Red Amber List of Medicines

RED
Drugs only to be prescribed by a specialist. Those drugs:

  • Requiring long-term specialist monitoring of efficacy
  • Requiring long-term specialist monitoring of toxicity (either because of difficulty in recognising side effects or high cost/availability of investigations to identify toxicity)
  • Designated as ‘hospital only’ by product licence, by DOH or by the company.
  • That are new or a new indication for an existing drug that needs evaluation to be undertaken to establish the place in therapy, with a recommendation that a formal review process be undertaken
  • That are hospital initiated unlicensed or clinical trial materials
  • That are not licensed for any indication in the UK

Prescribing in Children
General practitioners may prescribe unlicensed medicines (e.g. liquid formulations prepared by a “Specials Manufacturer”) or licensed medicines for unlicensed uses (“off-label”) in children. Prescribing should follow specialist advice and/or indications and doses recommended in the BNF for children.
Please refer to current edition of BNF for children (www.bnfc.org) for further information and guidance

AMBER
Drugs requiring initiation by a specialist, but with the potential to transfer to primary care, within written and agreed shared care frameworks, and according to the agreed process for transfer of care. Transfer to primary care is expected to be the normal practice. Those drugs:

  • Requiring short or medium term specialist monitoring of efficacy
  • Requiring short or medium term specialist monitoring of toxicity
  • Requiring specialist assessment to enable patient selection

If the general practitioner is unwilling to accept the responsibility for prescribing the amber drug, then the consultant should be informed within one week of receipt of the framework. In such cases the GP must provide information to the consultant of all medical information regarding the patient and any changes to the patient’s medication irrespective of indication.


GUIDELINE LED / SPECIALIST ADVISED
Drugs to be prescribed in accordance with NICE guidance or locally approved guidelines with the expectation that initiation will normally be advised by specialist.

These drugs do not require a Shared Care Framework. For drugs and indications which are not covered by NICE guidance, local prescribing guidelines will be available for general practitioners.