Amber List of Drugs

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.

Documents marked with an asterisk (*) require review. Please contact a specialist for further information.

Drug Name BNF Classification and Indication
Acamprosate

Alcohol withdrawal

Alzheimers Medication

Mild to moderate dementia in Alzheimer's disease

Anastrazole

Chemoprevention of Familial Breast Cancer

Apomorphine

Dopaminergic drug - Parkinson's disease

Atomoxetine

Treatment of ADHD

Azathioprine

Immunosuppression

Azathioprine and 6-mercaptopurine

Inflammatory Bowel Disease

Ciclosporin for Immunosuppression

Immunosuppression in adults

Ciclosporin in Renal Transplant

Renal

Cinacalcet

Secondary hyperparathyroidism in end stage Renal disease

Colistimethate (Colomycin or Promixin)

Treatment of colonisation and infections of the lung due to pseudomonas aeruginosa

Degarelix

Treatment of adult male patients with advanced hormone-dependent prostate cancer

Denosumab

Primary and secondary prevention of osteoporotic fractures in postmenopausal women

Dexamphetamine

Treatment of ADHD

Donepezil

Dementia

Erythropoetin

Renal Anaemia

Fulvestrant

Breast Cancer

Galantamine

Dementia

Grazax

Treatment of grass pollen allergies

Guanfacine

Attention Deficit Hyperactivity Disorder

Hydroxychloroquine

DMARD and immunosupression

Ibandronate

Metastatic bone disease

Isocarboxazid

Treatment of depressive illness

Leflunomide

Disease modifying anti-rheumatic drug

Lisdexamfetamine

Attention Deficity Hyperactivity Disorder

Lithium

Affective disorders and cluster headaches

Melatonin

Sleep disorders

Memantine

Dementia

Methotrexate for Immunosuppression

Immunosuppression

Methylphenidate

Treatment of ADHD

Midazolam Oromucosal Solution (Buccolam)

For the management of Status Epilepticus in adults and children

Modafinil

Narcolepsy

Mycophenolate Mofetil

Immunosuppression

Mycophenolate Mofetil or Mycophenolic Acid (Myfortic) Post Solid Organ Transplant

Post renal transplant

Naltrexone in Alcohol Relapse Prevention

Alcohol relapse prevention

Naltrexone in Relapse Prevention (Opioid Dependence)

Treatment of narcotic addiction

Penicillamine

Disease-modifying anti-rheumatic drug - rheumatoid arthritis

Phenelzine

Treatment of depressive illness

Raloxifiene

Chemoprevention of famillial breast cancer

Riluzole

Treatment of amytrophic lateral sclerosis

Rivastigmine

Dementia

Sirolimus

Immunosuppressant post renal transplant

Sodium Aurothiomalate (Gold Injection) in Rheumatoid Arthritis

Disease-modifying anti-rheumatic drug - rheumatoid arthritis

Somatostatin Analogues (Somatuline LA, Somatuline Autogel and Sandostatin LAR) *

Somatostatin Analogue - licensed indications (symptoms associated with carcinoid tumours with features of carcinoid syndrome, VIPomas, glucagonomas, acromegaly, prevention of complications following pancreatic surgery)

Somatropin

For adult growth hormone deficiency

Sulphasalazine

DMARD and immunosupression

Tacrolimus

Immunosuppression post transplant

Tamoxifen

Chemoprevention of familial breast cancer

Testosterone

Treatment of male hypogonadism menopausal symptoms in women

Tobramycin

Cystic fibrosis management

Tranylcypromine

Treatment of depressive illness

Verapamil

Cluster headaches