Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
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Details... |
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
- NMUH:
- RFL:
- Renal transplant: For transplant induction and rejection
- Liver transplant: For transplant rejection only
- 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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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 (as per TA) and Liver (contact Pharmacy) for 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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 (hospital only prescribing) for renal transplant
 for other transplants
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:
- RNOH:
- UCLH:
- WH:
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Ciclosporin
(Capsorin®)
(Transplant)
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Formulary
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 (hospital only prescribing) for renal transplant
 for other transplants
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:
- RNOH:
- UCLH:
- WH:
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Ciclosporin
(Deximune®)
(Transplant)
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Formulary
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 (hospital only prescribing) for renal transplant
 for other transplants
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:
- Liver transplant: Preferred brand for new patients
- Renal transplant: Not for new patients
- Transplant patients must be maintained on the same brand
- RNOH:
- UCLH:
- WH:
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Ciclosporin
(Neoral®)
(Transplant)
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Formulary
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 (hospital only prescribing) for renal transplant
 for other transplants
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:
- Liver transplant: Not for new patients unless liquid formulation required
- Renal transplant: Preferred brand for renal transplant
- Transplant patients must be maintained on the same brand
- RNOH:
- UCLH:
- WH:
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Ciclosporin
(Sandimmun®)
(Transplant)
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Formulary
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 (hospital only prescribing) for renal transplant
 for other transplants
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:
- Liver transplant: Not for new patients
- Renal transplant: Not for new patients
- Transplant patients must be maintained on the same brand
- RNOH:
- UCLH:
- WH:
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Sirolimus
(Transplant)
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Formulary
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(hospital only prescribing) for all new transplants, except liver
for 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:
- Approved for renal and liver transplants
- 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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(hospital only prescribing) for all new transplants, except liver
for existing transplants and liver transplants
Provider notes
- NMUH:
- Not to be intiated at NMUH. For continuation of immunosuppressant therapy
- RFL:
- Liver transplant: Preferred brand for new patients
- Kidney transplant: Preferred brand for 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
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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
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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:
- Historic transplant patients
- Transplant patients must be maintained on the same brand
- 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 once-daily tacrolimus is 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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Tacrolimus caps
(Chronic Histiocytic Intervillosities)

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Non Formulary

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Not approved for Chronic Histiocytic Intervillosities (JFC March 2019) |
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Traffic Light Status Information
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Description |
 
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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.
See link for the complete NCL Red List https://www.ncl-mon.nhs.uk/wp-content/uploads/2017/08/ncl_red_list.pdf |
 
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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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