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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
Notes:

The formulary for systemic anti-cancer treatments should be viewed alongside the 'National Cancer Drugs Fund list'

https://www.england.nhs.uk/publication/national-cancer-drugs-fund-list/

 Details...
08.02.01  Expand sub section  Antiproliferative immunosuppressants
Azathioprine
(Immunosuppresion)
View adult BNF View SPC online View childrens BNF
Formulary
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GP-RedRed (hospital only prescribing) for renal transplant

Grey for other indications

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:
    • Regular monitoring of FBC and LFTs is required.
 
Mycophenolate mofetil
(Rheumatology)
View adult BNF View SPC online View childrens BNF
Formulary
High Cost Medicine
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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:
  • RFL:
    • Restricted to Rheumatology Consultants only
  • RNOH:
    • Restricted to Rheumatology Consultants Only
  • UCLH:
  • WH:
    • Initiation restricted to Rheumatology only
 
Link  NCL JFC: DMARD Quick Reference Guide for Primary Care Prescribers
Link  RNOH + Herts CCG: Adult Rheumatology Shared Care - Principles and Responsibilities
Link  RNOH + Herts CCG: Mycophenolate in Adult Rheumatology - Shared Care Information
Mycophenolate mofetil
(Transplant)
View adult BNF View SPC online View childrens BNF
Formulary
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GP-RedRed (hospital only prescribing) for renal transplant

Grey for other transplants

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:
    • To be used for continuation of immunosuppressant therapy only
    • See links below
    • Check MHRA Drug Safety Updates
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Mycophenolate is approved for Dr Woolfson's use
    • Tabs 500mg
 
Link  NICE TA481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
Mycophenolate sodium
(Mycophenolic acid)
(Transplant)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
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GP-RedRed (hospital only prescribing) for renal transplant

Grey for other transplants

 

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Second-line to mycophenolate mofetil for renal transplant (Ceptava brand)
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NICE TA481 (not recommended as initial treatment): Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA482 (not recommended as initial treatment): Immunosuppressive therapy for kidney transplant in children and young people
 ....
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
Homecare
Homecare

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.

See link for the complete NCL Red List https://www.ncl-mon.nhs.uk/wp-content/uploads/2017/08/ncl_red_list.pdf

  

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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