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Nottinghamshire Area Prescribing Committee
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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
Notes:
For patient information about chemotherapy and chemotherapy regimens, please see the Macmillan cancer support website: 
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 Details...
08.01  Cytotoxic drugs
Durvalumab
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Restricted Drug Restricted
Red
Cancer Drugs Fund

Infusion

Available at NUH only:

Approved in accordance with compassionate named patient programme as a consolidation treatment in patients with Stage 3 non-small-cell lung cancer.

Approved in accordance with the Cancer Drugs Fund and NICE TA578 for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation

 
Link  NICE TA578: Durvalumab for treating locally advanced unresectable non-small-cell lung cancer
   
Pegaspargase (Oncaspar®)
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Formulary
Red
Injection
NUH only
  • Approved in line with NICE TA408 for treating acute lymphoblastic leukaemia.
     
  • Link  NICE TA408: Pegaspargase for treating acute lymphoblastic leukaemia
       
    Tivozanib (Fotivda®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Capsule

    NUH approved in accordance with NICE TA512 for the treatment of advanced renal cell carcinoma.

     
    Link  NICE TA512: Tivozanib for treating advanced renal cell carcinoma
       
    08.01  Side-effects of cytotoxic drugs
    08.01  Drugs for cytotoxic-induced side-effects
    Dexrazoxane (Cardioxane®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    NHS England
    BlueTeq

    Infusion

    Available through NUH only:

    • Approved for preventing cardiotoxicity in children and young people (under 25 years) receiving high-dose anthracyclines or related drugs for the treatment of cancer as per NHS England commissioning policy 200204P
     
       
    Dexrazoxane (Savene®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine

    Infusion- NUH only

     
    Link  Link to reviews
       
    Folinic acid
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    Formulary
    Red
    Available as:
    - Tablet 15mg (£5 each)
    - Injection, 15mg in 2mL, 15mg in 5mL, 300mg in 30mL.
  • Also known as calcium folinate and calcium leucovorin.
  • For Methotrexate rescue or toxicity. 
  • Link  NUH: Haematology guideline for the use of high dose methotrexate and folinic acid rescue
    Link  NUH: Oncology guideline for the use of high dose methotrexate
       
    Mesna
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    Formulary
    Red
    Tablet, Injection
  • Tablets and injection available. Injection can be diluted in a flavoured drink for oral administration- see BNF
  • At SFH, for dosage instructions in non-cancer indications refer to specific guidelines: cyclophosphamide (rheumatology) or cyclophosphamide (respiratory) 
  •    
    08.01.01  Alkylating drugs
    Bendamustine
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Infusion

    • Approved in accordance with NICE TA216 for the treatment of chronic lymphocytic leukaemia
    • Also approved in accordance with the National Cancer Drugs Fund List for the indications below where the specified criteria are met:

    -The treatment of Chronic Lymphocytic Leukaemia (2nd, 3rd or 4th line).   Was removed from the CDF list on 4th November 2015. Remains on  formulary for patients with funding approved prior to this date.
    -The first line treatment of low grade lymphoma
    -The treatment of relapsed low grade lymphoma
    -The treatment of rituximab refractory low grade lymphoma Was removed from the CDF list on 12th March 2015. Remains on formulary for patients with funding approved prior to this date.
    -The first line treatment of mantle cell non-Hodgkin's lymphoma
    -The treatment of relapsed mantle cell non-Hodgkin's lymphoma Was removed from the CDF list on 4th November 2015. Remains on formulary for patients with funding approved prior to this date.
    -The treatment of relapsed multiple myeloma
    -If to be funded by the CDF confirm approval on BlueTeq for all new starters NUH: For more information, including criteria, see the DTC website; available here

    • NUH: Bendamustine with rituximab approved in accordance with the clinical commissioning policy for:
      - relapsed and refractory mantle cell lymphoma and
      - for first line treatment of advanced indolent non-Hodgkin's lymphoma
     
    Link  Link to reviews
    Link  MHRA Drug Safety Update (July 2017)
    Link  NICE TA 216: Bendamustine for CLL
       
    Cytotoxic Drug Busulfan
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    Formulary
    Red
    Tablets 2mg
    NUH only: Infusion, capsules 25mg (unlicensed) 
    Link  SFH: Busulfan in ET and PV and MF (haematology)
       
    Cytotoxic Drug Carmustine (BiCNU®)
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    Formulary
    Red
    Injection 
    Link  NICE TA121: Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide
       
    Cytotoxic Drug Carmustine (Gliadel®)
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    Restricted Drug Restricted
    Red
    Implant- NUH only
    Approved in accordance with NICE TA121 
    Link  NICE TA121: Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide
       
    Cytotoxic Drug Chlorambucil
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    Formulary
    Red
    Tablet
     
    Link  SFH: Chlorambucil in ovarian cancer
    Link  SFH: Chlorambucil Regimen in CLL and Low Grade NHL
       
    Cytotoxic Drug Cyclophosphamide
    (Chemotherapy)
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    Formulary
    Red
    Tablet, Injection
  • No liquid available. At SFH, injection form is packed in bottles for oral use if necessary.Contact SPU (ext 3156). At SFH, do NOT send patients to retail pharmacies for supplies
    SFH:
  • SFH Cyclophosphamide in Myeloma XI trial (See link below for regimens): All cycles should only be screened by SPU permanent pharmacists
     
  • Link  SFH Haematology chemotherapy trials
    Link  SFH Oral haematology chemotherapy regimens
       
    Cytotoxic Drug Ifosfamide (Mitoxana®)
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    Formulary
    Red
    Injection- NUH only 
       
    Cytotoxic Drug Lomustine
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    Formulary
    Red
    Capsule (Unlicensed)
     
    Link  SFH: Cockle regimen in NHL
       
    Cytotoxic Drug Melphalan
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    Formulary
    Red
    Tablet, Injection
  • For melphalan dose in polycythaemia vera refer to BNF
     
  • Link  SFH: Melphalan and Thalidomide Regimen in Myeloma
    Link  SFH: Melphalan Regimen in Myeloma
       
    Thiotepa
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    Formulary
    Red
    Injection-NUH only 
       
    Treosulfan
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    Restricted Drug Restricted
    Red

    Infusion

    Available at NUH only:

    • Approved in accordance with NICE TA640 with fludarabine for malignant disease before allogeneic stem cell transplant
     
    Link  NICE TA640: Treosulfan with fludarabine for malignant disease before allogeneic stem cell transplant
       
    08.01.02  Anthracyclines and other cytotoxic antibiotics to top
    Cytotoxic Drug Doxorubicin
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    Formulary
    Red

    Injection

     
    Link  NICE TA465: Olaratumab in combination with doxorubicin for treating advanced soft tissue sarcoma
       
    Cytotoxic Drug Pegylated-liposomal doxorubicin (Caelyx®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Concentrate for intravenous infusion

    • Approved in line with NICE TA389 for treating recurrent ovarian cancer.
      NB: Trabectedin in combination with pegylated liposomal doxorubicin is not recommended for treatment of the first recurrence of platinum-sensitive ovarian cancer.
      Also approved in accordance with the National Cancer Drugs Fund List for the treatment of certain named sarcomas.
      NUH: For more information, including criteria, see the DTC website; available here. Confirm funding approved on BlueTeq for all new starters.
      SFH: Confirm funding by contacting the HCD Team on 4660
     
    Link  Link to reviews
    Link  MHRA: Liposomal and lipid-complex formulations: name change to reduce medication errors
    Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
       
    Cytotoxic Drug Bleomycin
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    Formulary
    Red
    Injection 
    Link  Link to reviews
       
    Cytotoxic Drug Dactinomycin (Cosmegen Lyovac®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Injection- NUH only 
    Link  Link to reviews
       
    Cytotoxic Drug Daunorubicin
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    Formulary
    Red
    Injection 
       
    Cytotoxic Drug Epirubicin
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    Formulary
    Red
    Injection 
       
    Cytotoxic Drug Idarubicin (Zavedos®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Caspule, Injection- NUH only 
    Link  SFH: Idarubicin-Dex (Z-DEx) in Myeloma and Palliative Lymphoma
       
    Liposomal Cytarabine-Daunorubicin (Vyxeos®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Infusion

    Available at NUH only: Approved in accordance with the Cancer Drugs Fund and NICE TA552 (expected entry in to baseline commissioning from 19th March 2019) for untreated acute myeloid leukaemia.

     
    Link  NICE TA552: Liposomal cytarabine–daunorubicin for untreated acute myeloid leukaemia
       
    Cytotoxic Drug Mitomycin
    (injection, bladder)
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    Formulary
    Red
     
    Link  SFH: Mitomycin and BCG (Oncotice) information for bladder cancer
       
    Cytotoxic Drug Mitoxantrone (Mitozantrone)
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    Formulary
    Red
    Infusion 
       
    Cytotoxic Drug Pixantrone
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    Restricted Drug Restricted
    Red
    High Cost Medicine

    Infusion

    • For non-Hodgkins B cell lymphoma as per NICE TA306
     
    Link  Link to reviews
    Link  TA306:Pixantrone monotherapy
       
    08.01.03  Antimetabolites
    Cytotoxic Drug Azacitidine (Vidaza®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Injection
  • Approved for use in line with NICE TA218 and. For more information see the D&T website at NUH, or contact Cancer services pharmacist (ext 3156)at SFH.
     
  • Link  Link to reviews
    Link  NICE TA218: azacitidine for myelodysplastic syndromes
    Link  NICE TA399: Azacitidine for treating acute myeloid leukaemia with more than 30% bone marrow blasts
    Link  NUH Drugs and Therapeutics Website
    Link  SFH: AZA-MDS-003 trial protocol (oral Azacitidine)
       
    Cytotoxic Drug Capecitabine (Xeloda®)
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    Formulary
    Red
    Tablet
     
    Link  Link to review
    Link  MHRA: risk of severe skin reactions—discontinue treatment
    Link  NICE TA100: Colon cancer (adjuvant) - capecitabine and oxaliplatin
    Link  NICE TA191: Gastric cancer (advanced) - capecitabine
    Link  NICE TA61: Colorectal cancer - capecitabine and tegafur uracil
    Link  SFH oral chemotherapy regimens
       
    Cytotoxic Drug Cladribine
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    Formulary
    Red
    High Cost Medicine
    Infusion
  • At NUH, SC cladribine is non-formulary.
  • Use in multiple sclerosis and pulmonary langerhans histiocytosis is not routinely commissioned - IFR approval must be sought before initiation.  
  • Link  Link to reviews
    Link  MHRA Drug Safety Update (December 2017): Cladribine and PML
    Link  SFH Cladribine regimen
       
    Cytotoxic Drug Cladribine (Mavenclad®)
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    Formulary
    Red
    High Cost Medicine
    Homecare

    Tablets

    • NUH: Approved in accordance with NICE TA616 for treating relapsing–remitting multiple sclerosis.
    • Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information
     
    Link  NICE TA616: Cladribine tablets for treating relapsing–remitting multiple sclerosis
       
    Cytotoxic Drug Clofarabine
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Intravenous Infusion- NUH only
    NUH: Approved in accordance with the National Cancer Drugs Fund List for the indication(s) below where the specified criteria are met:

    • The treatment of relapsed/refractory acute lymphoblastic leukaemia
    • The treatment of relapsed/refractory acute myeloblastic leukaemia. Removed from the CDF list January 2019 remains on formulary for patients with funding approved prior to removal.


    NUH: For more information, including criteria, see the DTC website; available here

    • At NUH, confirm funding approved on BlueTeq for all new starters
     
    Link  Drugs and Therapeutics Website
       
    Cytotoxic Drug Cytarabine
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    Formulary
    Red
    Injection
    NUH only:
  • Depot Intrathecal Injection (Depocyte®) for lymphomatous meningitis
  • Pre-filled syringes for ALL paediatric patients (Emergency chemotherapy). Unlicensed medicine - named patient use only
  • Pre-filled 20mg in 0.2mL syringes for subcutaneous administration in adult haematology. Unlicensed medicine - named patient use only
     
  • Link  Link to reviews
       
    Cytotoxic Drug Fludarabine Phosphate (Fludara®)
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    Formulary
    Red
    Tablet, Injection
     
    Link  NICE TA119: Leukaemia (lymphocytic) - fludarabine
    Link  NICE TA29: Leukaemia (lymphocytic) - fludarabine
    Link  SFH oral chemotherapy regimens
       
    Cytotoxic Drug Fluorouracil
    (Chemotherapy)
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    Formulary
    Red
    Capsule, Injection
     
       
    Cytotoxic Drug Gemcitabine (Gemzar®)
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    Formulary
    Red
    Injection
  • Gemcitabine in combination with carboplatin is not recommended for treatment of the first recurrence of platinum-sensitive ovarian cancer as per NICE TA389 
  • Link  Link to reviews
    Link  NICE TA116: Breast cancer - gemcitabine
    Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
    Link  NICE TA85: Pancreatic cancer - gemcitabine
       
    Cytotoxic Drug Mercaptopurine
    (chemotherapy)
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    Formulary
    Red
    Tablet, Suspension.
  • Classified red for the treatment of acute leukaemias, chronic myeloid leukaemia, cancer. See section 1.5.3 for IBD indication.
  • Suspension (Xaluprine®) (expensive) only for patients where tablets are not suitable (i.e. small doses in paediatrics) 
  • Link  UKMI Q&A: Which medicines require extra care when switching between liquid and tablet/capsule formulations?
       
    Cytotoxic Drug Methotrexate
    (Chemotherapy)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Tablet 2.5mg, Injection
  • Liquid can be made obtained if required.
  • Classified red for cancer indications- see sections 10.1.3 and 13.5.3 for rheumatology and psoriasis indications 
  • Link  NUH Lite Bite: Safer use of weekly oral methotrexate (Nov 2018)
    Link  SFH intrathecal policy
    Link  SFH methotrexate policy- see medicines policy section 4.5.1
    Link  SFH:Methotrexate oral regimen in LGL (haematology patients)
    Link  UKMI Q&A: alcohol and methotrexate guidance
    Link  UKMI Q&A: What is the clinical significance of the interaction between methotrexate and penicillins? (Oct13)
       
    Nelarabine (Atriance®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund
    Intravenous infusion
    Approved in accordance with the National Cancer Drugs Fund for the treatment of refractory T-cell acute lymphoblastic leukaemia or refractory T-cell lymphoblastic non-Hodgkin's lymphoma
    NUH: For more information, including criteria, see the DTC website; available here
    Confirm funding approved on BlueTeq for all new starters
    SFH: Ensure CDF funding approved by contacting the HCD Team on 4660. 
       
    Cytotoxic Drug Pemetrexed (Alimta®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Injection
    Approved in accordance with NICE:
  • TA135 for the treatment of malignant pleural mesothelioma

  • TA190 for the maintenance treatment of non-small-cell lung cancer

  • TA181 for the first-line treatment of non-small-cell lung cancer

  • TA402 for maintenance treatment for non-squamous non-small-cell lung cancer after pemetrexed and cisplatin

  • Confirm funding approved on BlueTeq for all new starters.
    SFH: Ensure funding approved by contacting the HCD team on 4660.
     
    Link  Link to reviews
    Link  NICE TA135: Mesothelioma - pemetrexed disodium
    Link  NICE TA181: Lung cancer (non-small cell, first line treatment) - pemetrexed
    Link  NICE TA190: Lung cancer (non-small-cell) - pemetrexed (maintenance)
    Link  NICE TA402:Pemetrexed maintenance treatment for non-squamous non-small-cell lung cancer after pemetrexed and cisplatin
       
    Cytotoxic Drug Raltitrexed (Tomudex®)
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    Restricted Drug Restricted
    Red

    Infusion

    Available at NUH only: Approved for metastatic colorectal cancer

     

     
       
    Cytotoxic Drug Tegafur with Uracil (Uftoral®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Capsule

     
    Link  NICE TA61: Capcitabine and tegafur - Colorectal cancer
    Link  SFH regimen: Tegafur with Uracil Regimen in Colorectal Cancer
       
    Cytotoxic Drug Tioguanine (Lanvis®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
     
       
    08.01.04  Vinca alkaloids and etoposide
    Cytotoxic Drug Etoposide
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Infusion, capsules
  • At SFH, injection is packed into bottles by SPU for patients with swallowing difficulties or doses that could not be made by strengths of capsules available.
     
  • Link  SFH: Etoposide chemo regimens
       
    Cytotoxic Drug Vinblastine Sulphate
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Injection 
       
    Cytotoxic Drug Vincristine Sulphate
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Injection 
       
    Cytotoxic Drug Vindesine Sulphate (Eldisine®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Injection 
       
    Cytotoxic Drug Vinflunine (Javlor®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Infusion
    NUH only For metastatic transitional cell carcinoma of the bladder or renal pelvis in accordance with compassionate use scheme.
    NB: NICE TA272 - not recommended
     
    Link  Link to reviews
    Link  NICE: Urothelial tract carcinoma (transitional cell, advanced, metastatic) - vinflunine (TA272)
       
    Cytotoxic Drug Vinorelbine
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    Formulary
    Red
    Injection, capsules 
    Link  SFH: Vinorelbine regimens in cancer
       
    08.01.05  Other antineoplastic drugs
    Acalabrutinib
    Restricted Drug Restricted
    Red

    Capsules : Unlicensed medicine - named patient use only

    Available at NUH only:

    • Approved in accordance with the Early Access Programme as monotherapy for adults with previously untreated CLL
     
    Link  SFH: Acalabrutinib regimen in CLL
       
    Cytotoxic Drug Aflibercept (Zaltrap®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund
    Infusion
    Was approved in accordance with the National Cancer Drugs Fund List for the second line treatment of metastatic colorectal cancer. Removed from the CDF list on 12th March 2015. Remains on formulary for patients with funding approved prior to this date.
    NUH: For more information, including criteria, see the DTC website; available here  
    Link  Link to reviews
    Link  MHRA Drug Safety Update (April 2016)
    Link  NICE TA307: Aflibercept in combination with irinotecan and fluorouracil-based therapy for treating metastatic colorectal cancer that has progressed following prior oxaliplatin-based chemotherapy
    Link  Visual impairment due to mycopic choroidal neovascularisation: afibercept
       
    Alectinib (Alecensa®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red

    Capsules

    NUH only: Approved in accordance with compassionate named patient programme for advanced (incurable) non-squamous ALK +ve NSCLC who have progressed/are intolerant to crizoinib or ceritinib.

    NUH only: Approved in accordance with NICE TA536, for untreated ALK-positive advanced non-small-cell lung cancer

     
    Link  NICE TA536: Alectinib for untreated ALK-positive advanced non-small-cell lung cancer
       
    Atezolizumab (Tecentriq®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Infusion

    Available at NUH only:

    • Approved, in accordance with the Cancer Drugs Fund and NICE TA492 for untreated locally advanced or metastatic urothelial cancer when cisplatin is unsuitable.
    • Approved, in accordance with NICE TA520 as an option for treating locally advanced or metastatic non-small-cell lung cancer after chemotherapy
    • Approved, in accordance with NICE TA525 for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy.
    • Approved in accordance with NICE TA584 in combination for treating metastatic non-squamous non-small-cell lung cancer
    • Approved, in accordance with NICE TA638 with carboplatin and etoposide for untreated extensive-stage small-cell lung cancer
    • Approved, in accordance with NICE TA639 with nab-paclitaxel for untreated PD-L1-positive, locally advanced or metastatic, triple-negative breast cancer
    • Approved, in accordance with Early Access to Medicines Scheme 00031/0012 in combination with bevacizumab for the treatment of adult patients with unresectable hepatocellular carcinoma who have received no prior systemic therapy.
    • Approved in accordance with the Cancer Drugs Fund with bevacizumab for treating advanced or unresectable hepatocellular carcinoma
     
    Link  NICE TA492: Atezolizumab for untreated locally advanced or metastatic urothelial cancer when cisplatin is unsuitable
    Link  NICE TA520: Atezolizumab for treating locally advanced or metastatic non-small-cell lung cancer after chemotherapy
    Link  NICE TA525: Atezolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy.
    Link  NICE TA584:Atezolizumab in combination for treating metastatic non-squamous non-small-cell lung cancer
    Link  NICE TA638: Atezolizumab with carboplatin and etoposide for untreated extensive-stage small-cell lung cancer
    Link  NICE TA639: Atezolizumab with nab-paclitaxel for untreated PD-L1-positive, locally advanced or metastatic, triple-negative breast cancer
    Link  EAMS 00031/0012: Atezolizumab in combination with bevacizumab for the treatment of adult patients with unresectable hepatocellular carcinoma who have received no prior systemic therapy
       
    Axitinib (Inlyta®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablet

    Available at NUH only

    • Approved for the treatment of advanced renal cell carcinoma after failue of a first-line kinase inhibitor or cytokine in accordance with NICE TA333.
    • Approved for use in combination with Avelumab, in accordance with NICE TA645 and the Cancer Drugs Fund, for untreated advanced or metastatic renal cell carcinoma
     
    Link  Link to reviews
    Link  NICE TA333: Axitinib for advanced renal cell carcinoma
    Link  NICE TA645: Avelumab with axitinib for untreated advanced renal cell carcinoma
    Link  SFH axitinib pharmacy screening procedure
       
    Bosutinib (Bosulif®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Tablets
  • Approved in accordance with NICE TA401 for use in chronic, accelerated and blast phase Philadelphia chromosome positive chronic myeloid leukaemia in adults if they have previously had 1 or more tyrosine kinase inhibitors, imatinib/nilotinib/dasatinib are not appropriate and it is discounted.  
  • Link  SFH: Bosutinib in CML
    Link  Link to reviews
    Link  NICE TA401: Bosutinib for previously treated chronic myeloid leukaemia
       
    Cabozantinib (Cabometyx®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Film-coated tablets
    NUH Only

    • Approved in accordance with NICE TA463 for previously treated advanced renal cell carcinoma
    • Approved in accordance with NICE TA542 for untreated advanced renal cell carcinoma
     
    Link  NICE TA463:Cabozantinib for previously treated advanced renal cell carcinoma
    Link  NICE TA542: Cabozantinib for untreated advanced renal cell carcinoma
    Link  SFH: Cabozantinib (Cabometyx brand only) in renal cancer
       
    Cytotoxic Drug Carfilzomib (Kyprolis®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Infusion

    Available at NUH only:

    • Approved in accordance with NICE TA657 for previously treated multiple myeloma
     
    Link  NICE TA657:Carfilzomib for previously treated multiple myeloma
       
    Ceritinib (Zykadia)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Capsules

    • NUH: Approved in accordance with NICE TA395 - for previously treated anaplastic lymphoma kinase positive non-small-cell lung cancer
    • NUH: Approved in accordance with NICE TA500 - for untreated ALK-positive non-small-cell lung cancer
     
    Link  NICE TA395: Ceritinib for previously treated anaplastic lymphoma kinase positive non-small-cell lung cancer
    Link  NICE TA500: Ceritinib for untreated ALK-positive non-small-cell lung cancer
       
    Dabrafenib (Tafinlar®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Capsule

    NUH only

    Approved in accordance with: 
    -NICE TA321 for treating unresectable or metastatic BRAF V600 mutation‑positive melanoma. 
    -NICE TA396 for treating unresectable or metastatic melanoma in combination with trametinib.
    -the National Cancer Drugs Fund (until Jan 2019) and NICE TA544 with trametinib for adjuvant treatment of resected BRAF V600 mutation-positive melanoma, where specified criteria are met.
    -Approved at NUH in accordance with NHS England’s interim treatment options for the following indications, available during the COVID-19 pandemic only.  For review post March 2021:
       - with trametinib for treating BRAF positive metastatic non-small cell lung cancer instead of chemotherapy to reduce risk of immunosuppression.

     
    Link  Link to reviews
    Link  NICE TA321:Dabrafenib for BRAF V600 +ve melanoma
    Link  NICE TA396:Trametinib in combination with dabrafenib for treating unresectable or metastatic melanoma
    Link  NICE TA544: Dabrafenib with trametinib for adjuvant treatment of resected BRAF V600 mutation-positive melanoma
       
    Dacomitinib monohydrate (Vizimpro®)
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    Formulary
    Red
    High Cost Medicine

    Tablets

    Available at NUH only:

    • Approved in accordance with NICE TA595 for untreated EGFR mutation-positive non-small-cell lung cancer
     
       
    Daratumumab (Darzalex®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Infusion
    Subcutaneous Injection

    Available at NUH only:

    • Approved in accordance with the National Cancer Drugs Fund List and NICE TA510 as monotherapy for treating relapsed and refractory multiple myeloma.
    • Approved in accordance with the National Cancer Drugs Fund List and NICE TA573 for use with bortezomib and dexamethsone for previously treated multiple myeloma.
    • Subcutaneous Injection: Approved for the above indications in accordance with NHS England guidance during the Covid-19 pandemic.
     
    Link  Risk of reactivation of hepatitis B virus, HCP letter (2019)
    Link  NICE TA510: Daratumumab monotherapy for treating relapsed and refractory multiple myeloma
    Link  NICE TA573: Daratumumab with bortezomib and dexamethasone for previously treated multiple myeloma
       
    Encorafenib (Braftovi®)
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    Formulary
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Capsules

    Available at NUH only:

    • Approved in accordance with NICE TA562 with binimetinib for unresectable or metastatic BRAF V600 mutation-positive melanoma
    • Approved in accordance with the National Cancer Drugs Fund with cetuximab for previously treated BRAF V600E mutation-positive metastatic colorectal cancer 
     
    Link  NICE TA562: Encorafenib with binimetinib for unresectable or metastatic BRAF V600 mutation-positive melanoma
       
    Cytotoxic Drug Eribulin (Halaven®)
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    Restricted Drug Restricted
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    High Cost Medicine

    Injection

    • Approved in accordance with NICE TA423 for treating locally advanced or metastatic breast cancer after two or more chemotherapy regimens
    • Not recommended for treating locally advanced or metastatic breast cancer after one chemotherapy regimen (in accordance with NICE TA515)
     
    Link  Link to reviews
    Link  NICE TA423: Eribulin for treating locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens
    Link  NICE TA515: Eribulin for treating locally advanced or metastatic breast cancer after 1 chemotherapy regimen
       
    Gemtuzumab ozogamicin  (Mylotarg®)
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    Restricted Drug Restricted
    Red

    Infusion

    NUH only: Approved in accordance with NICE TA545 for untreated acute myeloid leukaemia in people 15 years and over.

     
    Link  NICE TA545: Gemtuzumab ozogamicin for untreated acute myeloid leukaemia
       
    Ibrutinib (Imbruvica®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Tablets (140mg, 280mg, 420mg and 560mg) available at NUH, Capsules (140mg) (no longer available at NUH)

    Only to be prescribed by Consultant Haematologists for Lymphoma (See protocol for funding requirement)
    NUH and SFH: Approved in accordance with NICE TA429 for previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation
    NUH and SFH: Approved in accordance with NICE TA491 for treating Waldenstrom’s macroglobulinaemia
    NUH: Approved in accordance with NICE TA502 for treating relapsed or refractory mantle cell lymphoma in adults only if they have had only 1 previous line of therapy
    NUH and SFH: Approved in accordance with the National Cancer Drugs Fund List for the indications below where the specified criteria are met:

    • the treatment of relapsed/ refractory Mantle Cell Lymphoma
     
    Link  MHRA Drug Safety Update (August 2017)
    Link  NICE TA429: Ibrutinib for previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation
    Link  NICE TA491: Ibrutinib for treating Waldenstrom’s macroglobulinaemia
    Link  NICE TA502: Ibrutinib for treating relapsed or refractory mantle cell lymphoma
    Link  SFH: Flair study
    Link  SFH: Ibrutinib in CLL & Mantle Cell Lymphoma protocol
       
    Idelalisib (Zydelig®)
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    Restricted Drug Restricted
    Red

    Tablet-NUH and SFH
    Approved for use from Feb 16 in accordance with:

    • NICE TA359 for treating chronic lymphocytic leukaemia.
      Previous use via Cancer Drug Fund approval switches to routine commissioning from Feb 16.

    NUH Only: Approved in accordance with compassionate use scheme for:

    • Adult patients with follicular lymphoma that is refractory to two prior lines of treatment 
     
    Link  SFH: R- Idelalisib in CLL
    Link  MHRA Drug Safety Update (Sept 2016)
    Link  NICA TA359: Chronic lymphocytic leukaemia - Idelalisib
    Link  NICE TA604: Idelalisib for treating refractory follicular lymphoma (not recommended)
       
    Cytotoxic Drug Inotuzumab Ozogamicin  (Besponsa®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Powder for solution for infusion

    Approved in accordance with NICE TA541 for treating relapsed or refractory B-cell acute lymphoblastic leukaemia.

     
    Link  NICE TA541: Inotuzumab ozogamicin for treating relapsed or refractory B-cell acute lymphoblastic leukaemia
       
    Isatuximab (Sarclisa®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund
    BlueTeq

    Infusion

    Available at NUH only:

    Approved via the Cancer Drugs Fund in accordance with NICE TA658 with pomalidomide and dexamethasone for treating relapsed and refractory multiple myeloma.

     
    Link  NICE TA658: Isatuximab with pomalidomide and dexamethasone for treating relapsed and refractory multiple myeloma
       
    Ixazomib (Ninlaro®)
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    Restricted Drug Restricted
    Red
    Cancer Drugs Fund

    Capsules

    • Approved in accordance with the National Cancer Drugs Fund List and NICE TA505 with lenalidomide and dexamethasone for treating relapsed or refractory multiple myeloma.
     
    Link  SFH: Ixazomib-Lenalidomide in Myeloma
    Link  SFH: Myeloma 12 trial (Accord) (Haematology)
    Link  NICE: Ixazomib with lenalidomide and dexamethasone for treating relapsed or refractory multiple myeloma (TA505)
       
    Lenvatinib (Kisplyx®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine

    Capsule (Prescribe by brand)

    NUH: Approved with everolimus (Afinitor®) for previously treated advanced renal cell carcinoma in accordance with NICE TA498.

     
    Link  NICE TA498: Lenvatinib with everolimus for previously treated advanced renal cell carcinoma
       
    Lenvatinib (Lenvima®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Capsules (Prescribe by brand)

    Approved in accordance with NICE TA535 for treating differentiated thyroid cancer after radioactive iodine.

    Approved in accordance with the Cancer Drugs Fund and NICE TA551 (expected entry in to baseline commissioning on 19th March 2019) for untreated advanced hepatocellular carcinoma

     
    Link  NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine
    Link  NICE TA551: Lenvatinib for untreated advanced hepatocellular carcinoma
       
    Lorlatinib (Lorviqua®)
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    Restricted Drug Restricted
    Red

    Tablet

    Available through NUH only:

    Approved as per NICE TA628 for previously treated ALK-positive advanced non-small-cell lung cancer.

    For Oncology patients only at SFH and NUH

     
    Link  NICE TA628: Lorlatinib for previously treated ALK-positive advanced non-small-cell lung cancer
    Link  SFH: Lorlatinib in Lung cancer protocol
       
    Midostaurin (Rydapt®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine

    Capsules

    NUH only: Approved in accordance with NICE TA523, for untreated acute myeloid leukaemia

     
    Link  NICE TA523 - untreated acute myeloid leukaemia
       
    Cytotoxic Drug Panitumumab (Vectibix®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund
    Infusion
    NUH Only: approved in accordance with TA439 for previously untreated metastatic colorectal cancer.
    NUH Only: approved in accordance with the National Cancer Drugs Fund List for the indications below where the specified criteria are met:
  • The third or fourth line treatment of metastatic colorectal cancer as a single agent To be removed from the CDF list on 4th November 2015. Remains on formulary for patients with funding approved prior to this date.

  • NUH: For more information, including criteria, see the DTC website; available here. Confirm funding approved on BlueTeq for all new CDF starters 
    Link  Link to reviews
    Link  NICE TA439: Cetuximab and panitumumab for previously untreated metastatic colorectal cancer
       
    Cytotoxic Drug Panobinostat (Farydak®)
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    Formulary
    Red
    High Cost Medicine
    Capsule
    Approved by NICE as per TA380 from May 16. Final NICE guidance recommends panobinostat with bortezomib and dexamethasone for adults with relapsed and/or refractory multiple myeloma who have received ≥2 prior regimens including bortezomib and an immunomodulatory agent, if the company provides it with the discount agreed in the Patient Access Scheme.
     
    Link  NICE TA380: Panobinostat for treating multiple myeloma after at least 2 previous treatments
       
    Pembrolizumab (Keytruda®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Infusion -

    Available at NUH only in accordance with:

    - NICE TA357 for advanced melanoma after disease progression with ipilimumab
    - NICE TA366 for advanced melanoma not previously treated with ipilimumab. Patient access scheme exists
    - National Cancer Drugs Fund List for the treatment of PD-L1-positive non small-cell lung cancer after chemotherapy where the specified criteria are met then approved in accordance with TA428 for treating PDL1- positive non-small-cell lung cancer after chemotherapy.
    - National Cancer Drugs Fund for first line treatment of locally advanced or metastatic urothelial cancer in patients who are ineligible for cisplatin-based chemotherapy according to specified criteria.
    - NICE TA519 for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy
    - NICE TA522 for untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable.
    - NICE TA531 for untreated PD-L1-positive metastatic non-small-cell lung cancer
    - NICE TA553 for adjuvant treatment of resected melanoma with high risk of recurrence
    - National Cancer Drugs Fund for classical Hodgkin lymphoma according to specified criteria.
    - NICE TA557 for untreated, metastatic, non-squamous non-small-cell lung cancer with pemetrexed and platinum chemotherapy
    - NICE TA600 and National Cancer Drugs Fund with carboplatin and paclitaxel for untreated metastatic squamous non-small cell lung cancer
    NICE TA661 for untreated metastatic or unresectable recurrent squamous cell head and neck cancer
     
    Link  MHRA Drug Safety Update (July 2017)
    Link  NICE TA357: Pembrolizumab for melanoma after ipilimumab
    Link  NICE TA366: Pembrolizumab for advanced melanoma not previously treated with ipilimumab
    Link  NICE TA428: Pembrolizumab for treating PD-L1-positive non-small-cell lung cancer after chemotherapy
    Link  NICE TA522: Pembrolizumab for untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable
    Link  NICE TA531: Pembrolizumab for untreated PD-L1-positive metastatic non-small-cell lung cancer
    Link  NICE TA600: Pembrolizumab with carboplatin and paclitaxel for untreated metastatic squamous non-small-cell lung cancer
    Link  NICE TA661: Pembrolizumab for untreated metastatic or unresectable recurrent head and neck squamous cell carcinoma
    Link  Early access to medicines scheme (EAMS): pembrolizumab for non-small cell lung cancer
       
    Polatuzumab Vedotin
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Infusion

    Available at NUH only:

    • Approved for use in combination with bendamustine and rituximab, in accordance with NICE TA649 for the treatment of relapsed/refractory diffuse large B-cell lymphoma (DLBCL) in adult patients who are not eligible for hematopoietic stem cell transplant.
     
    Link  NICE TA649: Polatuzumab vedotin with rituximab and bendamustine for treating relapsed or refractory diffuse large B-cell lymphoma
       
    Ponatinib (Iclusig®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund
    Tablet
  • NUH approved in accordance with NICE TA451for treating chronic myeloid leukaemia and acute lymphoblastic leukaemia
     
  • Link  SFH: Ponatinib regimen in CML
    Link  MHRA Drug Safety Update (Apr 2017)
    Link  NICE TA451: Ponatinib for treating chronic myeloid leukaemia and acute lymphoblastic leukaemia
       
    Ruxolitinib (Jakavi®)
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    Restricted Drug Restricted
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    Tablet

    • Approved in accordance with NICE TA386 for treating disease-related splenomegaly or symptoms in adults with primary myelofibrosis, post-polycythaemia vera myelofibrosis or post-essential thrombocythaemia myelofibrosis in people with intermediate-2 or high risk disease only.
    • Use in people with intermediate-1 disease was removed from the Cancer Drugs Fund on 7th June 2016 and will no longer be available from that date. People with intermediate-1 disease already receiving ruxolitinib via the CDF have the option to continue treatment until they and their clinician consider it appropriate to stop.
      NUH only: Approved in accordance with compassionate use scheme for:
      • Acute and Chronic Graft-versus-Host-Disease (unlicensed indication). Compassionate use scheme now closed for new patients. Remains on formulary for existing patients.
      • Polycythaemia Vera resistant to hydroxycarbamide or in patients intolerant to hydroxycarbamide.
     
    Link  Link to reviews
    Link  NICE TA386: Ruxolitinib for treating disease-related splenomegaly or symptoms in adults with myelofibrosis
    Link  SFH: Majic trial protocol
    Link  SFH: Ruxolitinib regimen in haematology patients (non trial)
       
    Trametinib (Mekinist®)
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    Restricted Drug Restricted
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    High Cost Medicine
    Cancer Drugs Fund

    Tablets

    • Approved in accordance with NICE TA396 for treating unresectable or metastatic melanoma in combination with dabrafenib.
    • Approved in accordance with the National Cancer Drugs Fund (until Jan 2019) and NICE TA544 with dabrafenib for adjuvant treatment of resected BRAF V600 mutation-positive melanoma, where specified criteria are met.
    • Monotherapy with trametinib alone is non-formulary
    • Approved at NUH in accordance with NHS England's interim treatment options for the following indications, available during the COVID-19 pandemic only. For review post March 2021:
      - For advanced low grade serous ovarian carcinoma as oral alternative to intravenous chemotherapy and to reduce risk of immunosuppression. Unlicensed indication - named patient use only
     
    Link  Letter sent to healthcare professionals in February 2016
    Link  NICE TA396: Trametinib in combination with dabrafenib for treating unresectable or metastatic melanoma
    Link  NICE TA544: Dabrafenib with trametinib for adjuvant treatment of resected BRAF V600 mutation-positive melanoma
    Link  Risk of gastrointestinal perforation and colitis
       
    Trifluridine-tipiracil (Lonsurf®)
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    High Cost Medicine
    Tablets
    NUH only:
  • In accordance with NICE TA405 for previously treated metastatic colorectal cancer. 
  • Link  SFH: Trifluridine and Tipiracil in Colon Cancer protocol
       
    Venetoclax (Venclyxto®)
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    Red
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    Cancer Drugs Fund

    Tablets 

    - Approved in accordance with compassionate use scheme for the treatment of adult patients with chronic lymphocytic leukaemia (CLL) according to specified criteria.
    - Approved, in accordance with the Cancer Drugs Fund and NICE TA487 for treating chronic lymphocytic leukaemia, that is, in adults:

    • with a 17p deletion or TP53 mutation and when a B‑cell receptor pathway inhibitor is unsuitable, or whose disease has progressed after a B‑cell receptor pathway inhibitor or
    • without a 17p deletion or TP53 mutation, and whose disease has progressed after both chemo‑immunotherapy and a B‑cell receptor pathway inhibitor and
    • only if the conditions in the managed access agreement are followed.

    - Approved in accordance with NICE TA561 in combination with rituximab for previously treated chronic lymphocytic leukaemia.

    - Approved in accordance with NICE TA663 with obinutuzumab for untreated chronic lymphocytic leukaemia

     
    Link  SFH: Venetoclax in CLL
    Link  NICE TA487: Venetoclax for treating chronic lymphocytic leukaemia
    Link  NICE TA561: Venetoclax with rituximab for previously treated chronic lymphocytic leukaemia
    Link  NICE TA663: Venetoclax with obinutuzumab for untreated chronic lymphocytic leukaemia
       
    Vosaroxin (Qinprezo)
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    Injection
  • NUH only: Approved in accordance with compassionate use scheme for relapsed or refractory AML as a bridge to transplant. 
  •    
    08.01.05  Amsacrine
    Cytotoxic Drug Amsacrine (Amsidine®)
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    Formulary
    Red
    Infusion 
       
    08.01.05  Arsenic trioxide to top
    Cytotoxic Drug Arsenic Trioxide
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    Restricted Drug Restricted
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    High Cost Medicine

    Infusion

    • At SFH: Special approval needed for new starters.Do not authorise before contacting Cancer services pharmacist (3156).
    • NUH only: Approved in accordance with NICE TA526, for treating acute promyelocytic leukaemia
     
    Link  NICE TA526: treatment for acute promyelocytic leukaemia
    Link  NUH Drugs and Therapeutics Website
       
    08.01.05  Bevacizumab
    Bevacizumab (Avastin®)
    (Oncology)
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    Restricted Drug Restricted
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    High Cost Medicine
    Cancer Drugs Fund
    Infusion
    Only approved in accordance with the National Cancer Drugs Fund List for the indications below where the specified criteria are met:
  • The third line treatment of low grade gliomas of childhood
  • The first line treatment of recurrent or metastatic cervical cancer in combination with chemotherapy
  • The first line treatment of advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer
  • The treatment of advanced breast cancer.
  • >To be removed from the CDF list on 4th November 2015. Remains on formulary for patients with funding approved prior to this date.
  • The first line treatment of advanced colorectal cancer with a single agent fluoropyramidine. To be removed from the CDF list on 12th March 2015. Remains on formulary for patients with funding approved prior to this date.

  • The first line treatment of advanced colorectal cancer with combination chemotherapy. To be removed from the CDF list on 12th March 2015. Remains on formulary for patients with funding approved prior to this date.

  • The second or third line treatment of advanced colorectal cancer.
  • >To be removed from the CDF list on 4th November 2015. Remains on formulary for patients with funding approved prior to this date.
  • The second line treatment of advanced epithelial ovarian, fallopian tube or primary peritoneal cancer. To be removed from the CDF list on 12th March 2015. Remains on formulary for patients with funding approved prior to this date.

  • NUH: For more information, including criteria, see the DTC website; available here
  • Confirm funding approved on BlueTeq for all new CDF starters. Contact High Cost Drugs or oncology pharmacist for assistance.

  • Link to external medicines reviews here
     
  • Link  Link to reviews
    Link  MHRA advice: Risk of osteonecrosis of the jaw ( 2011)
    Link  NICE Evidence summary: Bevacizumab in combination with paclitaxel and carboplatin for first-line treatment of advanced ovarian cancer
    Link  NICE TA214: Breast Cancer with taxane
    Link  NICE TA263: Breast cancer with capecitabine
    Link  NICE TA285: Ovarian, fallopian tube and primary peritoneal cancer (recurrent advanced, platinum-sensitive or partially platinum-sensitive) - bevacizumab
       
    08.01.05  Bexarotene
    08.01.05  Bortezomib
    Cytotoxic Drug Bortezomib
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    Formulary
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Injection
    Approved for use in accordance with NICE:

    • TA129 for the treatment of progressive multiple myeloma in people who are at first relapse having received one prior therapy and who have undergone, or are unsuitable for, bone marrow transplantation. This indication is associated with a Patient Access Scheme; details can be found here
    • TA228 for the first-line treatment of multiple myeloma if high-dose chemotherapy with stem cell transplantation is considered inappropriate and the person is unable to tolerate or has contraindications to thalidomide
    • TA311 for induction therapy in multiple myeloma before high-dose chemotherapy and autologous stem cell transplantation
    • TA370 for previously untreated mantle cell lymphoma in adults when haematopoietic stem cell transplantation is unsuitable.
      Also approved in accordance with the National Cancer Drugs Fund List for the indication(s) below where the specified criteria are met:
    • The treatment of bortezomib naive relapsed multiple myeloma. Confirm CDF approval is in place before treatment by reference to Blueteq.
      The following indications were removed from the CDF list on 12th March 2015. Treatment remains available for patients with funding approved prior to this date:
    • The treatment of relapsed/refractory mantle cell lymphoma.
    • The treatment of relapsed multiple myeloma that has previously responded to bortezomib.
    • The treatment of relapsed Waldenstrom's Macroglobulinaemia.
      NUH: For more information, including criteria, see the DTC website; available here
     
    Link  Link to reviews
    Link  NICE TAG129: Multiple myeloma - bortezomib
    Link  NICE TAG228: 1st line treatment of multiple myeloma
    Link  NICE TAG311: Bortezomib for induction therapy in multiple myeloma
    Link  NICE TAG370: Bortezomib for previously untreated mantle cell lymphoma
    Link  NUH Drugs and Therapeutics website
       
    08.01.05  Brentuximab vedotin
    Brentuximab vedotinBlack Triangle (Adcetris®)
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    Restricted Drug Restricted
    Red
    High Cost Medicine
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    Infusion

    NUH only:

    • Approved in accordance with NICE TA478 for treating relapsed or refractory systemic anaplastic large cell lymphoma.
    • Approved in accordance with NICE TA524 for treating CD30-positive Hodgkin lymphoma
    • Approved in accordance with NICE TA577 for treating CD30-positive cutaneous T-cell lymphoma
    • Approved as per CDF and then NICE TA641 in combination for untreated systemic anaplastic large cell lymphoma. Funding available from CDF for this combination until routine commissioning
    • Approved at NUH in accordance with NHS England’s interim treatment options available during the COVID-19 pandemic only. For review post March 2021: For use in adults an paediatrics earlier in the pathway, following one prior therapy, in place of salvage chemotherapy or auto stem cell transplant for relapsed or refractory Hodgkin Lymphoma. Unlicensed indication in paediatrics - for named patient use only.  
    • At NUH, confirm funding approved on BlueTeq for all new starters

    SFH

    • Confirm funding approved by contacting the HCD Team on 4660.
    • Approved in accordance with NICE TA478 for treating relapsed or refractory systemic anaplastic large cell lymphoma.
    • Approved in accordance with NICE TA524 for treating CD30-positive Hodgkin Lymphoma
     
    Link  Link to reviews
    Link  NICE TA478: Brentuximab vedotin for treating relapsed or refractory systemic anaplastic large cell lymphoma
    Link  NICE TA524: for treating CD30-positive Hodgkin lymphoma
    Link  NICE TA641: Brentuximab vedotin in combination for untreated systemic anaplastic large cell lymphoma
       
    08.01.05  Cetuximab to top
    Cetuximab (Erbitux®)
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    Formulary
    Red
    High Cost Medicine
    Cancer Drugs Fund
    Infusion
    Approved in accordance with NICE:
  • TA145 for the treatment of locally advanced squamous cell cancer of the head and neck where platinum-based treatment is contraindicated

  • TA439 for previously untreated metastatic colorectal cancer

  • TA473 for treating recurrent or metastatic squamous cell cancer of the head and neck - only if the cancer started in the oral cavity
    Also approved in accordance with the National Cancer Drugs Fund List for the indication(s) below where the specified criteria are met:
  • The second or third line treatment of metastatic colorectal cancer with combination chemotherapy. Was removed from the CDF list on 12th March 2015. Remains on formulary for patients with funding approved prior to this date.
  • The third or fourth line treatment of metastatic colorectal cancer as a single agent. Was removed from the CDF list on 4th November 2015. Remains on formulary for patients with funding approved prior to this date.
    NUH: For more information, including criteria, see the DTC website; available here
  • At NUH, confirm funding approved on BlueTeq for all new CDF starters
  • Patient access scheme exists- at SFH contact Medicines Information for further info 
  • Link  MHRA: importance of establishing wild type RAS (KRAS and NRAS) status before treatment of metastatic colorectal cancer
    Link  NICE TA145: Head and neck cancer - cetuximab
    Link  NICE TA439: Cetuximab and panitumumab for previously untreated metastatic colorectal cancer
    Link  NICE TA473: Cetuximab for treating recurrent or metastatic squamous cell cancer of the head and neck
       
    08.01.05  Crisantaspase
    Crisantaspase (Erwinase®)
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    Formulary
    Red
    Injection
  • At SFH, not routinely stocked, but may be ordered in if required.
  • NB: See attached letter - vials of Erwinase® from Batch 160G (see also information on sub-lots) contain crisantaspase 9 200 units, NOT 10 000 units as is the case with all other batches.
  • NB: See attached letters - Notice of special handling instructions. VIALS of ERWINASE® from batch 174G* and batch 180G* should be used with a 5-micron filter needle 
  • Link  Letter: ERWINASE® Batch 160G Variation Information (July 2013)
    Link  Letter: ERWINASE® Batch BATCH 174G* use with a 5-micron filter needle (May 2016)
    Link  Letter: ERWINASE® Batch BATCH 180G* use with a 5-micron filter needle (Feb 2017)
       
    08.01.05  Dacarbazine and Temozolomide
    Cytotoxic Drug Dacarbazine
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Injection 
       
    Cytotoxic Drug Temozolomide (Temodal®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine

    Capsules

    • Licensed for use in glioblastoma. For use in CNS lymphoma please refer to protocol linked below. Contact haematology/High Cost drugs staff at NUH or SFH for more information.
    • Available at NUH only as adjuvant treatment for adults with newly diagnosed anaplastic astrocytoma without 1p/19q codeletion in accordance with the NHS England Clinical Commissioning Policy.
     
    Link  Clinical Commissioning Policy: anaplastic astrocytoma without 1p/19q codeletion
    Link  MHRA: risk of hepatic injury, including fatal hepatic failure
    Link  NICE TA121: Glioma (newly diagnosed and high grade)
    Link  NICE TA23: Guidance on the use of temozolomide for the treatment of recurrent malignant glioma (brain cancer)
    Link  SFH: Temozolomide in CNS lymphoma
       
    08.01.05  Erlotinib
    Erlotinib
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablets

    • Approved in accordance with NICE guidelines documented below.
     
    Link  Link to reviews
    Link  NICE TA227: Lung cancer (non-small-cell) maintenance - erlotinib
    Link  NICE TA258: Lung cancer (non-small-cell) 1st line- erlotinib
    Link  NICE TA374: Erlotinib and gefitinib for treating non-small-cell lung cancer that has progressed after prior chemotherapy
    Link  SFH: Erlotinib regimen in lung cancer (NSCLC)
       
    08.01.05  Hydroxycarbamide
    Cytotoxic Drug Hydroxycarbamide
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red

    Capsule, Oral solution: available at NUH only for patients unable to take capsules

    • See East Midlands Cancer network guidelines linked above for further information with regards to Hydroxycarbamide place in CML therapy
     
    Link  SFH Hydroxycarbamide Regimen in Myeloproliferative Disorders and Palliative AML regimen
       
    08.01.05  Imatinab to top
    08.01.05  Ipilimumab
    Ipilimumab (Yervoy®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Intravenous Infusion

    Available at NUH only:

    • Approved in accordance with NICE TA268 - for previously treated advanced (unresectable or metastatic) melanoma
    • Approved in accordance with NICE TA319 for previously untreated advanced (unresectable or metastatic) melanoma
    • Approved in line with NICE TA400 for treating advanced (unresectable or metastatic) melanoma in adults in combination with nivolumab. Funding available by CDF for this combination until routine commissioning.
    • Approved in accordance with the National Cancer Drugs Fund List and NICE TA581 with nivolumab for untreated advanced renal cell carcinoma
     
    Link  Link to reviews
    Link  MHRA: risk of CMV gastrointestinal infection with ipilimumab
    Link  NICE TA268: Ipilimumab for previously treated advanced (unresectable or metastatic) melanoma
    Link  NICE TA319: Ipilimumab for previously untreated advanced (unresectable or metastatic) melanoma
    Link  NICE TA400: Nivolumab in combination with ipilimumab for treating advanced melanoma
       
    08.01.05  Mitotane
    08.01.05  Panitumumab
    08.01.05  Pentostatin
    Cytotoxic Drug Pentostatin (Nipent®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Injection- NUH only 
       
    08.01.05  Platinum compounds to top
    Cytotoxic Drug Carboplatin
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Injection
    NUH – Also purchase unlicensed pre-filled bags 
       
    Cytotoxic Drug Cisplatin
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Injection 
    Link  Link to reviews
       
    Cytotoxic Drug Oxaliplatin
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Injection 
    Link  NICE TA100: Colon cancer (adjuvant) - capecitabine and oxaliplatin
       
    08.01.05  Porfimer sodium and temoporfin
    08.01.05  Procarbazine
    Cytotoxic Drug Procarbazine
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Capsule 
       
    08.01.05  Protein kinase inhibitors
    Abemaciclib (Verzenios®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Tablets

    Available at NUH only:

    • Approved in accordance with compassionate use scheme for treating Hormone Receptor (HR) positive, HER2 negative metastatic breast cancer in combination with fulvestrant, pre-treated with aromatase inhibitors. (Existing patients only.
    • Approved in accordance with NICE TA579 with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy
    • Approved in accordance with NICE TA563, with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
     
    Link  NICE TA563:Abemaciclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
    Link  NICE TA579: Abemaciclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy
       
    Afatinib (Giotrif®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Tablets
  • Approved in accordance with NICE TA310 for NSCLC  
  • Link  Link to reviews
    Link  NICE TA310: Afatinib for non-small-cell lung cancer
    Link  SFH: Afatinib protocol in Timely trial
    Link  SFHT: Afatinib protocol in NSCLC
       
    Brigatinib (Alunbrig®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Cancer Drugs Fund

    Tablets

    Available at NUH only:

    • Approved as per NICE TA571 for treating ALK-positive advanced non-small cell lung cancer after crizotinib.
     
    Link  NICE TA571: Brigatinib for treating ALK-positive advanced non-small-cell lung cancer after crizotinib
       
    Cabozantinib (Cometriq®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Capsule

    NUH: Approved in accordance with NICE TA516 for treating medullary thyroid cancer.

     
    Link  Link to reviews
    Link  NICE TA516: Cabozantinib for treating medullary thyroid cancer
       
    Crizotinib (Xalkori®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Capsule

    Approved in accordance with NICE:

    • TA406 for untreated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer.
    • TA422 for previously treated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer.
    • TA529 for treating ROS1-positive advanced non-small-cell lung cancer.
     
    Link  Link to reviews
    Link  NICE TA406: Crizotinib for untreated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer
    Link  NICE TA422: Crizotinib for previously treated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer
    Link  NICE TA529: Crizotinib for treating ROS1-positive advanced non-small-cell lung cancer
    Link  SFH: Crizotinib regimen in NSCLC
    Link  SFH: Exalt3 trial
    Link  MHRA: risk of cardiac failure with crizotinib
       
    Dasatinib (Sprycel®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund
    Tablets
    Approved in accordance with NICE:
  • TA426 for untreated chronic myeloid leukaemia (chronic-phase Philadelphia-chromosome-positive)
  • TA425 for treating imatinib-resistant or intolerant chronic myeloid leukaemia (chronic or accelerated-phase Philadelphia-chromosome-positive)
    Approved in accordance with the National Cancer Drugs Fund List for the indication(s) below where the specified criteria are met:
    - The treatment of Philadelphia chromosome positive (Ph+) acute lymphoblastic leukaemia. Removed from the CDF list 2015. Remains on formulary for patients with funding approved prior to removal.
    - The treatment of lymphoid blast crisis chronic myeloid leukaemia. Removed from the CDF list 2015. Remains on formulary for patients with funding approved prior to removal.
  • Confirm funding approved on BlueTeq for all new starters
  • NUH: For more information, including criteria, see the DTC website; available here
     
  • Link  Link to reviews
    Link  NICE TA425:Dasatinib, nilotinib and high-dose imatinib for treating imatinib-resistant or intolerant chronic myeloid leukaemia
    Link  NICE TA426:Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia
    Link  SFHT Dasatinib regimen in CML
    Link  SFHT Dasatinib regimen in Spirit trial
    Link  UKMI Q&A: Which medicines require extra care when switching between liquid and tablet/capsule formulations?
       
    Everolimus (Afinitor®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Tablets 2.5mg, 5mg, 10mg

    • Approved in accordance with NICE TA421; Everolimus with exemestane for treating advanced breast cancer after endocrine therapy.
    • NUH approved in accordance with NICE TA432; Everolimus for advanced renal cell carcinoma after previous treatment.
    • NUH approved in accordance with NICE TA449 for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease
    • NUH approved in accordance with NICE TA498; Everolimus with lenvatinib (Kisplyx®) for previously treated advanced renal cell carcinoma
     
    Link  Link to reviews
    Link  NICE TA348: Preventing Rejection in Liver Transplant
    Link  NICE TA421:Everolimus with exemestane in advanced breast cancer after endocrine therapy
    Link  NICE TA432:Everolimus for advanced renal cell carcinoma after previous treatment
    Link  NICE TA449:Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease
    Link  NUH Drugs and Therapeutics Website
    Link  SFH Everolimus Regimen for Renal Cancer
    Link  SFH Everolimus-Exemestane in breast cancer
    Link  SFH: Everolimus in Manta trial in breast cancer
    Link  SFH: Everolimus in Zebra trial
       
    Everolimus (Votubia®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Homecare

    Tablets 2.5mg, 5mg, 10mg

    Available at NUH only:

    • Approved for the treatment of subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex (TSC) in line with NHS England commissioning policy.
    • Blueteq submission required
    • Approved in line with NHSE Commissioning Policy for refactory focal onset seizures associated with tuberous sclerosis complex (ages 2 years and above)

    Available through Homecare for NUH patients. Please contact pharmacy medicines homecare team for further information.

     
    Link  Link to reviews
       
    Gefitinib
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablets

    • Approved in accordance with NICE TA192 for NSCLC
    • Patient access scheme exists. Further information can be found here
    • Gefitinib (Iressa®) is not recommended for treating non small cell lung cancer that has progressed after chemotherapy as per NICE TAG 374

      At SFH:
    • CANNOT be kept as stock in pharmacy. For first cycle, orders can only be processed after purchasing has received a Patient Registration Form (1) signed by the Oncologist.
    • Read Instructions for Dispensary for more detailed information.
     
    Link  Link to reviews
    Link  NICE TA192: Lung cancer (non-small-cell, first line) - gefitinib
    Link  NICE TA374: Erlotinib and gefitinib for treating non-small-cell lung cancer
    Link  SFH Gefitinib regimen in Lung cancer (NSCLC)
       
    Gilteritinib  (Xospata®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablets

    Available at NUH only:

    • Approved in accordance with NICE TA642, for treating relapsed or refractory acute myeloid leukaemia
    • Approved at NUH in accordance with NHS England’s interim treatment options available during the COVID-19 pandemic only. For review post March 2021: For use, instead of chemotherapy, in relapsed or refractory FLT3-mutation-positive Acute Myeloid Leukaemia in adults.
     
    Link  NICE TA642: Gilteritinib for treating relapsed or refractory acute myeloid leukaemia
       
    Imatinib
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablets
    NUH only:

    • Approved in accordance with NICE TA326 & TA209: for the treatment of unresectable and/or metastatic gastrointestinal stromal tumours and the adjuvant treatment.
    • Approved in accordance with NICE TA70 & TA251: for chronic myeloid leukaemia.
    • Approved in accordance with NICE TA425: for high dose therapy for CML - not recommended.
    • Approved in accordance with NICE TA426: for untreated, chronic-phase Philadelphia-chromosome-positive CML in adults
    • Approved for adults and children with newly diagnosed Ph+ acute lymphoblastic leukaemia

    • Glivec® brand must be used for Gastrointestinal Stromal Tumours (GIST)

     SFH

    • Existing patients to remain on homecare and no new patients to be on homecare
     
    Link  SFH: Imatinib NICE approved protocol (Haematology)
    Link  SFH: Imatinib CDF approval required protocol (Haematology)
    Link  SFH: Imatinib in GIST (Oncology)
    Link  SFH: Imatinib in SPIRIT protocol
    Link  Link to reviews
    Link  NICE TA425:Dasatinib, nilotinib and high-dose imatinib for treating imatinib-resistant or intolerant chronic myeloid leukaemia
    Link  NICE TA426:Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia
       
    Lapatinib (Tyverb®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Tablets
  • Approved in accordance with the National Cancer Drugs Fund List for the indication(s) below where the specified criteria are met:
  • The treatment of advanced breast cancer. To be removed from the CDF list on 12th March 2015. Remains on formulary for patients with funding approved prior to this date.
  • NUH: For more information, including criteria, see the DTC website; available here
  • Confirm funding approved on BlueTeq for all new starters.
  • At SFH, contact High Cost Drugs team (ext 4657).
  • Direct discount Patient access scheme applies. 
  • Link  Link to reviews
    Link  NICE TA257: Lapatinib in HER-2 positive metastatic breast cancer
    Link  NUH Drugs and Therapeutics Website
    Link  SFH oral chemotherapy regimens
       
    Larotrectinib (Vitrakvi®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Oral solution

    Available at NUH only:

    • Approved in accordance with the National Cancer Drugs Fund and NICE TA630 for treating NTRK fusion-positive solid tumours in adults and children.
     
    Link  NICE TA630: Larotrectinib for treating NTRK fusion-positive solid tumours
       
    Nilotinib (Tasigna®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Capsule
    Approved in accordance with NICE:
  • TA425 for chronic- or accelerated-phase Philadelphia-chromosome-positive CML in adults
  • TA426 for untreated chronic-phase Philadelphia-chromosome-positive CML in adults
  • Must not be prescribed on FP10s as there is a Patient Access Scheme in operation. Can be supplied via Homecare as long as the PAS is transferred.
  • At SFH patients are supplied via Homecare.
  • See EastMidlands Cancer network guidelines linked above for further information with regards to Nilotinib place in CML therapy
     
  • Link  Link to reviews
    Link  NICE TA425: Dasatinib, nilotinib and high dose imatinib for CML
    Link  NICE TA425:Dasatinib, nilotinib and high-dose imatinib for treating imatinib-resistant or intolerant chronic myeloid leukaemia
    Link  NICE TA426: Dasatinib, nilotinib and imatinib for first line treatment of CML
    Link  NICE TA426:Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia
    Link  SFH:nilotinib regimen in CML refractory/intolerant to imatinib
       
    Osimertinib (Tagrisso®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablet

    • Approved in accordance with NICE TA653 for treating EGFR T790M mutation-positive advanced non-small-cell lung cancer
    • Approved in accordance with NICE TA654 for untreated EGFR mutation-positive non-small-cell lung cancer
     
    Link  NICE TA653: Osimertinib for treating EGFR T790M mutation-positive advanced non-small-cell lung cancer
    Link  NICE TA654: Osimertinib for untreated EGFR mutation-positive non-small-cell lung cancer
       
    Pazopanib (Votrient®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Tablets
  • Approved in accordance with NICE TA215 for the first-line treatment of advanced renal cell carcinoma
    Also approved in accordance with the National Cancer Drugs Fund List for the indications below where the specified criteria are met:
  • The treatment of advanced non-adipocytic soft tissue sarcoma. To be removed from the CDF list on 12th March 2015. Remains on formulary for patients with funding approved prior to this date.
    NUH: For more information, including criteria, see the DTC website; available here
  • Confirm funding approved on BlueTeq for all new starters 
  • Link  Link to reviews
    Link  NICE TA 215: Pazopanib in renal cell cancer
    Link  SFH Pazopanib Regimen in renal cancer
    Link  SFH: Star trial protocol in renal cancer
       
    Regorafenib (Stivarga® )
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablets

    • Approved in accordance with NICE TA488 for previously treated unresectable or metastatic gastrointesrinal stromal tumors
    • Approved in accordance with NICE TA555 for previously treated advanced hepatocellular carcinoma
    • SFH: Confirm funding by contacting the HCD Team on 4660
     
    Link  Link to reviews
    Link  NICE TA488:Regorafenib for previously treated unresectable or metastatic gastrointestinal stromal tumours
    Link  NICE TA555: Regorafenib for previously treated advanced hepatocellular carcinoma
       
    Sorafenib (Nexavar®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablets

    NUH approved in accordance with:

    • NICE TA474 for treating advanced hepatocellular carcinoma - only for people with Child-Pugh grade A liver impairment
    • NICE TA535 for treating differentiated thyroid cancer after radioactive iodine

    At SFH: Do not authorise before contacting High Cost Drugs team (4657) or Cancer services pharmacist (3156).

     
    Link  Link to reviews
    Link  NICE TA474: Sorafenib for treating advanced hepatocellular carcinoma
    Link  NICE TA535: Sorafenib for treating differentiated thyroid cancer after radioactive iodine.
    Link  NUH Drugs and Therapeutics Website
    Link  SFH Sorafenib Regimen for Hepatic Cancer
    Link  SFH Sorafenib Regimen for Renal Cancer
       
    Sunitinib (Sutent®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund
    Capsules
  • Approved in accordance with NICE for the treatment of gastrointestinal stromal tumours and for the first-line treatment of advanced and/or metastatic renal cell carcinoma.
  • NUH approved in accordance with NICE TA449 for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease
  • Risk of osteonecrosis of the jaw (MHRA advice 2011)  
  • Link  Link to reviews
    Link  NICE TA169: Renal cell carcinoma - sunitinib
    Link  NICE TA179: Gastrointestinal stromal tumours - sunitinib
    Link  NICE TA449:Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease
    Link  SFH Sunitinib regimen for renal cancer
    Link  SFH: Sunitinib regimen for pancreatic cancer
    Link  SFH: Star trial protocol in renal cancer
       
    Cytotoxic Drug Temsirolimus (Torisel®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund
    Only approved in accordance with the National Cancer Drugs Fund List for the treatment of advanced renal cell carcinoma
  • At NUH, confirm funding approved on BlueTeq for all new CDF starters. For more information, including criteria, see the DTC website; available here
  • At SFH: Do not authorise before contacting High Cost Drugs team (4657) or Cancer services pharmacist (3156).
     
  • Link  NUH Drugs and Therapeutics Website
       
    Vemurafenib (Zelboraf®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Tablets- NUH only
  • NUH: Approved for use in oncology in accordance with NICE TA269
     
  • Link  Link to reviews
    Link  MHRA: Risk of potentiation of radiation toxicity with vemurafenib
    Link  NICE TA269: Vemurafenib for treating malignant melanoma
       
    Cytotoxic Drug EntrectinibBlack Triangle (Rozlytrek ®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Capsule

    Available at NUH only:

    • Approved in accordance with NICE TA643, for the treatment of ROS1-positive advanced non-small-cell lung cancer. Funding available from the Cancer Drugs fund until routine commisioning.
    • Approved in adults and children over 12 years old in accordance with NICE TA644 for treating NTRK fusion-positive solid tumours
     
    Link  NICE TA643: Entrectinib for treating ROS1-positive advanced non-small-cell lung cancer
    Link  NICE TA644: Entrectinib for treating NTRK fusion-positive solid tumours
       
    08.01.05  Taxanes
    Cytotoxic Drug Cabazitaxel (Jevtana®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Infusion
  • NUH approved in line with NICE TA391 for hormone-relapsed metastatic prostate cancer treated with docetaxel.
    Confirm funding approved on BlueTeq for all new starters 
  • Link  Link to reviews
    Link  NICE TA391: Cabazitaxel for hormone-relapsed metastatic prostate cancer treated with docetaxel
       
    Cytotoxic Drug Docetaxel (Taxotere®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Infusion
     
    Link  NICE TA101: Prostate cancer (hormone-refractory) - docetaxel
    Link  NICE TA509: Pertuzumab with trastuzumab and docetaxel for treating HER2-positive breast cancer
       
    Cytotoxic Drug Paclitaxel
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Infusion 
    Link  Link to reviews
    Link  NICE TA101: Prostate cancer (hormone-refractory) - docetaxel
    Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
    Link  SFH: IV drugs which need special giving sets
       
    Cytotoxic Drug Paclitaxel - Albumin Bound Formulation (Abraxane®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Intravenous Infusion
    NUH: Approved for the treatment of breast cancer in patients who have documented Taxane hypersensitivity, in accordance with routine NHSE commissioning.
    NUH approved in accordance with TA476 for untreated metastatic pancreatic cancer
  • Confirm funding approved on BlueTeq for all new starters 
  • Link  NICE TA476: Paclitaxel as albumin-bound nanoparticles with gemcitabine for untreated metastatic pancreatic cancer
       
    08.01.05  Topoisomerase I inhibitors to top
    Cytotoxic Drug Irinotecan Hydrochloride
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Infusion
    NUH – Also purchase unlicensed pre-filled bags 
    Link  Link to reviews
       
    Cytotoxic Drug Topotecan (Hycamtin®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Infusion, Capsule 0.25mg and 1mg
  • Approved in accordance with NICE TA183 and NICE TA184
  • Topotecan is not recommended for treating recurrent platinum resistant or platinum refractory ovarian cancer as per NICE TA389 
  • Link  Link to reviews
    Link  NICE TA183: Cervical cancer (recurrent) - topotecan
    Link  NICE TA184: Lung cancer (small-cell) - topotecan
    Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
    Link  SFH:Topotecan oral Regimen in Small cell lung cancer (SCLC)
       
    08.01.05  Trabectedin
    Cytotoxic Drug Trabectedin (Yondelis®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red

    Injection-NUH only
    Approved in accordance with NICE TA185 for soft tissue sarcoma by NUH D&T Committee 21/04/10

    • Patient access scheme exists
      Trabectedin in combination with pegylated liposomal doxorubicin is not recommended for treatment of the first recurrence of platinum-sensitive ovarian cancer.
     
    Link  Link to reviews
    Link  NICE TA185: Soft tissue sarcoma - trabectedin
    Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
       
    08.01.05  Trastuzumab
    Cytotoxic Drug Pertuzumab (Perjeta®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Infusion

    Approved in accordance with NICE TA424 for the neoadjuvant treatment of HER2-positive breast cancer

    Approved in accordance with NICE TA509 with trastuzumab and docetaxel for treating HER2-positive breast cancer. 

    Approved in accordance with NICE TA569 for adjuvant treatment of HER2-positive early stage breast cancer

    Confirm funding approved on BlueTeq for all new starters.
    SFH: Confirm funding by contacting the HCd Team on 4660

     
    Link  Link to reviews
    Link  NICE TA424: Pertuzumab for the neoadjuvant treatment of HER2-positive breast cancer
    Link  NICE TA509: Pertuzumab with trastuzumab and docetaxel for treating HER2-positive breast cancer
       
    Cytotoxic Drug Trastuzumab (Herceptin®)
    (Intravenous)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine

    Infusion-NUH only

    See 'trastuzumab for subcutaneous use (Herceptin®)' for subcutaneous use.  

    Note: a managed switch from IV Herceptin® to the biosimilar IV Ontruzant® will take place in September 2018.  Please check which brand should be used before prescribing. 

    At NUH only approved in accordance with:

    • NICE TA34 for the treatment of advanced breast cancer
    • NICE TA208 for the treatment of HER2-positive metastatic gastric cancer
    • NICE TA257 in combination with an aromatase inhibitor for HER2 positive metastatic breast cancer
    • NICE TA509 with pertuzumab and docetaxel for treating HER2-positive breast cancer

    **Care required**

    • Trastuzumab must be prescribed by brand i.e. Herceptin® IV or Ontruzant® IV 
    • To minimise the risk of errors due to the similarity of the product names for trastuzumab: Ontruzant® IV (biosimilar), Herceptin® IV and Herceptin® SC and trastuzumab emtansine: Kadcyla®, recommendations in Risk Minimisation materials and formulary advice should be followed when prescribing, dispensing and administering the product.
     
    Link  NICE TA34: Breast cancer - trastuzumab
    Link  Link to reviews
    Link  NICE TA208: Gastric cancer (HER2-positive metastatic) - trastuzumab
    Link  NICE TA257: in combination with an aromatase inhibitor for HER2 positive metastatic breast cancer
    Link  NICE TA509: Pertuzumab with trastuzumab and docetaxel for treating HER2-positive breast cancer
       
    Cytotoxic Drug Trastuzumab (Herceptin®)
    (Subcutaneous)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Homecare

    Injection 

    See 'trastuzumab (Ontruzant®)' or 'trastuzumab (Herceptin®)' for IV use.  

    Approved at NUH and SFH in accordance with:

    • NICE TA34 for the treatment of advanced breast cancer
    • NICE TA208 for the treatment of HER2-positive metastatic gastric cancer
    • NICE TA257 in combination with an aromatase inhibitor for HER2 positive metastatic breast cancer
    • NICE TA509 with pertuzumab and docetaxel for treating HER2-positive breast cancer

    **Care required**

    • Trastuzumab SC must be prescribed by brand i.e. Herceptin® SC

    At SFH: Prescribed on oncology charts. Stocked in ADU. Prescriptions should be screened ONLY by ADU trained pharmacists.

    Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information

     
    Link  NICE TA34: Breast cancer - trastuzumab
    Link  NICE TA208: Gastric cancer (HER2-positive metastatic) - trastuzumab
    Link  NICE TA257: in combination with an aromatase inhibitor for HER2 positive metastatic breast cancer
    Link  NICE TA509: Pertuzumab with trastuzumab and docetaxel for treating HER2-positive breast cancer
       
    Cytotoxic Drug Trastuzumab (Ontruzant®)
    (IV Biosimilar)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Infusion-NUH only

    See 'trastuzumab for subcutaneous use (Herceptin®)' for subcutaneous use.  

    Note: a managed switch from IV Herceptin® to the biosimilar Ontruzant® will take place in September 2018.  Please check which brand should be used before prescribing. 

    At NUH only approved in accordance with:

    • NICE TA34 for the treatment of advanced breast cancer
    • NICE TA208 for the treatment of HER2-positive metastatic gastric cancer
    • NICE TA257 in combination with an aromatase inhibitor for HER2 positive metastatic breast cancer
    • NICE TA509 with pertuzumab and docetaxel for treating HER2-positive breast cancer

    **Care required**

    • Trastuzumab must be prescribed by brand i.e. Herceptin® IV or Ontruzant® IV 
    • To minimise the risk of errors due to the similarity of the product names for trastuzumab: Ontruzant® IV (biosimilar), Herceptin® IV and Herceptin® SC and trastuzumab emtansine: Kadcyla®, recommendations in Risk Minimisation materials and formulary advice should be followed when prescribing, dispensing and administering the product.
     
    Link  NICE TA34: Breast cancer - trastuzumab
    Link  NICE TA208: Gastric cancer (HER2-positive metastatic) - trastuzumab
    Link  NICE TA257: in combination with an aromatase inhibitor for HER2 positive metastatic breast cancer
    Link  NICE TA509: Pertuzumab with trastuzumab and docetaxel for treating HER2-positive breast cancer
       
    Cytotoxic Drug Trastuzumab emtansine (Kadcyla®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    NUH only
    Infusion

    • Approved in accordance with NICE TA458 for treating HER2-positive advanced breast cancer after trastuzumab and a taxane
    • Approved in accordance with the National Cancer Drugs Fund List and then NICE TA632 for adjuvant treatment of HER2-positive early breast cancer

    **Care required**
    To minimise the risk of errors due to the similarity of the product name Kadcyla® (trastuzumab emtansine) with that of Herceptin® IV (trastuzumab) and Herceptin® SC (trastuzumab) the recommendations in the Risk Minimisation Plan educational material from the manufacturer should be followed when prescribing, dispensing and administering the product

     
    Link  Link to reviews
    Link  NICE TA458:Trastuzumab emtansine for treating HER2-positive advanced breast cancer after trastuzumab and a taxane
    Link  NICE TA632:Trastuzumab emtansine for adjuvant treatment of HER2-positive early breast cancer
       
    08.01.05  Tretinoin
    Tretinoin (Vesanoid®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Capsule
  • Also known as "All Trans Retinoic Acid" (ATRA). 
  •    
    08.01.05  Vismodegib
    Cytotoxic Drug Vismodegib (Erivedge®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Capsule
    Only approved in accordance with the National Cancer Drugs Fund List for the treatment of locally advanced or metastatic Basal Cell Carcinoma. Was removed from the CDF list on 22nd January 2018. Remains on formulary for patients with funding approved prior to this date.
    NUH: For more information, including criteria, see the DTC website; available here. Confirm funding approved on BlueTeq for all new starters.
    SFH: Confirm funding by contacting the HCD Team on 4660
    Note: Patient, prescriber, and supplying pharmacy must comply with the manufacturer’s pregnancy prevention programme

    NICE TA489 states that vismodegib is not recommended for treating symptomatic metastatic basal cell carcinoma, or locally advanced basal cell carcinoma that is inappropriate for surgery or radiotherapy, in adults.

     
    Link  Link to reviews
    Link  NICE TA489: Vismodegib for treating basal cell carcinoma
       
    08.02  Drugs affecting the immune response to top
    Blinatumomab (Blincyto®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Infusion

    Available at NUH only: 

    • Approved in accordance with NICE TA450 for previously treated Philadelphia-chromosome-negative acute lymphoblastic leukaemia in adults.
    • Approved in accordance with NICE TA589 and the Cancer Drug Fund for treating acute lymphoblastic leukaemia in remission with minimal residual disease activity in adults
     
    Link  NICE TA450:Blinatumomab for previously treated Philadelphia-chromosome-negative acute lymphoblastic leukaemia
    Link  NICE TA589: Blinatumomab for treating acute lymphoblastic leukaemia in remission with minimal residual disease activity
       
    08.02  Immunosuppressant therapy
    08.02.01  Antiproliferative immunosuppressants
    Cytotoxic Drug Azathioprine
    (Chemotherapy/ post- transplant)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Homecare

    Tablet, Injection

    • Cytotoxic - do not crush tablets.
    • Oral suspension (expensive) available as an unlicensed special - recommended strength is 50mg/5mL as per RCPCH guidance.
    • For post-transplant immunosuppression, prescribing for existing patients should remain with the current prescriber until repatriation to specialist centre is agreed.
    • Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information
     
    Link  UKMI Q and A: Can mothers breast feed while taking azathioprine?
       
    Cytotoxic Drug Azathioprine
    (Neurology)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 1
    • Approved for use in neuromuscular diseases (e.g. MG, LEMS), inflammatory neuropathies, inflammatory conditions of the central nervous system and autoimmune encephalitis, as per Shared Care Protocol. 
     
    Link  COVID19: DMARD shared care monitoring during COVID19 (Notts CCG)
    Link  Shared Care Protocol for neuroinflammatory conditions - azathioprine information sheet
    Link  Shared Care Protocol for neuroinflammatory conditions - azathioprine PIL
    Link  Shared Care Protocol for neuroinflammatory conditions - overarching protocol
       
    Mycophenolate Mofetil
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Homecare

    Capsule 250mg, Tablet 500mg, Oral Suspension, Infusion

    • Used off licence in Myaesthenia Gravis (MG)
    • Approved for use in Uveitis
    • Approved for use at NUH in neuromuscular diseases (e.g. MG, LEMS), inflammatory neuropathies, inflammatory conditions of the central nervous system and autoimmune encephalitis.
    • At NUH and SFH, generic stocked - no need for brand continuity, although NUH haematology currently like to standardise on Myfenax® brand.
    • Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information
     
    Link  EMA advice to avoid mycophenolate use in pregnancy
    Link  Link to reviews
    Link  MHRA: contraception advice for male patients
    Link  MHRA: risk of hypogammaglobulinaemia & bronchiectasis with mycophenolate
    Link  NICE Evidence summary: Mycophenolate for scleroderma
    Link  NICE Evidence summary: Mycophenolate for SLE
       
    Mycophenolic acid (sodium)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Homecare

    Tablet EC (as sodium salt)

    • Used in renal transplant patients at NUH - prescribe by brand and generic to avoid confusion with mycophenolate mofetil.
    • Myfortic® was the original brand but now other brands exist.
    • Mycophenolic acid 720mg (tablets) is approximately equivalent to mycophenolate mofetil 1g (liquid). (See table of liquid medicines requiring dose adjustment)
    • Available through homecare for NUH patients.  Please contact pharmacy medicines homecare team for further information.
     
    Link  Link to reviews
    Link  MHRA: contraception advice for male patients
    Link  NICE Evidence summary: Mycophenolate for scleroderma
       
    08.02.02  Corticosteroids and other immunosuppressants
    Antithymocyte immunoglobulin (rabbit)  (Thymoglobuline®)
    View adult BNF View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Injection 25 mg- NUH only

    • Also known as ATG
    • Used for vascular rejection in kidney transplant patients
    • Also used for aplastic anaemia and GVHD post BMT
     
    Link  Link to reviews
    Link  Manufacturer SPC
    Link  NUH: Kidney Transplant Guidelines (see p18-19 for rabbit ATG guidance)
       
    Basiliximab (Simulect®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine
    Injection used in renal transplant as per NICE guidelines - NUH only. 
    Link  NICE TA481: Immunosuppressive therapy for kidney transplant in adults
    Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
       
    Ciclosporin
    (transplants)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine
    Homecare

    Capsules 25mg, 50mg, 100mg, Oral Solution (Neoral®), Injection (Sandimmune®)

    • MHRA specify that ciclosporin must be prescribed and dispensed by brand as bioavailability differences exist between brands. Neoral is the preferred brand in Nottinghamshire for transplant indications.
    • Relative prices of different brands [Hospital price][GP price]
    • Neoral liquid is equivalent to Neoral capsules. If changing from any other preparation contact Medicines Information, on 3163 for assistance.

    Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information

     
    Link  NUH Lite Bite: Importance of Maintaining Brand for Certain Medicines
    Link  NUH: Therapeutic Drug Monitoring in Adults at NUH
    Link  SFH Drug levels information - compilation table
    Link  SFH: IV drugs which need special giving sets
    Link  Link to reviews
       
    Prednisolone
    (Immunosuppressant)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Green
     
       
    Prednisolone
    (Post- transplant)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    • Immunosuppressants for use post-transplant should be prescribed by the Transplant Centre that carried out the transplant. Prescribing for existing patients should remain with the current prescriber until repatriation to specialist centre is agreed.
    • See prednisolone notes in section 6.3.2
     
       
    Sirolimus (Rapamune®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine
    Homecare

    Tablet, Oral Solution- NUH only

    • Sirolimus for progressive lymphangioleiomyomatosis (LAM) approved subject to funding (individual funding request needs to be authorised before prescribing).
    • Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information
     
    Link  Link to reviews
    Link  UKMI Q&A: Which medicines require extra care when switching between liquid and tablet/capsule formulations?
       
    Advagraf®
    (Tacrolimus)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Homecare

    Capsule MR (Prescribe by brand)
    ONCE DAILY TACROLIMUS

    • NUH: Restricted for new renal transplant patients (part of first line immunosuppresion regimen)
    • Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information
     
    Link  Link to reviews
    Link  NUH Lite Bite: Importance of Maintaining Brand for Certain Medicines
    Link  NUH: Therapeutic Drug Monitoring in Adults at NUH
       
    Envarsus®
    (Tacrolimus)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Homecare

    Tablets MR (Prescribe by brand)
    ONCE DAILY TACROLIMUS

    • NUH: Restricted for adult renal transplant patients (part of first line immunosuppresion regimen) who are unable to use Adoport®, Advagraf®, Prograf®, or Modigraf® due to persistent tremor or other neurological disturbances, that do not resolve with dose modification.
      N.B. Brand prescribe - bioavailability differs to other brands

    Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information

     
    Link  NUH Lite Bite: Importance of Maintaining Brand for Certain Medicines
       
    AdoPORT® (Tacrolimus)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Homecare

    Capsule (Prescribe by brand)
    TWICE DAILY TACROLIMUS

    • NUH: Restricted to use within new patients only in accordance with a phased implementation plan in the following patient groups: Adult renal, Paediatric renal, Ophthalmology (adults), Gastroenterology (adults) and Haematology (adults).
    • Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information
     
    Link  Link to reviews
    Link  NUH Lite Bite: Importance of Maintaining Brand for Certain Medicines
    Link  NUH: Tacrolimus - Poster for pharmacy (updated Feb15)
    Link  NUH: Tacrolimus - Poster for pharmacy and wards (updated Feb15)
       
    Modigraf®
    (Tacrolimus)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Homecare

    Sachets (Prescribe by brand)
    TWICE DAILY TACROLIMUS

    • Restricted to paediatric renal patients or for tube administration
    • Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information
     
    Link  Link to reviews
    Link  NUH Lite Bite: Importance of Maintaining Brand for Certain Medicines
       
    Prograf®
    (Tacrolimus)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Homecare

    Capsule (Prescribe by brand).
    TWICE DAILY TACROLIMUS
    Injection

    • Injection: use Polyethylene (PE) giving set for infusion (NOT PVC!). See further info.

    Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information

     
    Link  Link to reviews
    Link  NUH Lite Bite: Importance of Maintaining Brand for Certain Medicines
       
    08.02.03  Anti-lymphocyte monoclonal antibodies
    Alemtuzumab (Lemtrada®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red

    Infusion

    • Approved in accordance with NICE TA312 for treating relapsing‑remitting multiple sclerosis. NHS England will fund up to three cycles in accordance with the clinical commisioning policy statement.
     
    Link  Link to reviews
    Link  NICE TA312: Alemtuzumab for relapsing‑remitting multiple sclerosis
       
    Alemtuzumab (MabCampath®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine

    Infusion- unlicensed

    • Has historically been used for multiple sclerosis, immunosuppression pre islet transplant and CLL.
    • From August 2012 licensed product no longer available. Available through a patient access programme for haematology and oncology patients. Patient Access Forms

    SFH:

    • Prescribed by haematologists (Patient Access forms need to be completed) and prepared in SPU (See link above)

    Available at NUH:

    • Available through a patient access programme as induction therapy in adult kidney transplant patients.
     
    Link  Link to reviews
       
    Cytotoxic Drug Avelumab (Bavencio®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Infusion

    Available at NUH only

    • Approved for the treatment of metastatic Merkel cell carcinoma in accordance with NICE TA517.
    • Approved for use in combination with Axitinib, in accordance with NICE TA645 and the Cancer Drugs Fund, for untreated advanced or metastatic renal cell carcinoma
    • Approved in accordance with the Early Access to Medicines Scheme (11648/0003) for first-line maintenance treatment of adult patients with locally advanced or metastatic urothelial carcinoma whose disease has not progressed with first-line platinum-based induction chemotherapy
     
    Link  NICE TA517: Avelumab for treating metastaic Merkel cell carcinoma
    Link  NICE TA645: Avelumab with axitinib for untreated advanced renal cell carcinoma
       
    Caplacizumab (Cablivi®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Solution for injection

    Available at NUH only:

    • Approved in accordance with NICE TA667 with plasma exchange and immunosuppression for treating acute acquired thrombotic thrombocytopenic purpura in adults
     
    Link  NICE TA667: Caplacizumab with plasma exchange and immunosuppression for treating acute acquired thrombotic thrombocytopenic purpura
       
    Obinutuzumab (Gazyvaro ®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Infusion
    Approved in accordance with:
    - TA343 for untreated chronic lymphocytic leukaemia in combination with chlorambucil if other conditions make treatment with full-dose fludarabine unsuitable and bendamustine is not suitable
    - TA629 with bendamustine for treating follicular lymphoma refractory to rituximab. NUH only
    -
    TA513 for untreated, advanced Follicular Lymphoma.

     
    Link  Link to reviews
    Link  NICE TA343: Obinutuzumab with chlorambucil for CLL
    Link  NICE TA513: Obinutuzumab for untreated advanced follicular lymphoma
    Link  NICE TA629: Obinutuzumab with bendamustine for treating follicular lymphoma after rituximab
       
    Ocrelizumab (Ocrevus®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Solution for infusion

    NUH only:

    Approved in accordance with NICE TA533, for treating relapsing–remitting multiple sclerosis 

    Approved in accordance with NICE TA585, for treating primary progressive multiple sclerosis

     
    Link  NICE TA533: Ocrelizumab for treating relapsing–remitting multiple sclerosis
    Link  NICE TA585: Ocrelizumab for treating primary progressive multiple sclerosis
       
    Rituximab (MabThera®)
    (Subcutaneous injection)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Subcutaneous Injection
    At NUH:
    Restricted for
    Maintenance therapy for follicular, marginal zone and mantle cell lymphoma responding to induction therapy
    Maintenance therapy for follicular relapsed stage III or IV follicular non-Hodgkin's lymphoma
    Rituximab must be prescribed by brand i.e. MabThera® 
       
    Rituximab (Truxima®)
    (Biosimilar)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Infusion (Rituximab biosimilar)
    See section 10.1.3 for rheumatology indications
    See 'Rituximab (MabThera®)' for intrathecal and intraventricular use
    See ‘Rituximab for subcutaneous use (MabThera®)’ for subcutaneous use
    Note: A staged switching programme in currently in progress to switch adult patients receiving IV MabThera® to the biosimilar product Truxima®. Please confirm which brand should be used as per indication before prescribing.
    At NUH:
    Restricted for
    Cancer as per NHS England commissioning policy
    ITP
    EBV reactivation post BMT
    Chronic graft versus host disease (GvHD) after stem cell transplantation
    Relapsing steroid-sensitive nephrotic syndrome unresponsive to conventional medication in patients aged between 1 and 18 years in line with the commissioning policy (EO3/P/b)
    Steroid resistant nephrotic syndrome in patients aged between 1 and 18 years in line with the commissioning policy EO3/P/c
    Antibody-mediated rejection, post kidney transplantation in paediatric patients
    As second line therapy for the eradication of inhibitors in patients with acquired haemophilia in line with the commissioning policy (F02/P/a)
    As part of desensitisation regimen to permit ABO blood group incompatible kidney transplants
    Treatment of membranous glomerulonephritis, subject to funding
    Neuromyelitis optica unresponsive to first line treatments

    Treatment of myasthenia gravis (adults) as per the clinical commissioning policy
    Relapsed and refractory mantle cell lymphoma - with bendamustine as per the clinical commissioning policy
    First line treatment of advanced indolent non-Hodgkin's lymphoma - with bendamustine as per the clinical commissioning policy 
    For idiopathic membranous nephropathy in adults in accordance with the RaDaR scheme and the Commissioning through Evaluation (CtE) process supported by NHS England

    For second line treatment for anti-NMDAR autoimmune encephalitis (all ages) in accordance with the NHS England commissioning policy

     
    At SFH:
    Restricted for
    Haematology – in line with the East Midlands Cancer Network haematology guidelines
    Rheumatology – for new patients who have previously not been on rituximab.
    Rituximab must be prescribed by brand, i.e. either Truxima® or MabThera® in line with guidance for biosimilar switch programmes.

     
    Link  Clinical Commissioning Policy: Rituximab for second line treatment for anti-NMDAR autoimmune encephalitis (all ages)
    Link  Commissioning Policy: For relapsing steroid-sensitive nephrotic syndrome
    Link  Commissioning Policy: For steroid resistant nephrotic syndrome in paediatric patients
    Link  Commissioning Policy: Rituximab bio-similar for the treatment of myasthenia gravis (adults)
    Link  Link to reviews
    Link  NHS England: For the eradication of inhibitors in acquired haemophilia
    Link  NHS England: Graft versus host disease
    Link  NHS England: Neuromyelitis optica
    Link  NICE guidelines for rituximab
    Link  Rituximab for ITP-NICE evidence summary
       
    Rituximab (MabThera®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Infusion
    See section 10.1.3 for rheumatology indications

    Note: a staged switch from MabThera® to the biosimilar Truxima® is currently in progress. Please check which brand should be used as per indication before prescribing.
    At NUH:
    Restricted for
    For intrathecal and intraventricular use within haematology
    At SFH:
    See section 10.1.3 for rheumatology indications
    Rituximab must be prescribed by brand, i.e. either Truxima® or MabThera® in line with guidance for biosimilar switch programmes.

     
    Link  Link to reviews
    Link  NICE guidelines for rituximab
       
    08.02.04  Other immunomodulating drugs to top
    Axicabtagene ciloleucel (YESCARTA®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red

    Infusion

    Available at NUH only: Approved in accordance with NICE TA559 for  treating diffuse large B-cell lymphoma and primary mediastinal large B-cell lymphoma after 2 or more systemic therapies.  Patients will be referred to an appropriate centre to receive treatment.

    Axicabtagene ciloleucel is a chimeric antigen receptor (CAR) T‑cell therapy.

     
       
    Canakinumab (Ilaris®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Homecare

    Injection
    Available at NUH only:

    • Approved in accordance with the Clinical Commissioning policy for treating periodic fever syndromes: TRAPS, HIDS/MKD and FMF (ages 2 years and older). Approval from Royal Free or GOSH must be gained before initiating treatment, in line with the agreed shared care process.

    •  - Use for cryoporin associated periodic syndrome is only commissioned at The Royal Free Hospital and Great Ormond Street Hospital as highly specialised centres.
    •  - GREY for refractory gout.
    •  - Not routinely commissioned for juvenile arthritis - approval via IFR must be sought before initiation of treatment.

    • Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information
     
    Link  Clinical Commissioning Policy: Canakinumab for treating periodic fever syndromes: TRAPS, HIDS/MKD and FMF (ages 2 years and older)
    Link  Link to reviews
       
    Cemiplimab (Libtayo ®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine

    Infusion

    Available at NUH only:

    • Approved in accordance with NICE TA592 for treating metastatic or locally advanced cutaneous squamous cell carcinoma
     
       
    Daclizumab (Zinbryta®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Injection
    NUH only:
  • Approved in accordance with NICE TA441 for treating relapsing–remitting multiple sclerosis. 
  • Link  MHRA- risk of severe liver injury
    Link  MHRA: risk of encephalitis persists for 12 months after stopping
    Link  MHRA: suspension of marketing authorisation
       
    Dimethyl fumarate (Tecfidera®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Homecare

    Capsule

    • NUH: Approved in accordance with NICE TA320 for the treatment of adult patients with active relapsing remitting multiple sclerosis (MS).
    • Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information
     
    Link  EMA advice re minimising risk of PML
    Link  Link to reviews
    Link  MHRA Drug Safety Update (April 2016)
    Link  NICE TA320: Dimethyl fumarate for multiple sclerosis
    Link  NICE TA475: Dimethyl fumarate for treating moderate to severe plaque psoriasis
       
    Cytotoxic Drug Dinutuximab beta
    (Qarziba®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Infusion

    NUH: Approved in accordance with NICE TA538 for treating neuroblastoma.

     
    Link  NICE TA538: Dinutuximab beta for treating neuroblastoma
       
    Fingolimod
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Homecare

    Capsules- NUH only

    • Approved for use in line with NICE TA254
    • Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information
     
    Link  All MHRA Drug Safety Update
    Link  Link to reviews
    Link  NICE TA254: Fingolimod for highly active relapsing remitting multiple sclerosis
       
    Lenalidomide
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Capsules.

    • Approved for use in accordance with NICE TA171 and NICE TA322.
    • Available at NUH only in accordance with NICE TA586 with dexamethasone for multiple myeloma after 1 treatment with bortezomib.
    • Available at NUH only in accordance with NICE TA587 with dexamethasone for previously untreated multiple myeloma.
    • Available at NUH only in accordance with NICE TA627 with rituximab for previously treated follicular lymphoma.


    Also approved in accordance with the National Cancer Drugs Fund List:

    • For the second line treatment of multiple myeloma where the specified criteria are met. Was removed from the CDF list on 4th November 2015. Remains on formulary for patients with funding approved prior to this date.
    • For the treatment of myelodysplastic syndromes (MDS) associated with a deletion 5q abnormality where the specified criteria are met.
    • Confirm funding approved on BlueTeq for all new CDF starters.
    • Prescription authorisation and records needed
    • Patient access scheme exists
    • Hepatic disorders: See company mailing and MHRA advice.

    Also approved through NUH only, in accordance with the compassionate access scheme, for relapsed/refractory lymphoma including diffuse large B cell lymphoma, Non-Hodgkin Lymphoma, mantle cell lymphoma.

    At NUH:
    For more information, including criteria, see the DTC website; available here


    At SFH:

    • On receipt of prescriptions contact HCD team (4657) before screening. Please see procedure in S:/staff/HCD folder.
    • Lenalidomide in Myeloma XI trial (See link below for regimens): may be screened by any pharmacist who has completed the oral chemotherapy validation.
     
    Link  Link to reviews
    Link  MHRA Drug Safety Update (Dec 2014)
    Link  NICE: Ixazomib with lenalidomide and dexamethasone for treating relapsed or refractory multiple myeloma (TA505)
    Link  SFH Haematology chemotherapy trials (incl Myeloma XI)
    Link  SFH Oral haematology chemotherapy regimens
       
    Niraparib (Zejula®)
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Capsules

    NUH only: Approved in accordance with NICE TA528 for maintenance treatment of relapsed, platinum-sensitive ovarian, fallopian tube and peritoneal cancer.

     
    Link  NICE TA528: Niraparib for maintenance treatment of relapsed, platinum-sensitive ovarian, fallopian tube and peritoneal cancer
       
    Nivolumab (Opdivo®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Infusion

    Available at NUH only:

    • Approved in accordance with NICE TA384 for treating advanced (unresectable or metastatic) melanoma
    • Approved in accordance with NICE TA400 for treating advanced melanoma in combination with Ipilimumab.
    • Approved in accordance with NICE TA417 for previously treated advanced renal cell carcinoma
    • Approved in accordance with NICE TA462 for treating relapsed or refractory classical Hodgkin lymphoma.
    • Approved in accordance with NICE TA490 for treating squamous cell carcinoma of the head and neck after platinum-based chemotherapy.
    • Approved in accordance with NICE TA484 for previously treated non-squamous non-small-cell lung cancer
    • Nivolumab is not recommended for treating locally advanced unresectable or metastatic urothelial cancer after platinum-containing chemotherapy as per NICE TA530. 
    • Approved in accordance with NICE TA558 for adjuvant treatment of completely resected melanoma with lymph node involvement or metastatic disease
    • Approved in accordance with the National Cancer Drugs Fund List and NICE TA581 with ipilimumab for untreated advanced renal cell carcinoma
    • Approved in accordance with NICE TA655 for advanced squamous non-small-cell lung cancer after chemotherapy
    • Approved in accordance with Early Access to Medicines Scheme (15105/0008) for treating advanced or recurrent gastric or gastroesophageal junction cancer after two or more systemic therapies. Closed to new patients August 2018.
    • Approved in accordance with Early Access to Medicines Scheme (15105/0010) for treatment of adult patients with unresectable advanced, recurrent or metastatic oesophageal cancer after prior chemotherapy. Unlicensed indication - available through NUH only.
    • Approved at NUH in accordance with NHS England’s interim treatment options for the following indications, available during the COVID-19 pandemic only.  For review post March 2021:
      - For use earlier in the pathway, after brentuximab, to replace salvage chemotherapy in the treastment of relapsed or refractory Hodgkin Lymphoma. Unlicensed indication - named patient use only.
      - As monotherapy to treat mesothelioma. Unlicensed indication - named patient use only.
      - Instead of chemotherapy for micro-satellite instability-high tumours to reduce toxicity and risks of treatment in endometrial cancer. Unlicensed 
      indication - named patient use only.
      - Instead of chemotherapy for micro-satellite instability-high tumours to reduce toxicity of treatment in upper gastrointestinal cancers (gastric, small bowel, biliary tract, pancreatic). Unlicensed indications - named patient use only.
      - Instead of chemotherapy for micro-satellite instability-high tumours to reduce toxicity of treatment in oesphageal cancer
     
    Link  Early access to medicines scheme (EAMS): nivolumab for non-squamous non-small cell lung cancer (NSCLC)
    Link  MHRA Drug Safety Update (July 2017)
    Link  NICE TA384: Nivolumab for treating advanced (unresectable or metastatic) melanoma
    Link  NICE TA400: Nivolumab in combination with ipilimumab for treating advanced melanoma
    Link  NICE TA417: Nivolumab for previously treated advanced renal cell carcinoma
    Link  NICE TA462:Nivolumab for treating relapsed or refractory classical Hodgkin lymphoma
    Link  NICE TA484: Nivolumab for previously treated non-squamous non-small-cell lung cancer
    Link  NICE TA490:Nivolumab for treating squamous cell carcinoma of the head and neck after platinum-based chemotherapy
    Link  NICE TA530: Nivolumab for treating locally advanced unresectable or metastatic urothelial cancer after platinum-containing chemotherapy (not recommended)
    Link  NICE TA581: Nivolumab with ipilimumab for untreated advanced renal cell carcinoma
    Link  NICE TA655: for advanced squamous non-small-cell lung cancer after chemotherapy
    Link  SMC advice (March 2016)
    Link  Early access to medicines scheme (EAMS): Nivolumab for treatment of adult patients with unresectable advanced, recurrent or metastatic oesophageal cancer after prior chemotherapy
       
    Olaparib (Lynparza®)
    View adult BNF View SPC online
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablets (100mg and 150mg) [Capsules 50mg being phased out 2020]

    Prescribe by brand AND formulation. Capsules and tablets are not interchangeable due to differences in dosing and bioavailability of each formulation. See Risk Minimisation Material here

    • Tablets are approved in accordance with NICE TA598 for maintenance treatment of BRCA mutation-positive advanced ovarian, fallopian tube or peritoneal cancer after response to first-line platinum-based chemotherapy
    • Tablets are approved in accordance with NICE TA620 for maintenance treatment of relapsed platinum-sensitive ovarian, fallopian tube or peritoneal cancer
    • Also available only for prescribing by the oncologists for patients on STOMP trial.
     
    Link  Letter about tablets versus capsules formulation
    Link  NICE TA598: Olaparib for maintenance treatment of BRCA mutation-positive advanced ovarian, fallopian tube or peritoneal cancer after response to first-line platinum-based chemotherapy
    Link  NICE TA620: Olaparib for maintenance treatment of relapsed platinum-sensitive ovarian, fallopian tube or peritoneal cancer
    Link  SFHT: Olaparib in STOMP trial
       
    Pomalidomide (Imnovid®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Capsules
  • Approved (NUH) in accordance with TA427 for multiple myeloma previously treated with lenalidomide and bortezomib. 
  • Link  Link to reviews
    Link  MHRA Drug Safety Update (May 2016)
    Link  NICE TA427: Pomalidomide for multiple myeloma previously treated with lenalidomide and bortezomib
    Link  SFH: Pomalidomide in myeloma protocol
       
    Rucaparib (Rubraca®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Tablets

    NUH only: Approved in accordance with NICE TA611 for maintenance treatment of relapsed platinum-sensitive ovarian, fallopian tube or peritoneal cancer.

     
    Link  NICE TA611: Rucaparib for maintenance treatment of relapsed platinum-sensitive ovarian, fallopian tube or peritoneal cancer
       
    Talimogene laherparepvac (Imlygic®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    BlueTeq

    Injection - (NUH only)

    • Approved in accordance with NICE TA410 for treating unresectable metastatic melanoma
     
    Link  NICE TA410: Talimogene laherparepvec for treating unresectable metastatic melanoma
       
    Teriflunomide (Aubagio®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Homecare

    Tablet

    • NUH: Approved in accordance with NICE TA303 for the treatment of relapsing–remitting multiple sclerosis.
    • Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information
     
    Link  Link to reviews
    Link  NICE TA 303: Teriflunomide for relapsing remitting MS
       
    Thalidomide (Celgene®)
    (haematology)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Capsules
  • Restricted to use in Multiple Myeloma. Use in other indications is unlicensed.
  • Prescription authorisation and records needed- at SFH see supply procedure below. 
  • Link  MHRA Drug Safety Update (December 2015)
    Link  SFH Haematology chemotherapy trials
    Link  SFH Oral haematology chemotherapy regimens
    Link  SFH Thalidomide supply procedure
       
    Tisagenlecleucel  (Kymriah®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Cancer Drugs Fund

    Infusion

    Available at NUH only:

    Approved in accordance with NICE TA554 for treating relapsed or refractory B-cell acute lymphoblastic leukaemia in people aged up to 25 years.  Patients will be referred to an appropriate centre to receive treatment.

    Approved in accordance with NICE TA567 for treating relapsed or refractory diffuse large B-cell lymphoma after 2 or more systemic therapies. Patients will be referred to an appropriate centre to receive treatment.

    Tisagenlecleucel is a chimeric antigen receptor (CAR) T‑cell therapy

     
    Link  NICE TA554:Tisagenlecleucel for treating relapsed or refractory B-cell acute lymphoblastic leukaemia in people aged up to 25 years
    Link  NICE TA567: Tisagenlecleucel for treating relapsed or refractory diffuse large B-cell lymphoma after 2 or more systemic therapies
       
    08.02.04  Interferon Alfa
    08.02.04  Interferon beta
    Interferon Beta-1a (Avonex®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Homecare

    Injection

    Approved in accordance with NICE TA527 for treating multiple sclerosis.

    Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information

     
    Link  NICE TA527: Beta interferons and glatiramer acetate for treating multiple sclerosis
       
    Interferon Beta-1a (Rebif®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Homecare

    Injection:6 mega units in 0.5mL Prefilled syringe

    NUH only: Approved in accordance with NICE TA527 for treating multiple sclerosis.

    Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information

     
    Link  Commissioning Policy - Multiple Sclerosis
    Link  MHRA Drug Safety Update (Dec 2014)
    Link  NICE TA527: Beta interferons and glatiramer acetate for treating multiple sclerosis
       
    Interferon beta-1b (Extavia®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Injection

    NUH only (via homecare): Approved in accordance with NICE TA527, for treating multiple sclerosis.

     
    Link  NICE TA527: Beta interferons and glatiramer acetate for treating multiple sclerosis
       
    Peginterferon Beta-1a (Plegridy®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Injection: 63micrograms in 0.5mL pre-filled pen, 94micrograms in 0.5mL pre-filled pen and 125micrograms in 0.5mL pre-filled pen

    • NUH only (via homecare): Approved for treating relapsing–remitting multiple sclerosis (RRMS) in adults, in accordance with NICE TA624 and the NHS England commissioning policy.
     
       
    08.02.04  Interferon gamma
    08.02.04  Aldesleukin
    BCG bladder instillation (OncoTICE®)
    View adult BNF View SPC online View childrens BNF
    Formulary  
    Link  SFH: BCG (Oncotice) and Mitomycin information in bladder cancer
       
    08.02.04  BCG bladder instillation to top
    08.02.04  Canakinumab
    08.02.04  Dimethyl fumarate
    08.02.04  Fingolimod
    08.02.04  Glatiramer acetate
    Glatiramer Acetate
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine
    Homecare

    Injection

    Available at NUH only:

    • Available as 20mg/ml syringes for once daily dosing and as 40mg/ml syringes for three times weekly dosing. Both regimens are cost equivalent and are commissioned.
    • New patients to be initiated on Brabio®, existing Copaxone® patients will remain on Copaxone®.
    • Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information
     
    Link  Commissioning Policy - Multiple Sclerosis
    Link  Glatiramer for the treatment of MS
    Link  Link to reviews
       
    08.02.04  Histamine to top
    08.02.04  Lenalidomide, pomalidomide, and thalidomide
    08.02.04  Mifamurtide
    Mifamurtide (Mepact®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Intravenous infusion
  • Approved in accordance with NICE TA235 for the treatment of high-grade resectable non-metastatic osteosarcoma 
  • Link  NICE TA235: Osteosarcoma - mifamurtide: guidance
       
    08.02.04  Natalizumab
    Natalizumab (Tysabri®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine
    Infusion- NUH only
  • Approved in accordance with NICE TA127 
  • Link  Commissioning Policy - Multiple Sclerosis
    Link  Link to reviews
    Link  MHRA Drug Safety Update (April 2016)
    Link  NICE TA127: Multiple sclerosis - natalizumab
       
    08.02.04  Teriflunomide
    08.03  Sex hormones and hormone antagonists in malignant disease to top
    08.03.01  Oestrogens
    Diethylstilbestrol
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Amber 2
    Tablet
  • Restricted for use in Breast and Prostate Cancer
     
  •    
    Ethinylestradol
    (Cancer)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2
    See section 06.04.01.01 for HRT uses
     
       
    08.03.02  Progestogens
    Medroxyprogesterone (Provera®)
    (Malignancy)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2

    Tablet

    • Tablets disperse in water if needed. See here for general advice on dispersing tablets. If crushing do so in water to reduce production of dust
    • Amber 2 for endometrial, prostate, breast and renal cell cancer
     
       
    Megestrol (Megace®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2

    Tablet

    • If needed tablets can be dispersed in water. More Info
    • 40mg tablets discontinued March 2008. 160mg tablets still available, and are scored.
    • Amber 2 for endometrial and breast cancer
     
       
    Norethisterone
    (Malignancy)
    View adult BNF View SPC online View childrens BNF
    Formulary

    Tablet

    • See section 06.04.01.02 for gynae indications
    • Tablets disperse in water if needed, if crushing do so in water to reduce dust production. See here for general advice on dispersing tablets.
     
       
    08.03.03  Androgens
    08.03.04  Hormone antagonists
    08.03.04.01  Breast cancer to top
    Anastrozole
    (Breast cancer)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2

    Tablet

    • Consultant recommendation for breast cancer only
    • No liquid version, but tablets disperse in water (may take up to 20 mins). Ideally do not crush first to avoid dust. This should be avoided by women of child bearing potential and preferably be done in a closed system. [More Info].
    • Note that use for gynaecomastia is classified Amber 3 (see Unlicensed section)
     
    Link  Link to reviews
       
    Exemestane
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Amber 2
    Tablet
  • Restricted to consultant recommendation only
  • Amber 2 for breast cancer after specialist recommendation
  • No liquid version, but tablets dissolve in about 30minutes. Ideally do not crush first. This should be avoided by women of child bearing potential and preferably be done in a closed system. [More Info].
     
  •    
    Fulvestrant (Faslodex®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red

    Injection

    • Restricted to consultant recommendation only
    • Approved through NUH in accordance with NICE TA619: Palbociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer

    Fulvestrant is not recommended for treating locally advanced or metastatic oestrogen-receptor positive breast cancer in postmenopausal women who have not had endocrine therapy before (NICE TA503).

     
    Link  Link to reviews
    Link  NICE TA239: Fulvestrant for the treatment of locally advanced or metastatic breast cancer
    Link  NICE TA503: Fulvestrant for untreated locally advanced or metastatic oestrogen-receptor positive breast cancer
    Link  SFH: Manta trial in breast cancer
       
    Goserelin (Zoladex®)
    (Breast cancer)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Amber 2
    Implant
    See section 08.03.04.02 for prostate cancer and 6.7.2 for gynae and gender dysphoria
  • Restricted to consultant recommendation only
  • Goserelin available for the treatment of breast cancer only. Zoladex brand of goserelin is licensed, but other gonaderelin analogues are not. For all other indications triptorelin should be used 
  •    
    Letrozole
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Amber 2
    Tablet
  • Restricted to consultant recommendation only
  • Amber 2 for breast cancer 
  •    
    Neratinib
    View adult BNF View SPC online
    Restricted Drug Restricted
    Red

    Tablet
    NUH only:

    Approved in accordance with compassionate named patient programme for patients with HER2+ve metastatic breast cancer, following disease progression on trastuzumab and trastuzumab emtansine.

    Approved in accordance with NICE TA612 for extended adjuvant treatment of hormone receptor-positive, HER2-positive early stage breast cancer after adjuvant trastuzumab.

     
    Link  NICE TA 612: Neratinib for extended adjuvant treatment of hormone receptor-positive, HER2-positive early stage breast cancer after adjuvant trastuzumab
       
    Palbociclib (Ibrance®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine

    Capsules

    Available through NUH only. Approved in accordance with:

    • NICE TA495, in combination with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer.
    • NICE TA619, with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer

    Blueteq form required

     
    Link  NICE TA495: Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
    Link  NICE TA619: Palbociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer
    Link  SFH: Palbociclib in breast cancer
       
    Ribociclib (Kisqali®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Cancer Drugs Fund

    Film-coated tablets

    Approved in accordance with:

    • NICE TA496 in combination with an aromatase inhibitor for the treatment of postmenopausal woman with previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer.
    • The Cancer Drugs Fund and NICE TA593 with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer.
     
    Link  NICE TA496: Ribociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
    Link  NICE TA593: Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer
       
    Tamoxifen
    (Breast cancer/ mastocytosis)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2

    Tablet (20mg*), Oral solution (10mg/5ml)

    • Also used in off label indication of systemic mastocytosis - consultant request only.
    • *Note that 10mg and 40mg tablets are much more expensive than 20mg tablets.
    • Oral solution available (approx £60 for 300ml, DT May18).
    • Tablets disperse in water if needed (not licensed). This should be avoided by women of child bearing potential and preferably be done in a closed system. See here for general advice on dispersing tablets
    • Note that use for gynaecomastia is classified Amber 3 (see Unlicensed section)
     
    Link  Drug interactions, genetic variants and variability in clinical response (MHRA drug safety update Nov 2010)
    Link  UKMI Q&A Does Tamoxifen interact with SSRI or SNRI antidepressants?
       
    08.03.04.02  Prostate cancer and gonadorelin analogues
    Radium-223 dichloride
    (Xofigo®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Injection - radiopharmaceutical
    NUH:
  • Approved in accordance with NICE TA412 for treating hormone-relapsed prostate cancer with bone metastases and no known visceral metastases in adults if already treated with docetaxel or docetaxel is contraindicated or not suitable (BlueTeq submission required)
  •  
    Link  MHRA Drug Safety Update
    Link  NICE TA412: Radium-223 dichloride for treating hormone-relapsed prostate cancer with bone metastases
       
    08.03.04.02  Gonadorelin analogues
    Degarelix (Firmagon®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Amber 2
    Injection
  • Approved in accordance with NICE TA404 
  • Link  Link to reviews
    Link  NICE TA404:Degarelix for treating advanced hormone-dependent prostate cancer
       
    08.03.04.02  Anti-androgens
    Abiraterone (Zytiga®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablets.

    • Approved in line with NICE TA259 for use by an oncologist for castration resistant metastatic prostate cancer, previously treated with docetaxel.
      Commissioners have confirmed that abiraterone in the above indication is not routinely commissioned in England in patients who have received prior enzalutamide therapy. An exception will be where enzalutamide has had to be stopped within 3 months of its start solely as a consequence of dose-limiting toxicity and in the clear absence of disease progression.
    • Approved in line with NICE TA387 for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated
    • At SFH, see link below.
    • Patients commenced on the drug prior to 1st May 2011 are eligible for free of charge stock via a compassionate use programme.
     
    Link  Link to reviews
    Link  NICE TA387:Abiraterone for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated
    Link  NICE TAG 259: Abiraterone for castration resistant prostate cancer
    Link  SFH: Abiraterone in Prostate Cancer Regimen
    Link  SFH: Abiraterone in Stampede trial (See arm G and J)
       
    Bicalutamide
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2
    Tablet
  • If needed tablets can be dispersed in water, but this should be avoided by women of child bearing potential. Carers should wear protective clothing to minimise contact with dispersed tablets More Info
  • Amber 2 for advanced prostate cancer
     
  • Link  Link to reviews
       
    Cyproterone
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2

    Tablet

    • If needed tablets can be dispersed in water, but this should be done in a closed system- put the tablet in an oral syringe and suck up some water to dissolve it. More Info
     
    Link  MHRA Drug safety update- advice regarding meningioma risk with cyproterone
       
    DarolutamideBlack Triangle (Nubeqa ®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablet

    Available at NUH only:

    • Approved in accordance with NICE TA660 with androgen deprivation therapy for treating hormone-relapsed non-metastatic prostate cancer

     

     

     
    Link  NICE TA660: Darolutamide with androgen deprivation therapy for treating hormone-relapsed non-metastatic prostate cancer
       
    Enzalutamide (Xtandi®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablets (NB: Capsules discontinued Sept 2019)

    • Approved in line with NICE TA377 for treating metastatic, hormone-relapsed prostate cancer before chemotherapy is indicated.
    • Enzalutamide is routinely commissioned for metastatic hormone-relapsed prostate cancer previously treated with a docetaxel-containing regimen in accordance with NICE TA316.
    • NB: The use of enzalutamide for treating metastatic hormone-relapsed prostate cancer previously treated with abiraterone is not covered by this guidance.
    • Enzalutamide requires National Cancer Drugs Fund approval (until April 2016) for the treatment of chemotherapy naïve castrate-resistant Metastatic Prostate Cancer. Confirm funding is approved on BlueTeq for all new CDF starters.
    • NUH: For more about CDF approved indications, including criteria, see the DTC website; available here
    • SFH: For all new starters contact the oncology pharmacy team (3156) or the HCD Team (4660) to confirm whether CDF approval is required or not.
     
    Link  Enzalutamide in Stampede trial (See arm J)
    Link  Link to reviews
    Link  NICE TA316: Enzalutamide for prostate cancer
    Link  NICE TA377: Enzalutamide for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated
    Link  SFH: Enzalutamide in prostate cancer regimen
       
    Flutamide
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2
    Tablet
  • Amber 2 for advanced prostate cancer 
  •    
    Triptorelin (Decapeptyl®)
    (Malignancy)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2

    Injection MR 3mg - 1 monthly
    Injection MR 11.25mg - 3 monthly
    Injection MR 22.5mg - 6 monthly

    • Amber 2 for advanced prostate cancer.
    • For gynae and paediatric indications see section see sections 6.7.2
     
    Link  Link to reviews
    Link  Notts APC position statement: Gonadorelin Prescribing in Primary Care
       
    Leuprorelin (Prostap® 3)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Amber 2

    Injection 11.25mg- 3 monthly

    • Triptorelin is GnRH analogue of choice for all indications except breast cancer. Leuprorelin is restricted to patients in whom IM injections should be avoided, eg those on anticoagulants (May 2014) as it may be given SC and therefore preferable to IM triptorelin.
     
    Link  Notts APC position statement: Gonadorelin Prescribing in Primary Care
       
    08.03.04.03  Somatostatin analogues
    Lanreotide (Somatuline Autogel®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    Homecare

    Injection - Prefilled syringe.

    • Restricted for use in Neuroendocrine Tumours and Acromegaly- Consultant endocrinologist and oncologist request only.
    • At SFH: Patient access scheme exists - first dose is replaced for free. For new patients complete the form below and contact Pharmacy High Cost Drugs Team (4660) for further information.
    • At NUH: Approved for preventing recurrent GI bleeding in patients who present with significant small bowel intestinal bleeding secondary to small bowel angioectasias (SBA) and in those with hereditary haemorrhagic telangiectasia (HHT) who are unable to tolerate further endoscopic treatment, according to specified criteria. (Unlicensed indication)

     

    Available through homecare for NUH patients receiving treatment for neuroendocrine tumours. Please contact pharmacy medicines homecare team for further information

     
    Link  SFH: Lanreotide FOC first dose request form
       
    Lutetium (177Lu) oxodotreotide (Lutathera®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine

    Infusion - radiopharmaceutical

    NUH: Approved in accordance with NICE TA539 for treating unresectable or metastatic neuroendocrine tumours.  Patients will be referred to Birmingham to receive treatment.

     
       
    Octreotide (Sandostatin Lar®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine
    Depot injection-NUH only
  • Restricted for use in Neuroendocrine Tumours and Acromegaly- Consultant endocrinologist and oncologist request only
     
  • Link  Link to reviews
       
    Octreotide (Sandostatin®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Amber 2
    High Cost Medicine

    Injection

    • Gastric secretions and nausea and vomiting in oncology and palliative care
    • NUH: For use as prophylaxis against carcinoid syndrome in selected patients with Neuroendocrine Tumours. 
     
    Link  Link to reviews
    Link  NUH: Octreotide Infusion Guideline for Adult Patients at Risk of Carcinoid Crisis
       
     ....
     Non Formulary Items
    Aldesleukin  (Proleukin®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    High Cost Medicine
     
    Amifostine  (Ethyol®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Anamorelin

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    No formal submission (APC March 2016)
     
    BCG bladder instillation  (ImmuCyst®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    Vial for bladder instillation
  • Product discontinued 2017
  •  
    Begelomab  (Begedina®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    No formal assessment (APC March 2016)
     
    Belatacept  (Nulojix®)

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    Non Formulary
    Grey
    High Cost Medicine
    For renal transplant.
    Not routinely commissioned - NICE TA is in progress.
     
    Buserelin
    (Prostate)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    For infertility treatment see section
    6.7.2
     
    Calcium Leofolinate  (Isovorin®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Cediranib  (Recentin®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    No formal assessment (APC Nov 2015)
     
    Ciclosporin  (Capsorin®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Cobimetinib  (Cotellic®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    No formal assessment (APC Jan 2016)
    Link  NICE TA414:Cobimetinib in combination with vemurafenib for treating unresectable or metastatic BRAF V600 mutation-positive melanoma
     
    Daclizumab  (Zenapax®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    This drug is now discontinued.
    Link  Link to reviews
     
    Cytotoxic Drug  Decitabine  (Dacogen®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    High Cost Medicine
  • Non-formulary as per NICE TA270.
  • May only be used after IFR approval
  • Link  Link to reviews
    Link  NICE: Leukaemia (acute myeloid ) - decitabine (terminated appraisal) (TA270)
     
    Dinutuximab  (Unituxin®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    No formal assessment (Nov 2015 APC)
     
    Disodium Folinate  (Sodiofolin®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Disodium Levofolinate
    (Lvofolinic acid )

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Elotuzumab  (Empliciti®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
  • No formal submission (NUH DTC April 2017)
  •  
    Estramustine Phosphate  (Estracyt®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Red
     
    Everolimus  (Certican®)
    (Transplant)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    High Cost Medicine
    • No formal submission
    • NICE TA - Everolimus is not recommended within its marketing authorisation for preventing organ rejection in people having a liver transplant.
    Link  NICE TA348: Preventing Rejection in Liver Transplant
     
    Fampridine

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    High Cost Medicine
    • Licensed for improving walking time in MS patients. Not currently routinely commissioned by NHS England.
    • IFR must be approved before initiation.
    • Red Traffic Light NUH only Approved for existing patients following participation in the ENHANCE and ENABLE clinical trials. Supplied via homecare.
    Link  Link to reviews
    Link  NHS England national commissioning policy
     
    Goserelin  (Zoladex®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    Triptorelin is preferred for all indications except breast cancer (see section 8.3.4.1)
    and gender dysphoria (see section 6.7.2)
    Link  Notts APC position statement: Gonadorelin Prescribing in Primary Care
     
    Goserelin  (Zoladex® LA)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    Triptorelin is preferred for all indications except breast cancer (see section 8.3.4.1)
    and gender dysphoria (see section 6.7.2)
    Link  Notts APC position statement: Gonadorelin Prescribing in Primary Care
     
    Histrelin  (Vantas®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    Nov 2016: Not available in UK
     
    Interferon Alfa  (Viraferon®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    High Cost Medicine
     
    Interferon Alfa-2a  (Roferon-A®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Red
    High Cost Medicine

    Discontinued

    Injection: as Vial, Cartridge, Prefilled syringe

    • At SFH not routinely stocked, but may be available on request
    • NB. different brands have different licensed indications
    • Roferon-A Prefilled Syringe 3miu and 6miu expected discontinuation date Sep 19
    • Roferon-A Prefilled Syringe 4.5miu expected discontinuation date Nov 19
     
    Interferon Alfa-2b  (IntronA®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    High Cost Medicine

    Discontinued in UK by manufacturer - December 2018

    Prefilled injection pens

    • 18MU pen delivers contents in doses ranging from 1.5-6 MU (in 0.3 MU increments - See PIL)
    • 30MU pen delivers contents in doses ranging from 2.5-10 MU (in 0.5 MU increments - See PIL)
    • 60MU pen delivers contents in doses ranging from 5-20 MU (in 1 MU increments - See PIL)
    • NB. different brands have different licensed indications
    • Screening information: Pre-filled syringes contain either 18, 30 or 60 MU.
    Link  NICE TA75: Interferon Alfa - Chronic Hepatitis C
     
    Interferon Beta  (Proleukin®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    High Cost Medicine
     
    Interferon Beta-1b  (Betaferon®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    High Cost Medicine

    Betaferon is not recommended within its marketing authorisation as an option for treating multiple sclerosis, as per NICE TA527.

     
    Cytotoxic Drug  Irinotecan hydrochloride trihydrate  (Onivyde®)
    (pegylated liposomal)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    Not recommended for treating pancreatic cancer after gemcitabine in adults as per TA440
     
    Lanreotide  (Somatuline® LA)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Leuprorelin Acetate  (Prostap® SR)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    Triptorelin is preferred for all indications except breast cancer
    Link  Notts APC position statement: Gonadorelin Prescribing in Primary Care
     
    Leuprorelin Acetate  (Staladex® 10.72mg implant )

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey

    Implant 10.72mg - no formal assesment 

    Link  Notts APC position statement: Gonadorelin Prescribing in Primary Care
     
    Mitotane  (Lysodren®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Red
     
    Necitumumab  (Portrazza®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    High Cost Medicine
    No formal submission (APC May 15)
    Link  NICE TA411: Necitumumab for untreated advanced or metastatic squamous non-small-cell lung cancer
     
    Ofatumumab  (Arzerra®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    High Cost Medicine

    Infusion
    Previously approved in accordance with NICE TA344 for untreated chronic lymphocytic leukaemia in combination with chlorambucil if treatments containing fludarabine or bendamustine are not suitable
    Was previously approved for the treatment of chronic lymphocytic leukaemia as a 2nd or 3rd line indication. Removed from the CDF list on 12th March 2015. Remains on formulary for patients with funding approved prior to this date.

    March 2019 - Removed from formulary as ofatumumab no longer available through commercial channels due to the availability of other effective treatments and consequent low demand.

    Link  Link to reviews
    Link  MHRA: Ofatumumab: screen for hepatitis B virus before treatment
    Link  MHRA: Risk of serious and fatal infusion reactions—always give premedication and monitor carefully
    Link  NICE TA344: Ofatumumab with chlorambucil or bendamustine for CLL
    Link  SFH: Information about IV filters
     
    Olaratumab  (Lartruvo®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    High Cost Medicine

    Infusion
    NUH: Was approved, in accordance with NICE TA465 and the Cancer Drugs Fund, in combination with doxorubicin for treating advanced soft tissue sarcoma in adults.

    January 2019 - In line with EMA advice no new patients should start treatment with olaratumab.

    June 2019 - NICE guidance has been withdrawn because olaratumumab (Lartruvo®) no longer has a marketing authorisation.

     
    Padeliporfin dipotassium  (Tookad®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey

    Injection

    Not recommended by NICE for untreated localised prostate cancer

    Link  NICE TA546: Padeliporfin not recommended for untreated localised prostate cancer
     
    Palifermin  (Kepivance®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    Classified grey for oral mucositosis in patients with haematological malignancies
    Link  Link to reviews
     
    Peginterferon Alfa  (PegIntron®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    High Cost Medicine
    Link  Link to reviews
     
    Peginterferon Alfa  (ViraferonPeg®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    High Cost Medicine
    Injection: Prefilled syringe, Pen- NUH only
  • For NICE Guidelines please see entries above for Pegasys
    December 2016: Product discontinued
  • Link  Link to reviews
     
    Peginterferon Alfa-2a  (Pegasys®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Red
    High Cost Medicine

    Discontinued

    Injection: Prefilled syringe

    Pen - NUH only, NB: 180 micrograms in 0.5ml pens are being discontinued from Ma