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Nottinghamshire Area Prescribing Committee
Joint Formulary
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 Formulary Chapter 6: Endocrine system - Full Chapter
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06.05.01  Expand sub section  Hypothalamic and anterior pituitary hormones and anti-oestrogens
06.05.01  Expand sub section  Anti-oestrogens
06.05.01  Expand sub section  Anterior pituitary hormones
Choriogonadotropin Alfa (Ovitrelle)
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Restricted Drug Restricted
Red
Injection- secondary care only as per approved guidelines
  • Also known as Human chorionic gonadotropin
  • Red - Treatment of infertility 
  •    
    Chorionic Gonadotrophin (Pregnyl)
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    Restricted Drug Restricted
    Red
    Injection- secondary care only as per approved guidelines
  • Also known as Human Chorionic Gonadotrophin; HCG
  • Red - Treatment of Infertility
     
  •    
    Follitropin Alfa  (Gonal-F)
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    Restricted Drug Restricted
    Red
    Injection - ampoule and prefilled pen
  • Secondary care only as per approved guidelines
  • Also known as recombinant human follicle stimulating hormone)
  • Red - Treatment of infertility
    Ensure all prescriptions and communications specify brand 
  • Link  Link to reviews
       
    Follitropin Alfa biosimilar (Bemfola)
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    Restricted Drug Restricted
    Red
    Injection - pre-filled pen
  • NUH only as per approved guidelines
  • Also known as recombinant human follicle stimulating hormone
  • Red - Treatment of infertility
    Biosimilar - Ensure all prescriptions and communications specify brand.
     
  • Link  Link to reviews
    Link  NICE KTT15: Biosimilar medicines
       
    Human Menopausal Gonadotrophins (Menopur)
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    Restricted Drug Restricted
    Red
    Injection
  • Secondary care use only as per approved guidelines
  • Red - Treatment of infertility 
  •    
    Pegvisomant (Somavert)
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    Restricted Drug Restricted
    Red
    High Cost Medicine

    Injection

    Available through Nottingham Treatment Centre only:

     
    Link  Link to reviews
       
    Somatropin
    (Growth hormone)
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    Restricted Drug Restricted
    High Cost Medicine
    Homecare

    Injection

    • Several brands available, prescribe by brand to avoid inadvertent switching as devices vary. First line products in Nottinghamshire are Omnitrope® (Sandoz), Humatrope® (Lilly), Genotropin® (Pharmacia), Norditropin Simplexx®(Novo Nordisk) and Zomacton® (Ferring). - Other brands may be used for existing patients, and those unable to tolerate or operate a first line brand device. Second line products include Saizen® (Merck Serono) and Nutropin Aq® (Ipsen)
    • For use in children only.
      Classified Red for the treatment of adults.
    • Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information.
     
    Link  Link to reviews
    Link  NICE KTT15: Biosimilar medicines
    Link  NICE TA188: Somatropin for growth failure in children
    Link  NICE TA64: Growth hormone deficiency (adults)
    Link  Shared Care Protocol (Notts APC): GP information
    Link  Shared Care Protocol (Notts APC): Overarching document
       
    Tetracosactide (Synacthen)
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    Formulary
    Red
    • Used to be called Tetracosactrin.
    • Available in two types; 250mcg (IM/IV) for short synacthen test and 1mg I.M. depot for prolonged Synacthen test.
    • SFH: Now £60 per dose. Only for supply on endocrinologist approval.
     
    Link  SFH: Endocrinology protocol
    Link  SFH: Paediatrics. Use approved NUH Endocrinology protocols
       
    Thyrotropin Alfa (Thyrogen)
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    Restricted Drug Restricted
    Red
    Injection- NUH only 
    Link  Click here for independent reviews
       
    06.05.01  Expand sub section  Hypothalmic hormones
     ....
     Non Formulary Items
    Chorionic Gonadotrophin  (Choragon)

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    Non Formulary
    Grey
     
    Corifollitropin Alfa  (Elonva®)

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    Non Formulary
    Grey
     
    Follitropin Alfa and Beta  (Puregon®)

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    Non Formulary
    Grey
     
    Human Menopausal Gonadotrophins  (Menogon®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Lutropin Alfa  (Luveris)

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    Non Formulary
    Red
     
      
    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
    SMC
    Scottish Medicines Consortium
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    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

    Grey

    Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.
    Grey / Non-Formulary (undergoing assessment): Work is ongoing and will be reviewed at a future APC meeting.
    Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market.
      

    Red

    Medicines which should normally be prescribed by specialists only. eg hospital only.
    For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.
      

    Amber 1

    Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised.
    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 Nottinghamshire APC.
      

    Amber 2

    Medicines suitable to be prescribed in primary care / general practice after specialist* recommendation or initiation.
    A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC.
    *Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice
      

    Amber 3

    Primary care/ non specialist may initiate as per APC guideline.
    The supporting prescribing guideline must have been agreed by the relevant secondary care trust D&TC(s) and approved by the Nottinghamshire APC.
      

    Green

    Medicines suitable for routine 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.   

    OTC

      

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