See NCL treatment pathways for place in therapy in adults (JFC April 2019). Approved for paediatric use (JFC January 2018).

Secondary care notes

• NMUH approvals:
  • Positive NICE TA. 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.
• RFL approvals:
  • Not applicable
• RNOH approval
  • Not applicable
• UCLH approvals:
• WH approvals:
  • As per NICE TA342 June 2015.

Approved as test vaccination to diagnose or exclude antibody deficiency including CVID and SAD (JFC May 2017)

Secondary care notes

• NMUH approvals:
• Not applicable
• RFL approvals:
• Not applicable
• RNOH approvals:
• Not applicable
• UCLH approvals:
• Diagnose or exclude antibody deficiency including CVID and SAD (UMC March 2017)
• WH approvals:
• Not applicable

Secondary care notes

• NMUH approvals:
• To be prescribed as per BHIVA Guidelines by the HIV team only
• RFL approvals:
• As per HIV guidelines
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
• For TB / HIV clinic only

Approved for:

• Rheumatoid arthritis in line with the NCL RA pathway
• Juvenile Idiopathic Arthritis (JIA; see NICE TAs)

Secondary care notes

• NMUH approvals:
• 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 be prescribed by Rheumatologists ONLY.
• Check MHRA Drug Safety Updates.
• See links below.
• RFL approvals:
  • Approved for Rheumatoid Arthritis, in line with NICE guidance.
  • PCT funding approval required.
• RNOH approvals:
  • Restricted to Rheumatology Consultants ONLY.
• UCLH approvals:
• WH approvals:
  • As per NICE TA and above

Secondary care notes

• NMUH approvals:
  • 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. To be prescribed as per NICE guidance
  • See links below
• RFL approvals:
  
  • Nil
• RNOH approval
  
  • Not Applicable
• UCLH approvals:
• WH approvals:
  
  • Not applicable to WH

Secondary care notes

• NMUH approvals:
  • See link below
• RFL approvals:
  • Nil
• RNOH approvals
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  
  • Restricted for patients allergic to Warfain only.
  • Check MHRA Drug Safety Updates
• RFL approvals:
  
  • Not applicable
• RNOH approvals:
  
  • Not applicable
• UCLH approvals:
• WH approvals:
  
  • Not applicable

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
  • Not applicable
• RFL approvals:
  • Not applicable
• RNOH approvals
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Acetylcysteine 5% preservative free drops (10mL) is an unlicensed special and restricted to Ophthalmology.

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approval
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Restricted to Dermatology
• RFL approvals:
  • Nil
• RNOH approvals
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Restricted to Dermatology use only

Secondary care notes

• NMUH approvals:
• Carbomix and Charcodote available
• RFL approvals:
• Actidose-Aqua Advance, Carbomix, Charcodote available
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
• Not applicable

Approved for:

• Rheumatoid arthritis in line with the NCL RA pathway
• Juvenile Idiopathic Arthritis (JIA; see NICE TA)
• Ankylosing Spondylitis (see NICE TAs)
• Psoriatic Arthritis (PsA; see NICE TAs)

Secondary care notes

• NMUH approvals: 
  • Check MHRA Drug Safety Updates
  • 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.
  • Restricted to Consultant Rheumatologists
  • See links below
• RFL approvals:
  • Prior funding approval required
  • Restricted to Dermatology, Gastroenterology, Paediatric Gastroenterology and Rheumatology
• RNOH approvals:
  • Restricted to Rheumatology Consultants Only
• UCLH approvals:
• WH approvals:
  • As per NICE TA and above

Secondary care notes

• NMUH approvals:
  • 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 approvals:
  • Not applicable
• RNOH approvals
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

Approved for acne (JFC April 2016)

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approval
  • Not applicable
• UCLH approvals:
• WH approvals:
  • See indication above

Secondary care notes

• NMUH approvals:
  
  • Nil
• RFL approvals:
  
  • Nil
• RNOH approvals
  
  • Nil
• UCLH approvals:
• WH approvals:
  
  • Nil

Emerade is preferred to EpiPen for anaphylaxis (JFC August 2015)

Secondary care notes

• NMUH approvals:
• Not applicable
• RFL approvals:
• Nil
• RNOH approvals
• Nil
• UCLH approvals:
• WH approvals:
• Not applicable

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  
  • Not applicable
• RNOH approval
  
  • Nil
• UCLH approvals:
• WH approvals:
  
  • Not applicable

Secondary care notes

• NMUH approvals:
  • Not applicable
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  
  • 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 approvals:
  
  • As per NICE TA
  • This drug for the treatment of malignant disease must be prescribed on chemocare (RFL electronic chemotherapy prescribing system).  Additionally for in-patients this drug must be prescribed on an in-patient prescription chart (paper or electronic)
• RNOH approvals
  
  • Not Applicable
• UCLH approvals:
• WH approvals:
  
  • NOT Applicable

Secondary care notes

• NMUH approvals:
  • 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.
  • To be prescribed by Consultant Ophthalmologists ONLY
  • See links below
• RFL approvals:
  • As per NICE guidance
  • To be prescribed by consultant opthalmologists only
• RNOH approvals
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
• Not applicable
• RFL approvals:
• Nil
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
• Not applicable

Secondary care notes

• NMUH approvals:
• For use for named patients only
• RFL approvals:
• Not applicable
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
• Nil

 Approved for

• Idiopathic CD4 lymphocytopenia (November 2012)

Secondary care notes

• NMUH approvals:
  
  • Not Applicable
• RFL approvals:
  
  • Nil
• RNOH approvals
  
  • Not Applicable
• UCLH approvals:
• WH approvals:
  
  • Not Applicable

Secondary care notes

• NMUH approvals:
  • Positive NICE TA This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary when in line with NICE recommendations and/or Local Trust Guidelines.
  • See links below
• RFL approvals:
  • Nil
• RNOH approvals:
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Controlled Drug Requirements
• RNOH approvals
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  
  • Restricted to Urology Department, second line use only.
• RFL approvals:
  
  • Not applicable
• RNOH approval
  
  • Nil
• UCLH approvals:
• WH approvals:
  
  • The use of alfuzosin is reserved for the Urology Department only

Secondary care notes

• NMUH approvals:
• 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.
• To be prescribed on the recommendation of Consultant Cardiologists and Endocrinologists ONLY
• See links below
• RFL approvals:
• Not applicable
• RNOH approvals
• Nil
• UCLH approvals:
• WH approvals:
• Not applicable

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

Secondary care notes

• NMUH approvals:
  • Not applicable
• RFL approvals:
  • Nil
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

If used for non-SLS indications

Secondary care notes

• NMUH approvals:
  
  • Red List Medicine – Hospital Only Prescribing
• RFL approvals:
  • Restricted to Urology and Endocrinology consultants
• RNOH approvals
  
  • Nil
• UCLH approvals:
• WH approvals:
  
  • Inj 20 micrograms only

If used for non-SLS indications

Secondary care notes

• NMUH approvals:
  
  • Red List Medicine – Hospital Only Prescribing Restricted to Consultants in Urology and Sexual Health (St. Ann's) use only.
• RFL approvals:
  • Nil
• RNOH approvals
  
  • Not Applicable
• UCLH approvals:
• WH approvals:
  
  • Not applicable

Secondary care notes

• NMUH approvals:
• Not applicable
• RFL:
• Approved for:
  • Iliofemoral DVT with (i) May-Thurner syndrome OR extensive clots AND (ii) who have severe symptoms despite 5-7 days anticoagulation OR where a limb is threatened (JFC July 2018)
  • Paget-Schroetter Syndrome
• Not approved for:
  • Massive or high risk PE (defined as acute PE with sustained hypotension [SBP ≤ 90 mm Hg for at least 15 min or requiring inotropic support, not due to a cause other than PE, such as arrhythmia, hypovolemia, sepsis, or LV dysfunction], pulselessness or persistent profound bradycardia [pulse < 40 bpm], with signs or symptoms of shock) (JFC July 2018)
• RNOH approvals
• Not applicable
• UCLH:
  • Approved for:
    • Iliofemoral DVT with (i) May-Thurner syndrome OR extensive clots AND (ii) who have severe symptoms despite 5-7 days anticoagulation OR where a limb is threatened (UMC June 2018)
    • Upper Limb Central Venous Catheter (CVC) Related Thrombosis as last-line therapy (UMC June 2018)
  • Not approved for:
    • Paget-Schroetter Syndrome- Refer patient to RFH (UMC June 2018)
    • Stent rethrombosis (UMC June 2018)
    • Massive or high risk PE (defined as acute PE with sustained hypotension [SBP ≤ 90 mm Hg for at least 15 min or requiring inotropic support, not due to a cause other than PE, such as arrhythmia, hypovolemia, sepsis, or LV dysfunction], pulselessness or persistent profound bradycardia [pulse < 40 bpm], with signs or symptoms of shock) (UMC June 2018)
• WH approvals:
• Not applicable

Secondary care notes

• NMUH approvals:
  • Suitable for use in children, adults and the elderly. NOT suitable for use in pregnancy and lactation.
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
• Nil
• RFL approvals:
• Nil
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
• Not applicable

Secondary care notes

• NMUH approvals:
• Nil
• RFL approvals:
• Nil
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
• Not applicable

Secondary care notes

• NMUH approvals:
• Not applicable
• RFL approvals:
• Not applicable
• RNOH approvals
• Nil
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
• Nil
• RFL approvals:
• Nil
• RNOH approvals
• Restricted
• UCLH approvals:
• WH approvals:
• Nil

Secondary care notes

• NMUH approvals:
• Restricted to Microbiology approval only
• RFL approvals:
• Restricted to Ophthalmology (intracameral); HIV; Haematology; ERCP prophylaxis
• Microbiology approval required for all other indications
• See link below
• RNOH approvals
• Nil
• UCLH approvals:
• WH approvals:
  • Microbiology approval only

unlicensed

MEH: Bacterial & Mycobacteria keratitis

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Available from 'special order' manufacturers
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
• Nil
• RFL approvals:
• Restricted for initiation until after a discussion with liaison psychiatry team.
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
• Restricted for initiation by a Consultant Psychiatrist only.

First choice agent for neuropathic pain. Refer to the NCL JFC Neuropathic Pain Prescribing Guideline below.

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals:
  • See link below
  • Oral solution available as 25 mg/5mL 
• UCLH approvals:
• WH approvals:
  
  • Nil

Secondary care notes

• NMUH approvals:
  
  • Nil
• RFL approvals:
  
  • Nil
• RNOH approvals
  
  • Nil
• UCLH approvals:
• WH approvals:
  
  • Nil

Secondary care notes

• NMUH approvals:
• Nil
• RFL approvals:
• Nil
• RNOH approvals
• Oral suspension available as 125 mg/5mL and 250 mg/5mL
• UCLH approvals:
• WH approvals:
• Nil

Secondary care notes

• NMUH approvals:
• As per Trust Guidelines
• RFL approvals:
• ???Not applicable
• RNOH approvals
• Microbiology approval only
• UCLH approvals:
• WH approvals:
• Microbiology approval only

Secondary care notes

• NMUH approvals:
• Not applicable
• RFL approvals:
• Nil
• RNOH approvals
• Not applicable
• UCLH approvals:
• See links below
• WH approvals:
• Nil

Approved for gout for patients who are hospitalised and refractory to all other treatments. The usual dose is 100 mg daily subcutaneously for 3 days (JFC September 2014) 

Secondary care notes

• NMUH approvals:
  • To be prescribed/ recommended by Rheumatology Consultants ONLY
  • Anakinra has been approved for gout. This is an unlicensed indication and the recommended dose is 100mg by subcutaneous injection ONCE a day for 3 days.
  • Check MHRA Drug Safety Updates
• RFL approvals:
• RNOH approvals:
  • Restricted to Rheumatology Consultants ONLY.
  • Unlicensed for the treatment of gout, 100mg daily for 3 days
• UCLH approvals:
• WH approvals:
  • Restricted to Rheumatology Consultants ONLY

Secondary care notes

• NMUH approvals:
  
  • Restricted to Oncology department use only.
• RFL approvals:
  
  • Nil
• RNOH approvals
  
  • Nil
• UCLH approvals:
• WH approvals:
  
  • Nil

Approved for oral mucositis post radiotherapy (JFC February 2019).

Secondary care notes

• NMUH approvals:
  • For oral mucositis and oesophageal lesions following radiotherapy. 
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
• This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary.
• It is available via the blood bank
• RFL approvals:
• Not available through pharmacy - obtain from the blood bank
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
• Available from Haematology (Ext 5035)

Patient-access scheme approved for non-metastatic castration resistant prostate cancer (JFC May 2018)

Secondary care notes

• NMUH approvals:
• Not applicable
• RFL approvals:
• Not applicable
• RNOH approvals:
• Not applicable
• UCLH approvals:
• WH approvals:
• Not applicable

Secondary care notes

• NMUH approvals:
  • Non-formulary
  • Check MHRA Drug Safety Update
• RFL approvals:
  • Nil
• RNOH approvals:
  • Restricted
• UCLH approvals:
• WH approvals:
  • Not applicable

Approved for:

• Psoriatic Arthritis (PsA; see NICE TA)

Secondary care notes

• NMUH approvals:
  • 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 be prescribed by Rheumatologists ONLY
  • See links below
  • Check MHRA Drug Safety Updates
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Rheumatology Consultants ONLY
• UCLH approvals:
• WH approvals:
  • As per NICE TA and above

Secondary care notes

• NMUH approvals:
• Restricted to Oncology Consultants only
• RFL approvals:
• Restricted to oncology and haematology only.
• RNOH approvals
• Restricted for severe emetogenesis.
• Restricted to Dr Kofi Agyare
• UCLH approvals:
• WH approvals:
• Reserved for the prophylaxis of nausea & vomiting associated with cisplatin (CINV)

Secondary care notes

• NMUH approvals:
•  Not applicable
• RFL approvals:
•  Nil
• RNOH approvals
•  Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
  • Check for MHRA Drug Safety Updates.
• RFL approvals:
  • Nil
• RNOH approval
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

Anticoagulation in adult patients with heparin-induced thrombocytopenia (HIT) type II who require parenteral antithrombotic therapy and have renal failure (February 2013)

Secondary care notes

• NMUH approval:
  
  • Not applicable
• RFL approval:
  
  • Not applicable
• RNOH approval:
  
  •  Requires Haematologist approval. See restriction above.
• UCLH approval:
  
  •  Restricted to consultant haematologists. For patients with severe renal impairment (CrCl<30ml/min)
• WH approval:
  
  • Not applicable

Intramuscular formulation (7.5mg/1mL) is approved for the rapid control of agitation and disturbed behaviours in adult patients with schizophrenia or with manic episodes in Bipolar I Disorder when oral therapy is not appropriate and where IM haloperidol is not recommended. (JFC January 2019)

Secondary care notes

• NMUH approvals:
• This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary but NOT routinely stocked in pharmacy. This medicine will be ordered if use is as per local Trust Guideline or is approved by the Trust Medicines Management Committee. Contact pharmacy medicines information on ext 2417 for further information.
• See links below
• RFL approvals:
• Restricted for initiation until after a discussion with liaison psychiatry team
• RNOH approvals
• Initiation with Psychiatry advice only
• UCLH approvals:
• WH approvals:
• Restricted for initiation by a Consultant Psychiatrist only

Secondary care notes

• NMUH approvals:
• To be used as per the NMUHT Malaria Guidelines, see links below
• RFL approvals:
• Nil
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
• First line for uncomplicated falciparum malaria, chloroquine-resistant non-falciparum malaria, and PO step down from IV artesunate
• See link below

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals:
  • Nil
• UCLH approvals:
• WH approvals:
  • Acidification may prevent encrustation of indwelling catheters, excess mucus formation in bladder augmentation and urinary tract infections. Many patients find high dose ascorbic acid unpalatable and may prefer to take cranberry juice drinks that are now widely available in the high street.

Secondary care notes

• NMUH approvals:
  • Not applicable
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Use restricted to Tissue Viability Nurse (TVN) specialist

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals:
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
• To be initiated by Consultants in HIV Medicine only
• RFL approvals:
• Not applicable
• RNOH approvals
• Not applicable  
• UCLH approvals:
• WH approvals:
• Not applicable

Secondary care notes

• NMUH approvals:
  • 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 approvals:
• As per NICE guidance
• This drug for the treatment of malignant disease must be prescribed on chemocare (RFL electronic chemotherapy prescribing system)
• RNOH approvals
• Not Applicable
• UCLH approvals:
• WH approvals:
• As per NICE TA 520

Secondary care notes

• NMUH approvals:
  
  • See NCL JFC Statins Guideline
• RFL approvals:
  
  • Use is restricted to HIV, Renal, and lipid clinic patients, as well as suspected simvastatin intolerance and drug interactions. Statin prescribing
• RNOH approvals
  
  • Restricted
• UCLH approvals:
• WH approvals:
  
  • Nil

Secondary care notes

• NMUH approvals:
• Nil
• RFL approvals:
• Microbiology/ID approval only
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
• For Microbiology use only

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals
  • Store in refrigerator 
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • 10cm x 10 cm is available on the recommendation of the Tissue Viability Nurse only.
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approval
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

• NOT recommended for dry skin conditions including eczema atopic dermatitis (JFC January 2019)
• Approved for ichthyosis and epidermolysis bullosa (JFC January 2019)

#Secondary care notes

• NMUH approvals:
•  Not applicable
• RFL approvals:
•  Nil
• RNOH approvals
•  Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Erectile dysfunction in men who have failed to respond to oral PDE5i (sildenafil and tadalafil) and intracavernosal/urethral alprostadil. Secondary care initiation, primary care continuation (SLS only) (JFC November 2017)

Secondary care notes

• NMUH approvals:
  
  • To be prescribed by Urology Consultants ONLY. To be used as a second line option after treatment failure or intolerance with oral PDE5i (tadalafil or sildenafil) and intracavernosal/ urethral alprostadil.
• RFL approvals:
  
  • Not applicable
• RNOH approvals
  
  • Not applicable
• UCLH approvals:
• WH approvals:
  
  • Approved by NCL as 2nd line treatment for erectile dysfuntion if alprostadil fails (JFC November 2016)

See NICE TA for eligibility criteria

Secondary care notes

• NMUH approvals:
  
  • 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 approvals:
  
  • Approved for Haematology for MDS, CMML and AML only
• RNOH approvals
  
  • Not Applicable
• UCLH approvals:
• WH approvals:
  
  • Nil

Approved for autoimmune hepatitis (JFC February 2018)

Secondary care notes

• NMUH approvals:
• RFL approvals:
• Nil
• RNOH approvals
• UCLH approvals:
• WH approvals:
  • Specialist initiation, continuation in primary care

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals:
  • Restricted to Rheumatology Consultants ONLY
  • See links below
• UCLH approvals:
• WH approvals:
  • Nil

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)

Secondary care notes

• NMUH approvals:
  • Not applicable
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Not applicable
• UCLH approvals:
  • See indication above
• WH approvals:
  • Not applicable

Approved for allergic rhinitis when 1st line betamethasone monotherapy and 2nd line fluticasone monotherapy have failed (JFC September 2015)

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Approved for the indication outlined above

Secondary care notes

• NMUH approvals:
• Nil
• RFL approvals:
• Restricted to Marlborough OPD; Obs & Gynae (TOP); Renal transplant
• Microbiology approval required for all other indications
• RNOH approvals
• Oral suspension available as 200 mg/5mL
• UCLH approvals:
• WH approvals:
  • Suspension is reserved for Paediatric and Neonatal use only

Secondary care notes

• NMUH approvals:
• Consultant Microbiologist recommendation only
• RFL approvals:
• Microbiology approval only
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals:
  • Oral liquid available as 5 mg/5mL
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Not applicable
• RFL approvals:
  • Not applicable
• RNOH approval
  • Nil
• UCLH approvals:
• WH approvals:
  • Not applicable

Approved for:

• Rheumatoid arthritis (see NICE TA)

Secondary care notes

• NMUH approvals:
  • 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 link below
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Rheumatology Consultants Only
• UCLH approvals:
• WH approvals:
  • As per NICE TA and above

Secondary care notes

• NMUH approvals:
  
  • Nil
• RFL approvals:
  
  • Not Applicable
• RNOH approvals
  
  • Not Applicable
• UCLH approvals:
• WH approvals:
  
  • Not Applicable

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals:
  • Nil
• UCLH approvals:
• WH approvals:
  • BCG Vaccine SSI is an unlicensed product

Secondary care notes

• NMUH approvals:
  • See links below
• RFL approvals:
  • Nil
• RNOH approvals
  • Clenil Modulite® is not interchangeable with other CFC-free beclometasone dipropionate inhalers and should be prescribed by brand name
• UCLH approvals:
• WH approvals:
  • First choice
  • CFC-free beclometasone inhalers are not equipotent and should be prescribed by brand name
  • Inhaler 50 micrograms, 100 micrograms, 200 micrograms, 250 micrograms/metered inhalation ONLY

Secondary care notes

• NMUH approvals:
  • See links below
• RFL approvals:
  • Not applicable
• RNOH approvals
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Fostair should only be supplied when prescribed by, or on the recommendation of, the Respiratory Team. This is to ensure that it is prescribed appropriately.

Secondary care notes

• NMUH approvals:
  
  • Not Applicable.
  • This medicine has a positive NICE Technology Appraisal, however, VENOM IMMUNOTHERAPY SERVICE IS NOT PROVIDED AT NMUH. 
• RFL approvals:
  
  • Not Applicable
• RNOH approvals
  
  •  Restricted
• UCLH approvals:
• WH approvals:
  
  • Nil

See NICE TA for eligibility criteria

Secondary care notes

• NMUH approvals:
  
  • Positive NICE TA 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 approvals:
  
  • Approved for multiple myeloma (January 2013)
  • Approved for Haematology for indolent NHL, PCT funding approval required
• RNOH approvals
  
  • Not Applicable
• UCLH approvals:
  
  • For relapsed multiple myeloma in line with Cancer Drugs Fund only
• WH approvals:
  
  • As per NICE TA(s)

Secondary care notes

• NMUH approvals:
• Not applicable  
• RFL approvals:
• Restricted for initiation until after a discussion with liaison psychiatry team.
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
• Not applicable

Secondary care notes

• NMUH approvals:
  • Not applicable
• RFL approvals:
  • Not applicable
• RNOH approval
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Not applicable
• RNOH approval
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Duac gel is restricted to Dermatology

Secondary care notes

• NMUH approvals:
  • Not applicable
• RFL approvals:
  • Not applicable
• RNOH approval
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Diprosone cream and Diprosone ointment are FORMULARY.
  • Diprosone lotion is NON-FORMULARY.
• RFL approvals:
  • ONLY ointment available at Royal Free Hospital
• RNOH approvals
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
  • Restricted to Dermatology department use ONLY
• RFL approvals:
  • Not applicable
• RNOH approvals
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
•  Nil
• RFL approvals:
  •  Nil
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
•  Nil
• RFL approvals:
•  Nil
• RNOH approvals
• Not applicable 
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approval
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Inj 4 mg/1 ml ONLY

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
•  Nil
• RFL approvals:
• Not applicable
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
• Not applicable

Secondary care notes

• NMUH approvals:
• Nil
• RFL approvals:
• Not applicable
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
•  Not applicable
• RFL approvals:
•  Nil
• RNOH approvals
•  Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
  
  • Nil
• RFL approvals:
  
  • Nil
• RNOH approvals
  
  • Not Applicable
• UCLH approvals:
• WH approvals:
  
  • Not Applicable

Secondary care notes

• NMUH approvals:
  
  • Not applicable
• RFL approvals:
  
  • Prior funding approval required
• RNOH approvals
  
  • Not Applicable
• UCLH approvals:
• WH approvals:
  
  • Not Applicable

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

See NCL guideline for place in therapy.

Secondary care notes

• NMUH approvals:
  • See link below
• RFL approvals:
  • Nil
• RNOH approvals:
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Restricted to patients with true preservative allergy and/or evidence of epithelial toxicity from preservatives and/or severe dry eyes. See NCL guideline for place in therapy.

Combination therapies to be used when compliance/cost issues arise. See NCL guideline for place in therapy.

Secondary care notes

• NMUH approvals:
  • Not Applicable
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
• Not applicable
• RFL approvals:
• Not applicable
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
• Nil

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Mix25: Non-formulary
  • Mix50: Formulary
• RNOH approvals:
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

First choice biphasic human insulin. See NCL guideline for insulin in Type 2 diabetes guideline.

Secondary care notes

• NMUH approvals:
  • Not applicable
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Nil
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
  
  • Nil
• RFL approvals:
  
  • Nil
• RNOH approvals
  
  • Nil
• UCLH approvals:
• WH approvals:
  
  • Nil

Secondary care notes

• NMUH approvals:
  
  • Nil
• RFL approvals:
  
  • Nil
• RNOH approvals
  
  • Not applicable
• UCLH approvals:
• WH approvals:
  
  • Nil

See NICE TA for eligibility criteria

Secondary care notes

• NMUH approvals:
• 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.
• To be prescribed by the Haematology Team ONLY
• See links below
• RFL approvals:
• As per NICE guidance
• This drug for the treatment of malignant disease must be prescribed on chemocare (RFL electronic chemotherapy prescribing system)
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
• Nil

Secondary care notes

• NMUH approvals:
  
  • Not applicable
• RFL approvals:
  
  • Prior funding approval required
  • Restricted to the treatment of pulmonary hypertension
• RNOH approvals:
  
  • Not applicable
• UCLH approvals:
• WH approvals:
  
  • Not applicable

Secondary care notes

• NMUH approvals:
  • Xeomin brand only
• RFL approvals:
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Not applicable
• RFL approvals:
• RNOH approvals:
  • Dysport (first line) and Botox brands only
  • Restricted 
• UCLH approvals:
• WH approvals:
  • Not applicable

Approved for Sphincter of Oddi Dysfunction  (JFC January 2013). QUERY funding

Secondary care notes

• NMUH approvals:
  • Xeomin is formulary when used in the treatment of achalasia (other brands and indications are non-formulary)
• RFL approvals:
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

See NICE TA for eligibility criteria

Secondary care notes

• NMUH approvals:
  
  • 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 approvals:
  
  • This drug for the treatment of malignant disease must be prescribed on chemocare (RFL elecctronic chemotherapy prescribing system)
• RNOH approvals
  
  • Not Applicable
• UCLH approvals:
• WH approvals:
  
  • As per NICE TA

See NCL guideline for place in therapy.

Secondary care notes

• NMUH approvals:
  • See link below
• RFL approvals:
  • Nil
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not to be used for first-line treatment - see link below

See NCL guideline for place in therapy.

Secondary care notes

• NMUH approvals:
  • See link below
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Use in line with NCL guideline below

Secondary care notes

• NMUH approvals:
  • 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 approvals:
  • Not applicable
• RNOH approvals
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not Applicable

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • 1mg tablets are non-formulary
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • 1^st Choice

Approved for active ulcerative colitis limited to the rectum and sigmoid colon as second-line (prednisolone retention enema is the first-line choice) (JFC October 2018).

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Restricted use
• RNOH approvals
  • Not applicable
• UCLH approvals:
• WH approvals:
  • As above

Secondary care notes

• NMUH approvals:
  • To be prescribed as per JFC Asthma / COPD guidelines
  • See link below
• RFL approvals:
  • Not applicable
• RNOH approvals
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
  • See links below
• RFL approvals:
  • Not applicable
• RNOH approvals
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Approved as second-line choice (after fluticasone inhaler) for eosinophilic oesophagitis in both adults and children. Dose should be dispersed in viscous suspending agent (e.g. Splenda slurry). Starting dose is 1 mg twice-daily for adults and children > 10 years old, 1 mg once-daily for children < 10 years old; down titrate dose for maintenance dosing (JFC February 2018)

Secondary care notes

• NMUH approvals:
• Not applicable
• RFL approvals:
• Not applicable
• RNOH approvals:
• Not applicable
• UCLH approvals:
• Not applicable
• WH approvals:
• As above

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals
  • Nil
• UCLH approvals:
• WH approvals:
  • INJ 0.25% (25MG/10ML); 0.5% (50MG/10ML) ONLY

Secondary care notes

• NMUH approvals:
  • A ready mixed bag of Fentanyl + Bupivicaine is available from Pharmacy
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Only buprenorphine patch (originally BuTrans) ‘5’ and ‘10’ patches are available. Restricted for patients unable to take oral opioids due to swallowing difficulties / short bowel AND requiring a lower dose transdermal opioid dose than the 12 micrograms fentanyl patch (JFC March 2015)

Secondary care notes

• NMUH approvals:
  • See restriction above
• RFL approvals:
• RNOH approvals:
  • See restriction above
• UCLH approvals:
• WH approvals:
  • See restriction above

Secondary care notes

• NMUH approvals:
• Positive NICE TA This medicine has a positive NICE Technology Appraisal and is listed in the Trust Medicines Formulary - see link below
• For continuation ONLY
• RFL approvals:
• Nil
• RNOH approvals
• Nil
• UCLH approvals:
• WH approvals:
• Not applicable

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Restricted to consultant gynaecologists only.
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
  
  • Nil
• RFL approvals:
  
  • Not Applicable
• RNOH approvals
  
  • Not Applicable
• UCLH approvals:
• WH approvals:
  
  • Not Applicable

See NICE TA for eligibility criteria

Secondary care notes

• NMUH approvals:
  
  • 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 approvals:
  
  • Prior funding approval required via CDF
• RNOH approvals
  
  • Not Applicable
• UCLH approvals:
• WH approvals:
  
  • Not applicable to WH

Secondary care notes

• NMUH approvals:
  • Restricted to Obs & Gynae Consultant use only
• RFL approvals:
  • Restricted to Endocrinology and Gynaecology.
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Cabergoline is reserved for use by Dr Moult and for suppression of lactation

See NICE TA for eligibility criteria

Secondary care notes

• NMUH approvals:
  
  • This medicine has a positive NICE Technology Appraisal but is not listed in the Trust Medicines Formulary as the service is not offered at NMUH.
• RFL approvals:
  
  • As per NICE guidance for the treatment of renal cell carcinoma
  • This drug for the treatment of malignant disease must be prescribed on chemocare (RFL electronic chemotherapy prescribing system).  Additionally for in-patients this drug must be prescribed on an in-patient prescription chart (paper or electronic)
• RNOH approvals
  
  • Not Applicable
• UCLH approvals:
• WH approvals:
  
  • Not applicable to WH

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Not applicable
• RNOH approval
  • Nil
• UCLH approvals:
• WH approvals:
  • Lotion BP 100 ml only

Secondary care notes

• NMUH approvals:
  • Restricted to consultant Dermatologists ONLY
• RFL approvals:
  • Restricted to Dermatology ONLY
• RNOH approvals
  • Not applicable
• UCLH approvals:
• WH approvals:
  • For patients who fail separate topical steroid + vitamin D2 (e.g. calcipotriol)
  • Dovobet ointment restricted to Dermatology use ONLY

Secondary care notes

• NMUH approvals:
  • See link below
  • Check MHRA Drug Safety Updates
• RFL approvals:
  • Only calcitonin injections kept at RFH
• RNOH approvals:
  • Restricted
  • Store in a refrigerator
  • Allow to reach room temperature before subcutaneous or intramuscular use.
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• RFL approvals:
  
  • Approved for percutaneous injection into the parathyroid gland for hyperparathyroidism if intolerant or unresponsive to oral therapy (November 2013)

Secondary care notes

• NMUH approvals:
  • Not applicable
• RFL approvals:
  • Restricted to renal patients only
• RNOH approvals:
  • Not applicable
• UCLH approvals:
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Not applicable
• RNOH approvals
  • Not applicable
• WH approvals:
  • Not applicable

Secondary care notes

• NMUH approvals:
  • Not applicable
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Not applicable
• RFL approvals:
  • Not applicable
• RNOH approvals:
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals:
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • Nil
• RFL approvals:
  • Nil
• RNOH approvals:
  • Nil
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
• Not applicable
• RFL approvals:
• Nil
• RNOH approvals
• Not applicable
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  • 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
  • Only on the recommendation of the Diabetes Team.
  • Check MHRA Drug Safety Alerts
• RFL approvals:
  • Restricted to Endocrinology
• RNOH approvals
  • Requires initiation by a Diabetes Specialist
  • Check MHRA Drug Safety Updates
• UCLH approvals:
• WH approvals:
  • Nil

Secondary care notes

• NMUH approvals:
  
  • Not applicable
• RFL approvals:
  
  • Primary percutaneous coronary intervention (PPCI) who are intubated and cannot tolerate oral antiplatelets (JFC October 2017)
• RNOH approvals:
  
  • Not applicable
• UCLH approvals:
  
  • Not applicable
• WH approvals:
  
  • Not applicable

Secondary care notes

• NMUH approvals:
• Not applicable
• RFL approvals:
• Not applicable
• RNOH approvals
• Not applicable
• UCLH approvals:
  • Approved for thrombotic thrombocytopenia while available under a manufacturer-funded patient access scheme only (UCLH only; JFC September 2018)
• WH approvals:
• Not applicable

Secondary care notes

• NMUH approvals: 
  • 0.025% NON FORMULARY
  • 0.075% restricted to pain clinic use ONLY
• RFL approvals: 
  • 0.025% NON FORMULARY
  • 0.075% strength kept at the RFH ONLY
• RNOH approvals:
  • 0.025% restricted for use in accordance with the NICE guideline for osteoarthritis
  • See link(s) below
  • 0.075% NON FORMULARY
• UCLH approvals:
• WH approvals:
  • 0.025% restricted to the Rheumatology team. This strength of capsaicin cream is indicated for osteoarthritis only.
  • 0.075% restricted to pain clinic ONLY