netFormulary Leicestershire Health Community NHS
Medicines Formulary  
 Formulary Chapter 4: Central nervous system - Full Chapter
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04.05  Expand sub section  Drugs used in the treatment of obesity
 note  Obesity

  • Obesity is a risk factor for cardiovascular disease, diabetes, gallstones and osteoarthritis. The simplest and most effective method to lose unwanted weight is to consume fewer calories than are required to maintain current body weight. If an increase in physical activity is also combined with this approach, weight loss will be accelerated.
  • Drugs to increase weight loss should only be prescribed for individuals with a BMI of 30 kg/m2 or above and in whom a 3-month program including supervised diet, exercise and behaviour modification has failed to produce a reasonable weight loss.
  • If other medical risk factors are present (e.g. coronary heart disease, diabetes hypertension or sleep apnoea) it may be appropriate to introduce drug treatment at a BMI of 28 kg/m2 or greater.
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Prescribe in line with NICE guidance.
Treatment with orlistat should be discontinued after 12 weeks if less than 5% of the body weight has been lost since the start of therapy.
Link  MHRA Advice: Orlistat: theoretical interaction with antiretroviral HIV medicines
 Non Formulary Items
Naltrexone–bupropion  (Mysimba®)

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Non Formulary
Not recommended by NICE TA 494
Link  MHRA Advice: Naltrexone/bupropion (Mysimba): risk of adverse reactions that could affect ability to drive
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
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NHS England

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.   


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


Drugs not yet reviewed  

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