netFormulary Leicestershire Health Community NHS
Medicines Formulary  
 Formulary Chapter 2: Cardiovascular system - Full Chapter
02.03  Expand sub section  Anti-arrhythmic drugs
  • Management of arrhythmias other than atrial fibrillation should be under the care of a specialist. Advice can be found in the Cardiology Handbook.
  • For management of atrial fibrillation see the relevant sections on beta-blockers, digoxin and calcium channel blockers.
  • Restricted drugs should only be initiated on the advice of an appropriate hospital specialist.
  • Before starting anti-arrhythmic drugs, ensure accurate diagnosis, assessment of the severity of symptoms, the patient's general condition, co-morbidities and consideration of the prognosis.
  • As a rule of thumb anti-arrhythmic drugs have the potential to be pro-arrhythmic!
  • Combinations of anti-arrhythmic agents are more likely to produce significant negative inotropic effects. Review periodically to determine whether treatment should be continued.
02.03.01  Expand sub section  Management of arrhythmias
note Notes
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Section Title Section Title (sub level)
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Restricted Drug
Unlicensed Drug
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Traffic Light Status Information

Status Description


Drugs not recommended for use in the Leicestershire Health Community because of lack of evidence of clinical effectiveness, cost prioritization or concerns over safety. All new drugs will be black until they have been through the appropriate approval process - then they will appear as a specific entry   


Drugs which should be prescribed only by hospital specialists (clinical review by specialist as appropriate and annually as a minimum).  

Amber SCA

Drugs which would initially be prescribed by a hospital specialist and then by a GP where full agreement to share the care of each specific patient has been reached under a LMSG Shared Care Agreement (SCA). Specific patient monitoring or intervention required.   

Amber Simple

Drugs suitable to be initiated and prescribed in primary care only after specialist assessment and recommendation. A shared care agreement is not required.  

Green Conditional

Drugs for which GPs are able to take full responsibility for prescribing and monitoring subject to specified conditions e.g. prescribing in line with agreed LMSG guidance or able to demonstrate suitable competence see comments under individual entries.   


Drugs for which GPs would normally take full responsibility for prescribing and monitoring. Drugs included in this list have been specifically considered by LMSG.