| Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
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| 08.02.02 |
Corticosteroids and other immunosuppressants |
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Antithymocyte immunoglobulin - rabbit (Thymoglobuline®)
(Transplant)
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 Restricted
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Provider notes - RFL:
- Resricted to renal team for the treatment of transplant rejection
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 NICE TA481 (not recommended as initial treatment): Immunosuppressive therapy for kidney transplant in adults
NICE TA482 (not recommended as initial treatment): Immunosuppressive therapy for kidney transplant in children and young people
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Basiliximab
(Transplant)
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Restricted
 
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See NICE TA for eligibility criteria Provider notes - NMUH:
- This medicine has a positive NICE Technology Appraisal but service is not offered at NMUH.
- Check MHRA Drug Safety Alerts
- RFL:
- Prior funding required for treatment of lymphoma with radiolabelled basiliximab Approved for Renal transplant patients.
- RNOH:
- UCLH:
- WH:
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NICE TA481: Immunosuppressive therapy for kidney transplant in adults
NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
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Ciclosporin (Capimune®)
(Transplant)
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Formulary
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NOTE: There is more than one monograph for Ciclosporin, click here to search for formulary status and its use for other indications. Provider notes
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Ciclosporin (Capsorin®)
(Transplant)
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Formulary
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NOTE: There is more than one monograph for Ciclosporin, click here to search for formulary status and its use for other indications. Provider notes
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Ciclosporin (Deximune®)
(Transplant)
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Formulary
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NOTE: There is more than one monograph for Ciclosporin, click here to search for formulary status and its use for other indications. Provider notes - NMUH:
- RFL:
- Deximune is the first-line choice for all new liver transplant patients.
- Previous liver tranplant patients must be maintained on the same brand (usually Neoral). Brand are not interchangeable.
- RNOH:
- UCLH:
- WH:
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Ciclosporin (Neoral®)
(Transplant)
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Formulary
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NOTE: There is more than one monograph for Ciclosporin, click here to search for formulary status and its use for other indications. Provider notes - NMUH:
- Restricted to Consultant use only.
- RFL:
- Patients must be maintained on the same brand
- 1st choice for renal transplant
- RNOH:
- UCLH:
- WH:
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Ciclosporin (Sandimmun®)
(Transplant)
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Formulary
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NOTE: There is more than one monograph for Ciclosporin, click here to search for formulary status and its use for other indications. Provider notes
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Sirolimus
(Transplant)
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Formulary
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For all new transplants, except liver  Existing transplants and liver transplants See NICE TA for eligibility criteria Provider notes - NMUH:
- See links below
- Not to be intiated at NMUH. For continuation of immunosuppressant therapy
- RFL:
- RNOH:
- UCLH:
- WH:
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NICE TA481 (not recommended as initial treatment): Immunosuppressive therapy for kidney transplant in adults
NICE TA482 (not recommended as initial treatment): Immunosuppressive therapy for kidney transplant in children and young people
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Tacrolimus (Adoport ®)
(Transplant)
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Formulary
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For all new transplants, except liver Existing transplants and liver transplants Provider notes - NMUH:
- Not to be intiated at NMUH. For continuation of immunosuppressant therapy
- RFL:
- Preferred brand of tacrolimus for all new liver transplant patients
- Preferred brand of tacrolimus for all new kidney transplant patients
- Brands are not interchangeable, patients must be maintained on the same brand
- See individual transplant policies for dosing information
- RNOH:
- UCLH:
- WH:
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NICE TA481: Immunosuppressive therapy for kidney transplant in adults
NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
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Tacrolimus (Modigraf ®)
(Transplant)
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Formulary
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For all new transplants, except liver Existing transplants and liver transplants Provider notes - NMUH:
- Not to be intiated at NMUH. For continuation of immunosuppressant therapy
- RFL:
- RNOH:
- UCLH:
- WH:
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NICE TA481: Immunosuppressive therapy for kidney transplant in adults
NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
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Tacrolimus (Prograf ®)
(Transplant)
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Restricted
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For all new transplants, except liver Existing transplants and liver transplants Provider notes - NMUH:
- RFL:
- Historic transplant patients
- Transplant patients must be maintained on the same brand
- RNOH:
- UCLH:
- WH:
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NICE TA481: Immunosuppressive therapy for kidney transplant in adults
NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
 NMUH: Trust Therapeutic Drug Monitoring Guidelines
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Tacrolimus (Vivadex ®)
(Transplant)
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Formulary
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For all new transplants, except liver Existing transplants and liver transplants Provider notes - NMUH:
- Not to be intiated at NMUH. For continuation of immunosuppressant therapy
- RFL:
- RNOH:
- UCLH:
- WH:
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NICE TA481: Immunosuppressive therapy for kidney transplant in adults
NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
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Tacrolimus modified release (Advagraf ®)
(Transplant)
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Formulary
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For all new transplants, except liver Existing transplants and liver transplants Provider notes - NMUH:
- Not to be intiated at NMUH. For continuation of immunosuppressant therapy
- RFL:
- Envarsus is now the preferred modified release preparation
- RNOH:
- UCLH:
- WH:
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NICE TA481 (not recommended as initial treatment): Immunosuppressive therapy for kidney transplant in adults
NICE TA482 (not recommended as initial treatment): Immunosuppressive therapy for kidney transplant in children and young people
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Tacrolimus modified release (Envarsus®)
(Transplant)
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Formulary
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For all new transplants, except liver Existing transplants and liver transplants Provider notes - NMUH:
- Not to be intiated at NMUH. For continuation of immunosuppressant therapy
- RFL:
- Approved for immunosuppression in liver and renal transplants for patient in whom Advagraf would otherwise be indicated. For RFL only (approved by DTC in May-16, ratified by JFC in June-16)
- RNOH:
- UCLH:
- WH:
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NICE TA481 (not recommended as initial treatment): Immunosuppressive therapy for kidney transplant in adults
NICE TA482 (not recommended as initial treatment): Immunosuppressive therapy for kidney transplant in children and young people
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| Non Formulary Items |
Belatacept
(Transplant)
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Non Formulary
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NICE TA481 (not recommended as initial treatment): Immunosuppressive therapy for kidney transplant in adults
NICE TA482 (not recommended as initial treatment): Immunosuppressive therapy for kidney transplant in children and young people
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Everolimus (Certican®)
(Transplant)
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Non Formulary
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DO NOT CONFUSE Afinitor®, Votubia® AND Certican® AS THEY ARE LICENSED FOR DIFFERENT INDICATIONS |
NICE TA348 (not recommended): Everolimus for preventing organ rejection in liver transplantation
NICE TA481 (not recommended as initial treatment): Immunosuppressive therapy for kidney transplant in adults
NICE TA482 (not recommended as initial treatment): Immunosuppressive therapy for kidney transplant in children and young people
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Key |
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High Cost Medicine
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Cancer Drugs Fund
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
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Description |
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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. |
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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. |
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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. |
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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. |
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Medicines on hospital formularies which have not been reviewed for suitability in primary care. |
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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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