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 Formulary Chapter 13: Skin - Full Chapter
13.05.03  Expand sub section  Drugs affecting the immune response
Adalimumab
(Dermatology)
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Restricted Drug Restricted
GP - Red
High Cost Medicine

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary when used in line with NICE recommendations and/or Local Trust Guidelines.
    • Restricted to Consultant Dermatologists for NICE approved indications.
    • See links below
    • Check MHRA Drug Safety Updates
  • RFL:
    • Approved for Psoriasis and Hydradenitis Suppurativa (NHSE)
    • Homecare available - usually after 1 month
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: Adult high-cost drug treatment pathway for psoriasis
Link  NICE TA146: Adalimumab for the treatment of adults with psoriasis
Link  NICE TA392: Adalimumab for treating moderate to severe hidradenitis suppurativa
Link  NICE TA455: Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
   
Apremilast
(Dermatology)
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Restricted Drug Restricted
GP - Red
High Cost Medicine

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

 Provider notes

  • NMUH: 
    • This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary when used in line with NICE recommendations and/or Local Trust Guidelines.
    • See links below.
    • Check MHRA Drug Safety Updates.
  • RFL:
    • For the treatment of Psoriasis in line with NICE guidance
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NCL JFC: Adult high-cost drug treatment pathway for psoriasis
Link  NICE TA419: Apremilast for treating moderate to severe plaque psoriasis
   
Azathioprine
(Oral mucosal inflammatory disease)
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Formulary

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Approved for Pemphigus Vulgaris (PV), Mucous membrane pemphigoid (MMP), Recurrent apthous stomatitis (RAS), Oral lichen planus (OLP), Oral Crohn’s disease (OCD) (JFC June 2017)

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • See above
  • RNOH:
    • Non-formulary
  • UCLH:
    • See indication above
  • WH:
    • Non-formulary
 
Link  NCL JFC: DMARD Quick Reference Guide for Primary Care Prescribers
   
Azathioprine
(Dermatology)
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Formulary

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NCL JFC: DMARD Quick Reference Guide for Primary Care Prescribers
   
Brodalumab
(Dermatology)
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Restricted Drug Restricted
GP - Red
High Cost Medicine

Provider notes

  • NMUH:
    • This medicine has a positive NICE TA and is listed in the Trust Medicines Formulary when used in line with NICE recommendations and/or Local Trust Guidelines - TO AWAIT UPDATED NCL JFC PATHWAY PRIOR TO PRESCRIBING
    • See links below
  • RFL:
    • As per NICE guidance
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NCL JFC: Adult high-cost drug treatment pathway for psoriasis
Link  NICE TA511: Brodalumab for treating moderate to severe plaque psoriasis
   
Certolizumab pegol
(Dermatology)
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Formulary
GP - Red
High Cost Medicine

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

See NICE TA for eligibility criteria

Provider notes

  • NMUH:
    • This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary when used in line with NICE recommendations and/or Local Trust Guidelines. 
    • See links below
  • RFL:
    • As per NICE guidance
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NCL JFC: Adult high-cost drug treatment pathway for psoriasis
Link  NICE TA574: Certolizumab pegol for treating moderate to severe plaque psoriasis
   
Ciclosporin
(Dermatology)
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Formulary

NOTE: There is more than one monograph for Ciclosporin, click here to search for formulary status and its use for other indications. 

Approved for:

  • chronic refractory idiopathic urticaria (JFC - January 2015)
  • severe atopic dermatitis (DMARD fact sheet)
  • severe psoriasis (DMARD fact sheet)

 

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: DMARD Quick Reference Guide for Primary Care Prescribers
Link  NCL JFC: Chronic urticaria and angioedema treatment pathway
   
Dimethyl fumarate (Skilarence)
(Dermatology)
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Formulary

DO NOT CONFUSE Tecfidera® AND Skilarence® AS THEY ARE LICENSED FOR DIFFERENT INDICATIONS

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • As per NICE guidance
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NCL JFC: Adult high-cost drug treatment pathway for psoriasis
Link  NICE TA475: Dimethyl fumarate for treating moderate to severe plaque psoriasis
   
Etanercept
(Dermatology)
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Restricted Drug Restricted
GP - Red
High Cost Medicine

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

JFC approved Benepali as the brand of choice.

Provider notes

  • NMUH:
    • This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary when used in line with NICE recommendations and/or Local Trust Guidelines.
    • Restricted to Consultant Dermatologists
    • Check MHRA safety updates.
    • See links below.
  • RFL:
    • Approved for use in the treatment of Psoriasis in line with NICE guidance
    • Homecare available - usually after first month
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: Adult high-cost drug treatment pathway for psoriasis
Link  NICE TA103: Etanercept and efalizumab for the treatment of adults with psoriasis
Link  NICE TA455: Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
   
Guselkumab
(Dermatology)
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Formulary
High Cost Medicine

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • As per NICE guidance
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NCL JFC: Adult high-cost drug treatment pathway for psoriasis
Link  NICE TA521: Guselkumab for treating moderate to severe plaque psoriasis
   
Hydroxychloroquine
(Dermatology)
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Restricted Drug Restricted

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Approved for symptomatic erosive oral lichen planus refractory to topical treatment (corticosteroids or tacrolimus) (JFC June 2018). 

DMARD fact sheet also specifies approval for "Dermatological conditions caused or aggravated by sunlight".

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NCL JFC: DMARD Quick Reference Guide for Primary Care Prescribers
   
Infliximab
(Dermatology)
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Restricted Drug Restricted
High Cost Medicine

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Remsima is the preferred brand

Provider notes

  • NMUH:
    • This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary when used in line with NICE recommendations and/or Local Trust Guidelines.
    • See links below
    • Restricted to Consultant Dermatologists 
    • See MHRA Drug Safety Updates
  • RFL:
    • Approved for use in the treatment of Psoriasis and Hydradenitis Suppurativa (NHSE)
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Restricted
 
Link  NCL JFC: NCL JFC: Adult high-cost drug treatment pathway for psoriasis
Link  NHSE 16018/P: Infliximab for the treatment of hidradenitis suppurativa
Link  NICE TA134: Infliximab for the treatment of adults with psoriasis
   
Ixekizumab injection
(Dermatology)
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Restricted Drug Restricted

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary when used in line with NICE recommendations and/or Local Trust Guidelines.
    • See link below
  • RFL:
    • For Psoriasis in line with NICE guidance
    • Homecare available - usually after first month
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: Adult high-cost drug treatment pathway for psoriasis
Link  NICE TA442 : Ixekizumab for treating moderate to severe plaque psoriasis
   
Methotrexate
(Dermatology)
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Restricted Drug Restricted

NOTE: There is more than one monograph for Methotrexate, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    •  See link below
  • RFL:
    •  All patients must be issued with a methotrexate monitoring booklet which must be reviewed at each dispensing
    • Only 2.5mg tablets to be prescribed
    • See pharmacy policy for the safe dispensing of methotrexate
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
Link   NCL JFC: Shared care Guideline - Prescribing and Monitoring of oral methotrexate for licensed and off-label indications
   
Pimecrolimus 1% cream (Elidel)
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Restricted Drug Restricted

Provider notes

  • NMUH:
    • Restricted to Dermatology
  • RFL:
    • Restricted to Dermatology
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Pimecrolimus cream is restricted to Dermatology use only
 
Link  NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
   
Risankizumab
(Dermatology)
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Formulary

See NICE TA for eligibility criteria

Provider notes

  • NMUH:
    • This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary when used in line with NICE recommendations and/or Local Trust Guidelines.
    • See links below
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
    • Non-formulary
  • WH:
    • Non-formulary
 
Link  NCL JFC: Adult high-cost drug treatment pathway for psoriasis
Link  NICE TA596: Risankizumab for treating moderate to severe plaque psoriasis
   
Secukinumab
(Dermatology)
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Restricted Drug Restricted
GP - Red
High Cost Medicine

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

 Provider notes

  • NMUH:
    • This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary when used in line with NICE recommendations and/or Local Trust Guidelines.
    • See links below
  • RFL:
    • Approved for use in the treatment of Psoriasis in line with NICE guidance
    • Homecare available - usually after first month
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • For use by Dermatologists and Rheumatologists ONLY
    • See links below
 
Link  NCL JFC: Adult high-cost drug treatment pathway for psoriasis
Link  NICE TA350: Secukinumab for treating moderate to severe plaque psoriasis
Link  NICE TA407: Secukinumab for active ankylosing spondylitis after treatment with non-steroidal anti-inflammatory drugs or TNF-alpha inhibitors
   
Tacrolimus ointment (Protopic)
(Dermatology)
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Restricted Drug Restricted

Approved for atopic eczema, including the eyelids (JFC September 2016)

Provider notes

  • NMUH:
    • Restricted to Dermatology
  • RFL:
    • Restricted to Dermatology only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Tacrolimus ointment is restricted to dermatology
    • See indication above
 
Link  NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
   
Tildrakizumab
(Dermatology)
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Formulary
High Cost Medicine

Provider notes

  • NMUH:
    • This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary when used in line with NICE recommendations and/or Local Trust Guidelines. 
    • See links below
  • RFL:
    • As per NICE guidance
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NCL JFC: Adult high-cost drug treatment pathway for psoriasis
Link  NICE TA575: Tildrakizumab for treating moderate to severe plaque psoriasis
   
Ustekinumab
(Dermatology)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
GP - Red
High Cost Medicine

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary when used in line with NICE recommendations and/or Local Trust Guidelines.
    • See links below
    • TA455 does not apply to NMUH as service is not offered.
    • Check MHRA Drug Safety Updates
  • RFL:
    • For the treatment of Psoriasis in line with NICE guidance
    • Homecare available - usually after first month
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Restricted to Dermatology use ONLY 
    • See links below
 
Link  NCL JFC: Adult high-cost drug treatment pathway for psoriasis
Link  NICE TA180: Ustekinumab for the treatment of adults with moderate to severe psoriasis
Link  NICE TA340: Ustekinumab for treating active psoriatic arthritis
Link  NICE TA455: Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
   
 ....
 Non Formulary Items
Efalizumab  (Raptiva)

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Non Formulary
 
Omalizumab
(Atopic dermatitis)

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Non Formulary
Black

NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Not approved for atopic dermatitis / eczema (March 2014)

 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

GP - 1st

Medicines suitable for first-line use within primary care.

Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.

  

GP - 2nd

Medicines suitable for second-line use within primary care.

Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.

  

GP - Amber

Medicines that should be initiated by a specialist. Prescribing can be transferred to primary care once the patient has been stabilised.

Shared care: For drugs with regular, ongoing need for monitoring and/or assessment of efficacy or toxicity. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the North Central London JFC.

Fact sheet: For drugs with some concerns surrounding safety or efficacy but do not require regular monitoring and/or monitoring of effectiveness/toxicity.

  

GP - Red

Medicines which should normally be prescribed by specialists only (hospital only).

For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.

  

GP - Grey

Medicines on hospital formularies which have not been reviewed for suitability in primary care.  

Black

Medicines not recommended for routine use in primary or secondary care.

Medicines, which the North Central London JFC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.

  

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