraemia
Topotecan, IV Non-proprietary Lung cancer, small cell (NICE TA184)
Topotecan, IV Non-proprietary Not recommended within its marketing authorisation for treating the first recurrence of platinum‑sensitive ovarian cancer
Topotecan, IV Non-proprietary Recurrent platinum‑resistant or platinum‑refractory ovarian cancer (not recommended) in NICE TA389
Trabectedin Yondelis®

Relapsed platinum sensitive ovarian cancer when in combination with PLDH

(NICE TA222)

Trabectedin Yondelis® Trabectedin in combination with PLDH is not recommended within its marketing authorisation for treating the first recurrence of platinum‑sensitive ovarian cancer
Tramadol MR tablets Non-proprietary Moderate to severe pain
Tramadol and Paracetamol  Tramacet®  Moderate to severe pain
Trastuzumab Herceptin® In combination with an aromatase inhibitor for women who have been through the menopause and who have metastatic breast cancer that is hormone receptor and HER2 positive (as per NICE TA257)
Trastuzumab emansine Kadcyla® HER2-positive, unrectable locally advanced or metastatic breast cancer after treatement with trastuzumab and a taxane - NICE TA371
Triamcinolone Hexadetonide Injection   Approved for use for JIA only in ELHE - Not approved for other indications
Umeclidinium Incruse®▼ copd

Valsartan and Amlodipine Exforge® Hypertension
Vardenafil Levitra® Those patients prescribed this before July 2012 may continue on it


Viagra® Viagra® Generic Prescribing Only
Vinflunine Javlor® Urothelial tract carcinoma
Vildagliptin  Galvus® 

Type II Diabetes /

Use sitagliptin 

Vitamin D capsules Fultium® Vitamin D deficiency
Zinc Oral food supplement Post bariatric surgery - patient to purchase own
Zoster vaccine live Zostavax® Shingles vaccine


All material in this section is aimed at health professionals, but is information currently held within the public domain.   Members of the public seeking advice on medicine-related matters are encouraged to speak with their GP, pharmacist or nurse, or contact NHS Direct on 0845 46 47.  

Richard Lee, East Lancashire Health Economy New Drugs Pharmacist.


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