Injection Restricted for use by Nurture clinic Red - Treatment of infertility
Discontinued Decmber 2019. No new patients to be started. Unlicensed supplies may be available for patients taking for unlicensed indications and unable to be switched to alternatives. See CAS alert for more info.
Nasal spray - for endometriosis restricted to NUH only Injection - Restricted to Nurture clinic only as per approved guidelines
For malignant disease indications See section 188.8.131.52
Restricted for use by Nurture clinic
Red - Treatment of infertility, restricted to Nuture clinic
Triptorelin (Non- malignant indications)
Decapeptyl® SR: Injection MR 3mg - 1 monthly Injection MR 11.25mg - 3 monthly Injection MR 22.5mg - 6 monthly - only approved for use in precocious puberty (The slightly different doses are due to whether or not it includes the overage and is caused by European labelling rules)
Traffic light classifications: Red - Gynae indications Red - Chronic pain of unknown origin Red - Precocious puberty
For malignant disease indications see section 184.108.40.206
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.
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.
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.
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
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.
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.