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Nottinghamshire Area Prescribing Committee
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 Formulary Chapter 9: Nutrition and blood - Full Chapter
09.01.04  Expand sub section  Drugs used in autoimmune thrombocytopenic purpura
Anagrelide
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Restricted Drug Restricted
Red
Capsule
  • SFH: On Haematologist advice only. Relatively expensive. Supplies for patients in PT1 trial are supplied 2 for the price of one. 
  •    
    Avatrombopag (Doptelet)
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    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablet

    NUH and Nottingham NHS Treatment Centre only:

    • Approved for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure, in accordance with TA626, following hepatology MDT approval.
    • Availability: Company have advised medication supply should be available November 2020
     
    Link  NICE TA626: Avatrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure
       
    Eltrombopag (Revolade)
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    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablet

    At NUH:

    • All patients, for whom treatment with a thrombopoietin (TPO) agonist is being considered, should be discussed at a haematology MDT meeting.
    • Approved for treating chronic immune (idiopathic) thrombocytopenic purpura in adults, in accordance with TA293.
    • Approved for treating chronic immune (idiopathic) thrombocytopenic purpura refractory to other treatments in paediatrics.

    At SFH: Supplied via Homecare. Please contact High Cost Drugs Team (4657) if eltrombopag is required.

     
    Link  Link to reviews
    Link  MHRA: eltrombopag interference with creatinine and bilirubin tests
    Link  NICE TAG 293: Eltrombopag for treating chronic ITP
       
    Lusutrombopag (Mulpleo)
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    Restricted Drug Restricted
    Red
    High Cost Medicine

    Tablet

    NUH and Nottingham NHS Treatment Centre only:

    • Approved for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure, in accordance with TA617, following hepatology MDT approval.
     
    Link  NICE TA617: Lusutrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure
       
    Romiplostim (Nplate)
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    Restricted Drug Restricted
    Red
    High Cost Medicine

    Injection

    • Restricted for use in line with NICE guidance (TAG 221) and NUH guideline
     
    Link  Link to reviews
    Link  NICE TA221: Thrombocytopenic purpura - romiplostim
       
     ....
    Key
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Unlicensed
    Track Changes
    Display tracking information
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    Link to adult BNF
    click to search medicines.org.uk
    Link to children's BNF
    click to search medicines.org.uk
    Link to SPCs
    SMC
    Scottish Medicines Consortium
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Grey

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

    Red

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

    Amber 1

    Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised.
    Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the Nottinghamshire APC.
      

    Amber 2

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

    Amber 3

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

    Green

    Medicines suitable for routine use within primary care.
    Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.   

    OTC

      

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