Report : A-Z HCD items in Formulary 03/08/2020 12:40:07

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Section Status HCD Name 05.03.01 Restricted Use Abacavir Ziagen® 05.03.01 Restricted Use Abacavir and Lamivudine  05.03.01 Restricted Use Abacavir and Lamivudine and Zidovudine Trizivir® 10.01.03 Restricted Use Abatacept Orencia® 08.01.05 Formulary Abemaciclib Verzenios® 08.03.04.02 Restricted Use Abiraterone Zytiga® 01.05.03 Restricted Use Adalimumab  10.01.03 Restricted Use Adalimumab  11.04.02 Restricted Use Adalimumab   13.05.03 Restricted Use Adalimumab  05.03.03.01 Restricted Use Adefovir Dipivoxil Hepsera® 08.01.05 Restricted Use Aflibercept Zaltrap® 11.08.02 Restricted Use Aflibercept Eylea® 09.08.01 Non Formulary Agalsidase Alfa and Beta Fabrazyme® 09.08.01 Non Formulary Agalsidase Alfa and Beta Replagal® 02.11 Restricted Use Albutrepenonacog alfa Idelvion® 08.02.04 Non Formulary Aldesleukin Proleukin® 08.02.03 Formulary Alemtuzumab MabCampath® 09.08.01 Non Formulary Alglucosidase Alfa Myozyme® 13.05.01 Restricted Use Alitretinoin Toctino® 02.05.01 Non Formulary Ambrisentan  10.02.01 Non Formulary Amifampridine Firdapse 05.02 Restricted Use Amphotericin Abelcet® 05.02 Restricted Use Amphotericin AmBisome® 10.01.03 Restricted Use Anakinra Kineret® 05.02.04 Restricted Use Anidulafungin Ecalta® 02.11 Restricted Use Antithrombin III Kybernin® 09.01.03 Non Formulary Antithymocyte Immunoglobulin (Equine)  08.02.02 Restricted Use Antithymocyte immunoglobulin (rabbit)  Thymoglobuline® 13.05.03 Restricted Use Apremilast Otezla® 08.01.05 Restricted Use Arsenic Trioxide  09.08.01 Non Formulary Asfotase alfa Strensiq® 10.02 Restricted Use Ataluren Translarna® 05.03.01 Restricted Use Atazanavir  05.03.01 Restricted Use Atazanavir sulfate and cobicistat Evotaz® 08.01.05 Restricted Use Atezolizumab Tecentriq® 09.01.04 Restricted Use Avatrombopag Doptelet® 08.02.03 Restricted Use Avelumab Bavencio® 08.01.05 Restricted Use Axitinib Inlyta® 08.01.03 Restricted Use Azacitidine Vidaza® 05.01.02.03 Restricted Use Aztreonam nebuliser solution Cayston® 10.01.03 Restricted Use Baricitinib Olumiant® 08.02.02 Formulary Basiliximab Simulect® 05.01.09 Restricted Use Bedaquiline Sirturo® 08.02.02 Non Formulary Belatacept Nulojix® 10.01 Restricted Use Belimumab Benlysta® 08.01.01 Restricted Use Bendamustine  03.05.02 Non Formulary Beractant Survanta® 08.01.05 Restricted Use Bevacizumab Avastin® 05.03.01 Restricted Use Bictegravir, emtricitabine and tenofovir alafenamide Biktarvy® 08.02 Restricted Use Blinatumomab Blincyto® 05.03.03.02 Non Formulary Boceprevir Victrelis® 08.01.05 Formulary Bortezomib  02.05.01 Formulary Bosentan  08.01.05 Restricted Use Bosutinib Bosulif® 04.07.04.02 Formulary Botulinum Toxin Type A botox® 08.01.05 Restricted Use Brentuximab vedotin Adcetris® 13.05.02 Restricted Use Brodalumab Kyntheum® 03.04.03 Formulary C1 esterase inhibitor Cinryze® 03.04.03 Restricted Use C1 Esterase Inhibitor Berinert® 08.01.05 Restricted Use Cabazitaxel Jevtana® 08.01.05 Restricted Use Cabozantinib Cabometyx® 08.01.05 Restricted Use Cabozantinib Cometriq® 08.02.04 Non Formulary Canakinumab Ilaris® 08.01.05 Restricted Use Carfilzomib Kyprolis® 09.08.01 Restricted Use Carglumic Acid Carbaglu® 05.02.04 Restricted Use Caspofungin  02.11 Non Formulary Catridecacog NovoThirteen® 08.02.04 Formulary Cemiplimab Libtayo ® 08.01.05 Restricted Use Ceritinib Zykadia 10.01.03 Restricted Use Certolizumab Pegol Cimzia® 08.01.05 Formulary Cetuximab Erbitux® 09.08.01 Non Formulary Chenodeoxycholic acid Xenbilox® 09.08.01 Non Formulary Chenodeoxycholic acid Leadiant biosciences 01.09.01 Non Formulary Cholic acid Orphacol® 01.09.01 Non Formulary Cholic acid Kolbam® 08.02.02 Formulary Ciclosporin  05.03.02.02 Restricted Use Cidofovir infusion  09.05.01.02 Restricted Use Cinacalcet  08.01.03 Formulary Cladribine  08.01.03 Formulary Cladribine Mavenclad® 08.01.03 Restricted Use Clofarabine  05.03.01 Restricted Use Cobicistat Tybost® 04.09.01 Restricted Use Co-Careldopa Duodopa® 09.05.02.02 Non Formulary Colestilan BindRen® 05.01.07 Restricted Use Colistimethate Promixin® 05.01.07 Formulary Colistimethate for nebulisation Colomycin® 05.01.07 Restricted Use Colistimethate inhaler Colobreathe® 10.03.01 Non Formulary Collagenase Xiapex® 03.04.03 Non Formulary Conestat Alfa Ruconest® 08.01.05 Restricted Use Crizotinib Xalkori® 08.01.05 Restricted Use Dabrafenib Tafinlar® 05.03.03.02 Non Formulary Daclatasvir  Daklinza® 08.02.04 Restricted Use Daclizumab Zinbryta® 08.01.05 Formulary Dacomitinib monohydrate Vizimpro® 08.01.05 Restricted Use Daratumumab Darzalex® 09.01.03 Restricted Use Darbepoetin Alfa Aranesp® 05.03.01 Restricted Use Darunavir  05.03.01 Restricted Use Darunavir and Cobicistat Rezolsta® 05.03.03.02 Restricted Use Dasabuvir Exviera® 08.01.05 Restricted Use Dasatinib Sprycel® 20 Formulary DAUNORUBICIN saline pre-filled syringe  08.01.03 Non Formulary Decitabine Dacogen® 09.01.03 Restricted Use Deferasirox Exjade® 09.01.03 Formulary Deferiprone Ferriprox® 02.10.02 Formulary Defibrotide  20 Non Formulary DEFIBROTIDE Capsules 400 mg  05.01.09 Non Formulary Delamanid Deltyba® 09.01.03 Formulary Desferrioxamine Mesilate  11.04.01 Restricted Use Dexamethasone intravitreal implant Ozurdex® 08.01 Restricted Use Dexrazoxane Savene® 08.01 Restricted Use Dexrazoxane Cardioxane® 05.03.01 Restricted Use Didanosine Videx® 02.01.01 Restricted Use Digoxin specific antibody fragments Digifab® 18 Restricted Use Digoxin specific antibody fragments Digifab® 08.02.04 Restricted Use Dimethyl fumarate Tecfidera® 13.05.02 Restricted Use Dimethyl Fumarate   08.02.04 Restricted Use Dinutuximab beta  05.03.01 Formulary Dolutegravir  05.03.01 Formulary Dolutegravir and lamivudine Dovato® 05.03.01 Formulary Dolutegravir and rilpivirine Juluca® 05.03.01 Formulary Dolutegravir, abacavir & lamivudine Triumeq® 05.03.01 Non Formulary Dolutegravir, lamivudine & tenofovir Acriptega® 05.03.01 Restricted Use Doravirine Pifeltro® 05.03.01 Restricted Use Doravirine and Lamivudine and Tenofovir disoproxil Delstrigo® 03.07 Formulary Dornase Alfa Pulmozyme® 08.01.02 Restricted Use Doxorubicin Caelyx® 13.05.03 Restricted Use Dupilumab Dupixent® 09.01.03 Restricted Use Eculizumab  05.03.01 Restricted Use Efavirenz Sustiva® 02.11 Restricted Use Efmoroctocog alfa Elocta® 02.11 Restricted Use Eftrenonacog alfa Alprolix® 05.03.03.02 Restricted Use Elbasvir/Grazoprevir Zepatier® 09.08.01 Non Formulary Eliglustat Cerdelga® 09.08.01 Non Formulary Elosulfase alfa Vimizim® 09.01.04 Restricted Use Eltrombopag Revolade® 02.11 Restricted Use Emicizumab Hemlibra® 05.03.01 Restricted Use Emtricitabine Emtriva® 05.03.01 Restricted Use Emtricitabine + rilpivirine + tenofovir alafenamide Odefsey® 05.03.01 Restricted Use Emtricitabine + tenofovir alafenamide Descovy® 05.03.01 Restricted Use Emtricitabine 200mg, Rilpivirine 25mg and Tenofovir 245mg Eviplera® 08.01.05 Formulary Encorafenib Braftovi® 05.03.01 Formulary Enfuvirtide Fuzeon® 05.03.03.01 Restricted Use Entecavir  08.03.04.02 Restricted Use Enzalutamide Xtandi® 09.01.03 Restricted Use Epoetin alfa Eprex® 09.01.03 Restricted Use Epoetin beta NeoRecormon® 02.08.01 Restricted Use Epoprostenol Flolan® 20 Non Formulary Eptotermin Alfa  Osigraft® 08.01.05 Restricted Use Eribulin Halaven® 08.01.05 Restricted Use Erlotinib  10.01.03 Restricted Use Etanercept Enbrel® 13.05.03 Formulary Etanercept Enbrel® 05.03.01 Restricted Use Etravirine Intelence® 08.01.05 Restricted Use Everolimus Votubia® 08.01.05 Restricted Use Everolimus Afinitor® 08.02.02 Non Formulary Everolimus Certican® 02.11 Restricted Use Factor Eight Inhibitor Bypassing Fraction Feiba® 02.11 Non Formulary Factor IX Fraction, Dried  02.11 Restricted Use Factor VIIa (Recombinant), Eptacog alfa NovoSeven® 02.11 Restricted Use Factor VIII NovoEight® 02.11 Restricted Use Factor VIII - Von willebrand factor Type 8Y® 02.11 Restricted Use Factor VIII - Von willebrand factor Wilate® 02.11 Restricted Use Factor VIII + von Willebrand factor Voncento® 02.11 Non Formulary Factor VIII Fraction, Dried  02.11 Non Formulary Factor VIII Inhibitor Bypassing Fraction  02.11 Non Formulary Factor XIII Fraction, Dried  08.02.04 Non Formulary Fampridine  05.01.07 Formulary Fidaxomicin Dificlir® 09.01.06 Formulary Filgrastim Nivestim® 09.01.06 Restricted Use Filgrastim Neupogen® 08.02.04 Restricted Use Fingolimod  11.04.01 Restricted Use Fluocinolone intravitreal implant Iluvien® 18 Restricted Use Fomepizole  05.03.01 Restricted Use Fosamprenavir Telzir® 05.03.02.02 Restricted Use Foscarnet Sodium Foscavir® 05.03.02.02 Restricted Use Ganciclovir  08.01.05 Restricted Use Gefitinib  08.01.05 Restricted Use Gilteritinib  Xospata® 08.02.04 Formulary Glatiramer Acetate  05.03.03.02 Formulary Glecaprevir/Pibrentasvir Maviret® 18 Restricted Use Glucarpidase Carboxypeptidase 01.05.03 Restricted Use Golimumab Simponi® 10.01.03 Restricted Use Golimumab Simponi® 13.05.03 Restricted Use Guselkumab Tremfya® 09.08.02 Non Formulary Haem Arginate Normosang® 02.11 Restricted Use Human Fibrinogen Riastap® 08.01.05 Restricted Use Ibrutinib Imbruvica® 03.04.03 Restricted Use Icatibant Firazyr® 02.05.01 Formulary Iloprost injection   08.01.05 Restricted Use Imatinib  09.08.01 Non Formulary Imiglucerase Cerezyme® 05.03.01 Non Formulary Indinavir Crixivan® 01.05.03 Restricted Use Infliximab Remicade® 01.05.03 Non Formulary Infliximab Inflectra® 01.05.03 Restricted Use Infliximab Remsima® 10.01.03 Restricted Use Infliximab Remicade® 13.05.03 Formulary Infliximab Remicade® 08.01.05 Restricted Use Inotuzumab Ozogamicin  Besponsa® 08.02.04 Non Formulary Interferon Alfa Viraferon® 08.02.04 Formulary Interferon Alfa-2a Roferon-A® 08.02.04 Non Formulary Interferon Alfa-2b IntronA® 08.02.04 Non Formulary Interferon Beta Proleukin® 08.02.04 Restricted Use Interferon Beta-1a Avonex® 08.02.04 Restricted Use Interferon Beta-1a Rebif® 08.02.04 Restricted Use Interferon beta-1b Extavia® 08.02.04 Non Formulary Interferon Beta-1b Betaferon® 08.01.05 Restricted Use Ipilimumab Yervoy® 03.07 Restricted Use Ivacaftor  13.05.02 Restricted Use Ixekizumab Taltz® 05.03.01 Restricted Use Lamivudine Zeffix® 05.03.01 Restricted Use Lamivudine Epivir® 05.03.01 Non Formulary Lamivudine & raltegravir Dutrebis® 03.04.03 Restricted Use Lanadelumab  08.03.04.03 Restricted Use Lanreotide Somatuline Autogel® 09.05.02.02 Restricted Use Lanthanum Fosrenol ® 08.01.05 Restricted Use Lapatinib Tyverb® 09.08.01 Non Formulary Laronidase Aldurazyme® 08.01.05 Restricted Use Larotrectinib Vitrakvi® 05.03.03.02 Restricted Use Ledipasvir and Sofosbuvir Harvoni® 08.02.04 Restricted Use Lenalidomide  09.01.06 Restricted Use Lenograstim Granocyte® 08.01.05 Restricted Use Lenvatinib Lenvima® 08.01.05 Restricted Use Lenvatinib Kisplyx® 05.03.02.02 Formulary Letermovir Prevymis® 09.08.01 Formulary Levocarnitine Carnitor® 05.01.12 Restricted Use Levofloxacin Quinsair® 06.02.01 Restricted Use Liothyronine (IV)  08.01.02 Restricted Use Liposomal Cytarabine-Daunorubicin Vyxeos® 02.12 Non Formulary Lomitapide Lojuxta® 05.03.01 Restricted Use Lopinavir and Ritonavir Kaletra® 09.01.04 Restricted Use Lusutrombopag Mulpleo® 08.03.04.03 Restricted Use Lutetium (177Lu) oxodotreotide Lutathera® 02.05.01 Non Formulary Macitentan Opsumit® 03.07 Restricted Use Mannitol inhalation Bronchitol ® 05.03.01 Formulary Maraviroc Celsentri® 06.07.04 Non Formulary Mecasermin Increlex® 09.08.01 Non Formulary Mercaptamine Cystagon® 09.08.01 Formulary Mercaptamine (cysteamine) eye drops   09.01.03 Restricted Use Methoxy Polyethylene Glycol-Epoetin Beta Mircera® 05.02.04 Restricted Use Micafungin Mycamine® 08.01.05 Restricted Use Midostaurin Rydapt® 09.08.01 Non Formulary Migalastat Galafold® 09.08.01 Non Formulary Miglustat Zavesca® 02.11 Restricted Use Moroctocog alfa Refacto® 08.02.01 Restricted Use Mycophenolate Mofetil  08.02.04 Formulary Natalizumab Tysabri® 08.01.05 Non Formulary Necitumumab Portrazza® 08.01.03 Restricted Use Nelarabine Atriance® 05.03.01 Non Formulary Nelfinavir Viracept® 05.03.01 Restricted Use Nevirapine  08.01.05 Restricted Use Nilotinib Tasigna® 03.11 Restricted Use Nintedanib Ofev® 03.11 Restricted Use Nintedanib Vargatef® 08.02.04 Restricted Use Niraparib Zejula® 20 Restricted Use Nitazoxanide  08.02.04 Restricted Use Nivolumab Opdivo® 02.11 Restricted Use Nonacog alfa BeneFIX® 14.05.01 Restricted Use Normal immunoglobulin for Intramuscular use  14.05.01 Restricted Use Normal immunoglobulin for Intravenous use  14.05.01 Restricted Use Normal immunoglobulin for Subcutaneous use  01.09.01 Restricted Use Obeticholic acid Ocaliva® 08.02.03 Restricted Use Obinutuzumab Gazyvaro ® 08.02.03 Restricted Use Ocrelizumab Ocrevus® 11.08.02 Restricted Use Ocriplasmin Jetrea® 02.11 Restricted Use Octocog alfa Kogenate® 02.11 Restricted Use Octocog alfa Advate® 08.03.04.03 Formulary Octreotide Sandostatin® 08.03.04.03 Formulary Octreotide Sandostatin Lar® 08.02.03 Non Formulary Ofatumumab Arzerra® 08.02.04 Restricted Use Olaparib Lynparza® 08.01.05 Non Formulary Olaratumab Lartruvo® 03.04.02 Restricted Use Omalizumab Xolair® 05.03.03.02 Restricted Use Ombitasvir/ paritaprevir/ ritonavir Viekirax® 08.01.05 Restricted Use Paclitaxel - Albumin Bound Formulation Abraxane® 08.03.04.01 Formulary Palbociclib Ibrance® 05.03.05 Restricted Use Palivizumab Synagis® 08.01.05 Restricted Use Panitumumab Vectibix® 08.01.05 Formulary Panobinostat Farydak® 06.06.01 Non Formulary Parathyroid Hormone Preotact® 06.05 Non Formulary Pasireotide  08.01.05 Restricted Use Pazopanib Votrient® 11.08.02 Non Formulary Pegaptanib Sodium Macugen® 09.01.06 Non Formulary Pegfilgrastim Neulasta® 08.02.04 Non Formulary Peginterferon Alfa PegIntron® 08.02.04 Non Formulary Peginterferon Alfa ViraferonPeg® 08.02.04 Formulary Peginterferon Alfa-2a Pegasys® 08.02.04 Restricted Use Peginterferon Beta-1a Plegridy® 06.05.01 Restricted Use Pegvisomant Somavert® 08.01.05 Restricted Use Pembrolizumab Keytruda® 08.01.03 Restricted Use Pemetrexed Alimta® 08.01.05 Restricted Use Pertuzumab Perjeta® 03.11 Restricted Use Pirfenidone Esbriet® 08.01.02 Restricted Use Pixantrone  09.01.07 Restricted Use Plerixafor Mozobil® 08.02.04 Restricted Use Pomalidomide Imnovid® 08.01.05 Restricted Use Ponatinib Iclusig® 03.05.02 Formulary Poractant Alfa Curosurf® 05.02 Restricted Use Posaconazole (IV) Noxafil® 05.02 Restricted Use Posaconazole (oral) Noxafil® 02.11 Restricted Use Protein C Concentrate Ceprotin® 02.11 Restricted Use Prothrombin Complex Concentrate  Octaplex® 08.03.04.02 Restricted Use Radium-223 dichloride  05.03.01 Formulary Raltegravir Isentress ® 08.01.05 Non Formulary Ramucirumab Cyramza® 11.08.02 Formulary Ranibizumab Lucentis® 10.01.04 Restricted Use Rasburicase Fastertec® 08.01.05 Restricted Use Regorafenib Stivarga® 05.03.05 Restricted Use Ribavirin  08.03.04.01 Restricted Use Ribociclib Kisqali® 05.03.01 Restricted Use Rilpivirine hydrochloride Edurant® 04.09.03 Restricted Use Riluzole  02.05.01 Non Formulary Riociguat Adempas® 13.05.02 Formulary Risankizumab Skyrizi® 05.03.01 Restricted Use Ritonavir  08.02.03 Restricted Use Rituximab MabThera® 08.02.03 Restricted Use Rituximab Truxima® 08.02.03 Restricted Use Rituximab MabThera® 10.01.03 Restricted Use Rituximab Truxima® 10.01.03 Restricted Use Rituximab  MabThera® 09.01.04 Restricted Use Romiplostim Nplate® 08.02.04 Restricted Use Rucaparib Rubraca® 08.01.05 Restricted Use Ruxolitinib Jakavi® 09.04.01 Formulary Sapropterin Dihydrochloride  Kuvan® 05.03.01 Restricted Use Saquinavir Invirase® 10.01.03 Restricted Use Sarilumab Kevzara® 13.05.03 Restricted Use Secukinumab Cosentyx® 09.05.02.02 Restricted Use Sevelamer Carbonate  09.05.02.02 Non Formulary Sevelamer Hydrochloride  Renagel® 02.05.01 Formulary Sildenafil Revatio® 05.03.03.02 Non Formulary Simeprevir Olysio® 02.11 Restricted Use Simoctocog alfa Nuwiq® 20 Non Formulary Sipuleucel- T  08.02.02 Formulary Sirolimus Rapamune® 04.01.01 Restricted Use Sodium Oxybate Xyrem® 05.03.03.02 Restricted Use Sofosbuvir Sovaldi® 05.03.03.02 Restricted Use Sofosbuvir and Velpatasvir Epclusa® 05.03.03.02 Restricted Use Sofosbuvir, Velpatasvir and Voxilaprevir  Vosevi® 06.05.01 Restricted Use Somatropin  08.01.05 Restricted Use Sorafenib Nexavar® 05.03.01 Non Formulary Stavudine Zerit® 08.01.05 Restricted Use Sunitinib Sutent® 02.11 Restricted Use Susoctocog alfa Obizur® 20 Non Formulary Taribavirin  01.04.02 Non Formulary Teduglutide Revestive® 05.03.03.02 Non Formulary Telaprevir Incivo® 08.01.05 Formulary Temozolomide Temodal® 08.01.05 Restricted Use Temsirolimus Torisel® 05.03.01 Restricted Use Tenofovir 245mg, Efavirenz 600mg and Emtricitabine 200mg  05.03.01 Restricted Use Tenofovir alafenamide, elvitegravir, cobicistat & emtricitabine Genvoya® 05.03.01 Restricted Use Tenofovir and Emtricitabine  05.03.01 Restricted Use Tenofovir Disproxil  05.03.01 Restricted Use Tenofovir, cobicistat, elvitegravir & emtricitabine Stribild® 08.02.04 Restricted Use Teriflunomide Aubagio® 06.06.01 Restricted Use Teriparatide Forsteo® 06.06.01 Restricted Use Teriparatide Movymia® 20 Formulary TETRAHYDROBIOPTERIN Tablets 10 mg  03.07 Formulary Tezacaftor + Ivacaftor Symkevi® 08.02.04 Restricted Use Thalidomide Celgene® 13.05.03 Restricted Use Tildrakizumab Ilumetri® 05.03.01 Restricted Use Tipranavir Aptivus® 08.01 Restricted Use Tivozanib Fotivda® 05.01.04 Restricted Use Tobramycin  05.01.04 Restricted Use Tobramycin inhaler TOBI Podhaler® 10.01.03 Restricted Use Tocilizumab RoActemra® 10.01.03 Restricted Use Tofacitinib citrate  06.05.02 Restricted Use Tolvaptan Jinarc® 06.05.02 Non Formulary Tolvaptan Samsca® 08.01.05 Restricted Use Trametinib Mekinist® 08.01.05 Formulary Trastuzumab Herceptin® 08.01.05 Restricted Use Trastuzumab Herceptin® 08.01.05 Restricted Use Trastuzumab Ontruzant® 08.01.05 Restricted Use Trastuzumab emtansine Kadcyla® 20 Non Formulary Treprostinil   08.01.05 Restricted Use Trifluridine-tipiracil Lonsurf® 13.05.03 Formulary Ustekinumab  05.03.02.02 Restricted Use Valganciclovir  01.05.03 Restricted Use Vedolizumab Entyvio® 08.01.05 Restricted Use Vemurafenib Zelboraf® 08.01.05 Restricted Use Venetoclax Venclyxto® 11.08.02 Restricted Use Verteporfin Visudyne® 08.01.05 Restricted Use Vismodegib Erivedge® 02.11 Restricted Use Von willebrand factor Willfact® 05.02 Restricted Use Voriconazole Vfend® 08.01.05 Restricted Use Vosaroxin Qinprezo 05.03.01 Restricted Use Zidovudine Retrovir® 05.03.01 Formulary Zidovudine and lamivudine

Nottinghamshire Area Prescribing Committee