netFormulary The Pennine Acute Hospitals NHS
NHS Trust Formulary  
 Formulary Chapter 6: Endocrine system - Full Chapter
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 Details...  Expand sub section  Intermediate- and long-acting insulins

Any decision to commence an insulin analogue needs to be balanced carefully against the lack of long term safety data and increased prescribing costs (see NPC document ‘Key Therapeutic Topics’ for full information);

The NICE guideline on type 2 diabetes; NICE CG87: Type 2 diabetes recommends that, when insulin therapy is necessary, human NPH (isophane) insulin (e.g. Insulatard®, Humulin I® or Insuman® Basal) is the preferred option. Long-acting insulin analogues have a role in some patients, and can be considered for those who fall into specific categories e.g. those who require assistance from a carer or healthcare professional to administer their insulin injections, or those with problematic hypoglycaemia. However, for most people with type 2 diabetes, long-acting insulin analogues offer no significant advantage over human NPH insulin and are much more expensive.  Expand sub section  Biphasic insulins  Expand sub section  Intermediate-acting Insulin  Expand sub section  Long-acting Insulin Analogues
Abasaglar® (Insulin glargine)
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First Choice

3mL pre-filled disposible pen (KwikPen®)
3mL cartridge

Semglee® (Insulin Glargine)
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First Choice

3mL pre-filled disposible pen

Lantus® (Insulin Glargine)
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Formulary 3ml cartridge (via ClikSTAR® or Autopen®24 devices)
3ml prefilled disposable pen (Solostar®)

Toujeo® (Insulin Glargine 300units/mL)
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1.5ml prefilled disposable pen (Solostar®)


Restricted Item Only to be used in line with GMMMMG recommendations

Link  Educational risk-minimisation materials
Link  GMMMG Recommendation: Insulin Glargine – Toujeo® (300 units/mL)
Link  PAT Policy for the Management of High Strength Insulin in the Hospital Setting
Levemir® (Insulin Detemir)
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Formulary 3ml cartridges (via Novopen®4 device)
3ml prefilled disposable pen (Flexpen® or Innolet®
Tresiba® (Insulin degludec)
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Formulary 3ml cartridges (via Novo Nordisk® devices)
3ml pre-filled disposable pen (Flextouch®)

**Only the 100units/mL strength has been approved by the Division of Medicine. Use of the 200units/ml strength requires named-patient approval from Medical D&T Committee Chair** 
note Notes
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Restricted Drug
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Unlicensed Drug
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NHS England

Traffic Light Status Information

Status Description


Drugs designated amber are suitable for shared care arrangements under a shared care protocol. Prescribing may be transferred from secondary to primary care once the patient is stabilised and agreed shared care arrangements have been established. Alternatively primary care may initiate under the supervision of secondary care if this option is given in the shared care document. It is recommended that shared care arrangements should be drawn up following local discussion and agreement by prescribing parties.   


These products have been reviewed by the GM Joint Formulary Group and have been deemed not suitable for prescribing for adults in primary or secondary care within Greater Manchester. These decisions have been made on the basis of safety, efficacy and cost-effectiveness of the products.  


Not used   

Green 1

Drugs designated green1 are suitable for initiation and ongoing prescribing within primary care.   

Green 2

Drugs designated green2 can be initiated by primary care following written or verbal advice from a specialist and then be subsequently safely prescribed in primary care with little or no monitoring required.  

Green 3

Drugs designated green3 are suitable for on-going prescribing within primary care after specialist initiation and an initial review (unless specified) in secondary care. Little or no monitoring is required.  


Not suitable for routine prescribing but may be suitable for a defined patient population. Whilst prescribers should think very carefully before prescribing or recommending any of the products on the grey list, there may be exceptional instances when the use of one of these products is necessary for a particular patient.   


Drugs designated red are considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs should not be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy, this may include arranging for supply via a home care company.