This flowchart summarises the current guidance for therapeutic options for COVID-19 positive patients.  If prescribing these drugs, you must be familiar with the local guidelines, available on the microguide site/app.  The guidance/flowchart is reviewed regularly by the trust COVID therapies working group as national guidelines are evolving , so please always defer to this site to check that you are using the most up to date version. 

NOV 2022 UPDATE TO GUIDANCE (summary of changes below)

• Blueteq forms still need to be completed for use of each of these drugs (with exception of steroids).

• Tocilizumab is the first-line IL-6 inhibitor for hospitalised patients with COVID-19. Patients may continue to be  considered for treatment with sarilumab where tocilizumab is unavailable for this indication or cannot be used.

• New age guidance for the use of remdesivir - Adults and paediatric patients (at least 4 weeks of age and weighing at least 3 kg) hospitalised due to symptoms of COVID-19 are eligible for treatment.

• Baricitinib may be administered in combination with IL-6 receptor inhibitors (as well as corticosteroids, unless contraindicated), according to clinical judgement, in patients with severe or critical COVID-19. If an IL-6 inhibitor is not deemed suitable, or eligibility criteria (for an IL-6 inhibitor) are unmet, baricitinib treatment may still be considered.

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NHS Flowchart for medicines management of patients hospitalised due to COVID-19