6.

Drugs used in the treatment of disorders of the Endocrine System

6.1 Drugs used in diabetes

6.1.1 Insulins

6.1.1.1 Short-acting insulins Soluble insulin

- Human Actrapid®
- Human Velosulin®
- Humulin S®
- Hypurin Neutral®
- Insuman Rapid®
- Pork Actrapid®
Insulin aspart
- NovoRapid®
Insulin lispro
- Humalog®

6.1.1.2 Intermediate- and long-acting insulins insulin detemir (initiated by Diabetologists only)
insulin glargine (initiated by Diabetologists only)
insulin glulisine (initiated by Diabetologists only)

Isophane insulin
- Human Insulatard®
- Humulin I®
- Hypurin Isophane®
- Insuman Basal®
- Pork Insulatard®
Biphasic insulin aspart
NovoMix 30®
Biphasic insulin lispro
Humalog® Mix25
Humalog® Mix50
Biphasic isophane insulin
- Human Mixtard 10®
- Human Mixtard 20®
- Human Mixtard 30®
- Human Mixtard 40®
- Human Mixtard 50®
- Humulin M3®
- Insuman Comb®
6.1.2 Oral antidiabetic drugs - Pork Mixtard 30®

Avandamet® (rosiglitazone/metformin)
gliclazide
glipizide
metformin
metformin MR (Diabetologists and Dr Staniland only)
nateglinide
pioglitazone
6.1.4 Treatment of hypoglycaemia rosiglitazone
vildagliptin (only in line with NICE recommendations)

glucagons

6.2 Thyroid and antithyroid drugs

6.2.1 Thyroid hormones liothyronine
levothyroxine sodium/thyroxine sodium

6.2.2 carbimazole
propylthiouracil

6.3 Corticosteroids
6.3.1 Replacement therapy fludrocortisone
6.3.2 Glucocorticoid therapy betametasone
cortisone
dexamethasone
hydrocortisone
methylprednisolone
prednisolone

6.4 Sex Hormones

6.4.1 Female sex hormones
6.4.1.1 Estrogens and HRT
- estradiol with progestogen
- estradiol only
- ethinylestradiol
Femoston Conti® tablets (continuous)
Femoston® tablets
estradiol implants
estradiol transdermal patches (FemSeven®)
estradiol vaginal ring (Menoring®)
estradiol valerate (Elleste Solo® tablets)
ethinylestradiol
raloxifene (rheumatology and endocrinology only)

6.4.1.2 Progestogens dydrogesterone

hydroxyprogesterone caproate
medroxyprogesterone acetate
norethisterone
progesterone

6.4.2 Male sex hormones and antagonists cyproterone acetate (urology only)
testosterone & esters (includes intramuscular injection, implants,
Nebido® - endocrinology only)
Miscellaneous dehydroepiandrosterone (endocrinology only - unlicenced)

6.5 Hypothalamic and pituitary hormones and anti-oestrogens

6.5.1 Hypothalamic and anterior pituitary chorionic gonadotrophin (hcg)

hormones and anti-oestrogens clomiphene citrate
gonadorelin (lhrh)
menotrophin (lh & fsh)
protirelin (trh)
somatropin (in accordance with NICE guidance) -
Follow restricted high cost drug procedure when prescribing somatropin
tetracosactide
urofollitropin (fsh)

6.5.2 Posterior pituitary hormones and demeclocycline

antagonists desmopressin
terlipressin (Gastroenterology, A&E and EAU only)
vasopressin (Gastroenterology only)

6.6 Drugs affecting bone metabolism

6.6.1 Calcitonin calcitonin salmon/salcatonin

6.6.2 Bisphosphonates
6.7 Other endocrine drugs
6.7.1 Bromocriptine & other dopamine-
receptor stimulants
6.7.2 Drugs affecting gonadotrophins
Gonadorelin analogues
6.7.3 Metyrapone and trilostane
alendronic acid (including once a week products)
disodium etidronate
disodium pamidronate
ibandronate IV (Bonviva®) (For use by consultant rheumatologists in the treatment of
post-menopausal osteoporosis only)
risedronate sodium (weekly risedronate is first line, except for male patients and patients with
gastro-intestinal problems whereby alendronate should be considered first line)
sodium clodronate
strontium ranelate (Rheumatology and Elderly Care consultants only in accordance with Trust
Guidelines for the Prevention and Management of Osteoporosis)
teriparatide (Dr T O'Neill only) -
Follow restricted high cost drug procedure when prescribing teriparatide
tiludronic acid (Rheumatology only)
zoledronic acid (licensed indications only - for use by Urology and Haematology [Myeloma IX
trial] directorates only)
bromocriptine
cabergoline (obs & gynae only)
danazol
buserelin
goserelin (consultant only)
leuprorelin (Prostap® SR) (Obstetric and Gynaecology directorate only - a shared care
protocol is required if care is to be continued in primary care)
metyrapone