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 Formulary Chapter 21: Short term approval only - Full Chapter
21.01  Expand sub section  Approved under evaluation
 note 

These drugs are only to be used as part of an evaluation. Please contact your formulary Pharmacist before prescribing, ordering or dispensing these items.

Alitretinoin
(Pityriasis rubra pilaris)
View adult BNF View SPC online View childrens BNF
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. 

Alitretinoin for pityriasis rubra pilaris
Evaluation at RFL site only (August 2016)

 
   
Alteplase
(Visceral thrombosis)
View adult BNF View SPC online View childrens BNF
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. 

Alteplase for complicated visceral thrombosis
Evaluation at RFL site only (July 2014)

 
   
Cacicol
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted

Non-healing corneal ulcers/ persistent epithelial defects. 
Under evaluation at MEH only (restricted to corneal eye disease service only, April 2017)

 
   
Co‐careldopa
(Hemispatial neglect)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted

Rotigotine or co‐careldopa for Hemispatial neglect that is interfering with progress of neurorehabilitation - UCLH only
Approval was subject to Dr Swayne working with Dr Sofat and JFC support to agree the datacollection form and the duration of the pilot study. Duration of audit TBC (November 2016).

 
   
Diltiazem cream
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted

Diltiazem cream for transrectal ultrasound guided prostate biopsy
Twelve-month evaluation at UCLH site only (March 2015)

 
   
Fentanyl patch
(Acute post-operative pain)
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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. 

Fentanyl patch for acute post-operative pain in primary knee replacement surgery
30 patient evaluation at RNOH site only. Evaluation to be reviewed at JFC (April 2015)

 
   
Fibrin sealant (Artiss)
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Restricted Drug Restricted

Simple mastectomies - as part of the '23 hour mastectomy' pathway
Under evaluation at RFL only (October 2017)

Provider notes

  • RFL:
    • See above
 
   
Florbetapir F 18 injection
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Restricted Drug Restricted

Amyvid (florbetapir) for Alzheimer's disease
10 patient evaluation at RFL site only. Evaluation to be reviewed at JFC (JFC September 2014 and February 2015)

 
   
Gardasil (Human papillomavirus vaccine)
(Recalcitrant warts)
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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. 

Guardasil (HPV) vaccine for recalcitrant warts
5 patient evaluation at RFL site only (March 2013)

 
   
Gemcitabine + oxaliplatin
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Restricted Drug Restricted

Gemcitabine + oxaliplatin for biliary tract cancer where cisplatin is contraindicated
Approved under evaluation at RFL only (July 2014)

 
   
Hyaluronic acid injection (Ostenil Plus)
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Restricted Drug Restricted

Hyaluronic acid injection (Ostenil Plus) to prevent surgery
Approved under evaluation at RNOH only (July 2014)

RNOH: Restricted for use in accordance with the evaluation protocol by consultants in the Shoulder and Elbow Unit

 
   
Ketamine oral solution
(Pain)
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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. 

Acute pain unresponsive to opiates (inpatient use only; initiation by Pain team consultant or consultant Anaesthetist)
Evaluation for RFL only (approved by DTC in July-17, ratified by JFC in August-17)

 
   
Ketoconazole tablets
(Refractory prostate cancer)
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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. 

Ketoconazole for metastatic hormone refractory prostate cancer (third-line and beyond)
Approved under evaluation for 10 patients. RFL only (January 2017)

 
   
Octreotide long acting injection (Sandostatin Lar)
(Polycystic liver disease)
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Restricted Drug Restricted
NHS England

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

Polycystic liver disease
Approved under evaluation at RFL only - requires NHSE IFR approval (August 2015)

 
   
Oxybutynin modified release
(Hyperhydrosis)
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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. 

Oxybutynin MR for hyperhydrosis
Approved for 30 patients at RFL only. Evaluation to be reviewed at JFC (DTC review in March 2016,
decision ratified at JFC in April 2016)

 
   
Paracetamol IV
(Patent ductus arteriosus)
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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. 

Paracetamol IV for closure of the patent ductus arteriosus (PDA)
Approved second line option after ibuprofen. All eligible patients in NCL to be included in the audit. Evaluation to be reviewed at UCLH or JFC in 12 months (March 2016).

 
Link  RFL: Guidelines for Use of IV Paracetamol
   
Pitolisant
(Narcolepsy)
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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. 

Pitolisant for narcolepsy with or without cataplexy
Under evaluation at UCLH only (June-17)

 
   
Pregabalin
(Spinal-cord injury)
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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. 

Spinal-cord injury neuropathic pain 
Approved under evaluation for 1 year; restricted to RNOH site (March 2015)

 
   
Ribavirin
(Chronic norovirus in PID)
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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. 

Ribavirin for chronic norovirus in PID
3 patient evaluation at RFL site only (January 2015)

 
   
Rotigotine patch
(Hemispatial neglect)
View adult BNF View SPC online View childrens BNF
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. 

Rotigotine or co‐careldopa for Hemispatial neglect that is interfering with progress of neurorehabilitation - UCLH only.
Approval was subject to Dr Swayne working with Dr Sofat and JFC support to agree the datacollection form and the duration of the pilot study. Duration of audit TBC (November 2016).

 
   
Sirolimus tablets
(Vascular)
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Formulary

Sirolimus for low-flow vascular malformations in the head and neck.

Evaluation for RFL only (JFC April 2018)

- see local policy for use / dose

 
   
Tetrahydrocannabinol + Cannabidiol Oromucosal Spray (Sativex)
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Restricted Drug Restricted

Sativex for Tourette’s syndrome
Evaluation for UCLH only (March-17)

 
   
Tropicamide + Lidocaine hydrochloride + Phenylephrine hydrochloride eye drops (Mydrane)
(Ophthalmic)
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Restricted Drug Restricted

Mydrane for obtaining intraoperative pupil dilatation and intracamerular anaesthesia during topical anaesthesia cataract surgery
Evaluation for MEH only (approved by DTC in January-17, ratified by JFC in April-17)

 
   
Vernakalant
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Restricted Drug Restricted

Vernakalant (pilot study) for new-onset atrial fibrillation
Twenty patients only at RFL, Barnet Site (January 2017)

 
   
Maribavir
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Restricted Drug Restricted

Maribavir for resistant CMV infections
Approved for 3 patients and then to be reviewed at RFL only (January 2015)

 
   
 ....
 Non Formulary Items
Alteplase + dornase alpha intrapleural infusion
(Complex pleural infections)

View adult BNF View SPC online View childrens BNF
Non Formulary

Approved as intrapleural fibrinolytics (alteplase + dornase alfa) for ongoing sepsis in association with a persistent pleural collection, who have not responded to 12-24 hours of antibiotics and simple tube drainage, or there is radiological evidence (either on ultrasound and/or CT) that the effusion is unlikely to drain due to multiple loculation; rather than referring for surgical intervention. Evaluation sites to be approved at DTCs (JFC March 2019)

Notes: The majority of trials use dornase alfa (DNase) 5 mg and alteplase (t-PA) 10 mg administered intrapleurally twice daily for up to 3 days. Administration was followed by clamping of the drain to permit the study drug to remain in the pleural space for 1 hour. One study used dornase alfa (DNase) 5 mg and alteplase (t-PA) 5 mg twice daily. 

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
  
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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