BNF Chapter 8

1. Gastro-Intestinal System | 2. Cardiovascular System | 3. Respiratory System | 4. Central Nervous System | 5. Antimicrobials | 6. Endocrine System | 7. Obstetrics, Gynaecology & Urology | 8. Malignant Disease & Immunosuppression | 9. Nutrition & Blood | 10. Musculoskelatal & Joint Diseases | 11. Opthalmology | 12. Ear, Nose & Oropharynx | 13. Dermatology | 14. Immunology & Vaccines | 15. Anaesthetics |  GP Centre Home


Malignant Disease & Immunosuppression

 

IMMUNE SYSTEM
1 Immune System Disorders and Transplantation
IMMUNOSUPPRESSANTS – Antimetabolites
AZATHIOPRINE 25mg & 50mg Tablets

 

 Link to Shared Care Guideline for approved indications

Shared Care Agreement Communication Form

APC traffic light status: AMBER

50mg Injection.
IMMUNOSUPPRESSANTS – Calcineurin inhibitors and related drugs
CICLOSPORIN Capsules 10mg, 25mg, 50mg & 100mg
100 mg / ml Oral Liquid
There are a number of brands of this drug. If initiating oral ciclosporin, Capsorin brand is 1st choice.

Avoid unnecessary switching between brands because of pharmacokinetic differences (in transplant patients).

Minimum 1 month supply for rheumatology & dermatology indications before GP can accept shared care prescribing.

Link to Shared Care Guideline for approved indications

Shared Care Agreement Communication Form

APC traffic light status: AMBER

50 mg Injection.
TACROLIMUS  Capsules
500micrograms, 1mg & 5mg
APC traffic light status: RED
IMMUNOSUPPRESSANTS – Purine Synthesis inhibitors
MYCOPHENOLATE250mg Capsules

500 mg Tablets

1 g / 5ml Suspension

There are a number of brands of this drug. Avoid unnecessary switching because of pharmacokinetic differences (in transplant patients).

Minimum 3 months supply for non-transplant indications before GP can accept shared care prescribing.

Link to Shared Care Guideline for approved indications

Shared Care Agreement Communication Form

Non-transplant indications APC traffic light status: AMBER

(Transplant APC traffic light status:Red)

1.1 Multiple Sclerosis
IMMUNOSTIMULANTS – Interferons
INTERFERON BETA-1aREBIF:

22micrograms (6MU) Pre-filled syringe

44micrograms (12MU) Pre-filled syringe

AVONEX:

300micrograms (6MU) Injection (Powder for reconstitution)

Prescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE

NICE TA527: Beta interferons and glatiramer acetate for treating multiple sclerosis

NICE TA624: Peginterferon beta-1a for treating relapsing–remitting multiple sclerosis

APC traffic light status: RED

IMMUNOSTIMULANTS – Other
GLATIRAMER20mg/ml, 40mg/ml pre-filled syringesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE

NICE TA527: Beta interferons and glatiramer acetate for treating multiple sclerosis

APC traffic light status: RED

IMMUNOSUPPRESSANTS -Immunomodulating Drugs
DIMETHYL FURATE (TECFIDERA) 120mg, 240mg CapsulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE

NICE TAG320 Dimethyl Fumerate for relapsing-remitting MS
NHSE intent to treat letter v1.2
NICE CG Multiple Sclerosis

APC traffic light status: RED

IMMUNOSUPPRESSANTS – Monoclonal Antibodies – Anti-LymphoctesBiologics must be prescribed by brand. The brand providing best value in local health economy should be prescribed for all new patients. Following patient consent, existing patients should be switched to the rand providing best value in local health economy.
ALEMTUZUMAB10mg/ml, 30mg/ml solution for infusionPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE. IFR required if for Aplastic anaemia – see APC statement below.

NICE TA312: Alemtuzumab for treating relapsing‑remitting multiple sclerosis

PCN statement: Alemtuzumab for Aplastic Anaemia

APC traffic light status: RED

NATALIZUMAB (TYSABRI)IV Infusion 20mg/ml
Concentrate for Infusion
Prescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE

NICE TA127 Natalizumab for relapsing-remitting MS
NHSE intent to treat letter v1.2
NICE CG Multiple Sclerosis

APC traffic light status: RED

IMMUNOSUPPRESSANTS – Pyrimidine Synthesis Inhibitors
TERIFLUNOMIDE (AUBAGIO) 7mg & 14mg Oral TabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE

NICE TA303 Teriflunoide for relapsing-remitting MS
Funding through NHS England / specialised commissioning
NHSE intent to treat letter v1.2
NICE CG Multiple Sclerosis

APC traffic light status: RED

MALIGNANT DISEASE
1 Antibody Response Malignancy
ANTINEOPLASTIC DRUG – Monoclonal Antibodies
ATEZOLIZUMAB1200mg/20ml concentrate for solutionPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE CDF.

NICE TA520: Atezolizumab for treating locally advanced or metastatic non-small-cell lung cancer after chemotherapy

NICE TA525: Atezolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy

NICE TA492: Atezolizumab for untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable

TA 584: Atezolizumab in combination for treating metastatic non-squamous non-small-cell lung cancer

NICE TA638: Atezolizumab with carboplatin and etoposide for untreated extensive-stage small-cell lung cancer

NICE TA639: Atezolizumab with nab-paclitaxel for untreated PD-L1-positive, locally advanced or metastatic, triple-negative breast cancer

APC traffic light status: RED

BLINATUMOMABvials 38.5microgramsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE

NICE TA450: Blinatumomab for previously treated Philadelphia-chromosome-negative acute lymphoblastic leukaemia

NICE TA 589: Blinatumomab for treating acute lymphoblastic leukaemia in remission with minimal residual disease activity

APC traffic light status: RED

BRENTUXIMAB VEDOTIN50mg powder for concentrate for solution for infusionPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE through CDF.

NICE TA446: Brentuximab vedotin for treating CD30-positive Hodgkin lymphoma

NICE TA478: Brentuximab vedotin for treating relapsed or refractory systemic anaplastic large cell lymphoma

NICE TA524: Brentuximab vedotin for treating CD30-positive Hodgkin lymphoma

APC traffic light status: RED

CEMIPLIMAB350mg/7ml vialsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE through CDF.

NICE TA 592: Cemiplimab for treating metastatic or locally advanced cutaneous squamous cell carcinoma

APC traffic light status: RED

DARATUMUMAB100mg/5ml solutionPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE CDF.

NICE TA 510 Daratumumab monotherapy for treating relapsed and refractory multiple myeloma

NICE TA 573: Daratumumab with bortezomib and dexamethasone for previously treated multiple myeloma

APC traffic light status: RED

 DURVALUMAB120mg/2.4ml vials

500mg/10ml vials

Prescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE

NICE TA578: Durvalumab for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation

APC traffic light status: RED

GEMTUZUMAB OZOGAMICIN5mg vialPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE. IFR required if for Aplastic anaemia – see PCN statement below.

NICE TA 545: Gemtuzumab ozogamicin for untreated acute myeloid leukaemia

APC traffic light status: RED

INOTUZUMAB OZOGAMICIN1mg vialPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA541: Inotuzumab ozogamicin for treating relapsed or refractory B-cell acute lymphoblastic leukaemia

APC traffic light status: RED

NIVOLUMAB1mg/ml solution for infusionPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA462: Nivolumab for treating relapsed or refractory classical Hodgkin lymphoma

NICE TA483: Nivolumab for previously treated squamous non-small-cell lung cancer

NICE TA484: Nivolumab for previously treated non-squamous non-small-cell lung cancer

NICE TA558: Nivolumab for adjuvant treatment of completely resected melanoma with lymph node involvement or metastatic disease

APC traffic light status: RED

OBINUTUZUMAB1000mg/40ml concentrate for solution for infusion vialsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE (CDF).

NICE TA472: Obinutuzumab with bendamustine for treating follicular lymphoma refractory to rituximab

NICE TA513 Obinutuzumab for untreated advanced follicular lymphoma

NICE TA 629: Obinutuzumab with bendamustine for treating follicular lymphoma after rituximab

APC traffic light status: RED

PEMBROLIZUMAB100mg/4ml concentrate for solution for infusion

50mg powder for concentrate for solution

Prescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE (CDF).

NICE TA447: Pembrolizumab for untreated PD-L1-positive metastatic non-small-cell lung cancer

NICE TA336 – Pembrolizumab for advanced melanoma not previously treated with ipilimumab

NICE TA357 – Pembrolizumab for treating advanced melanoma after disease progression with ipilimumab

NICE TA428 – Pembrolizumab for treating PD-L1-positive non-small-cell lung cancer after chemotherapy

NICE TA531: Pembrolizumab for untreated PD-L1-positive metastatic non-small-cell lung cancer

NICE TA522: Pembrolizumab for untreated PD-L1-positive locally advanced or metastatic urothelial cancer when cisplatin is unsuitable

NICE TA540: Pembrolizumab for treating relapsed or refractory classical Hodgkin lymphoma

NICE TA553: Pembrolizumab for adjuvant treatment of resected melanoma with high risk of recurrence

NICE TA 557: Pembrolizumab with pemetrexed and platinum chemotherapy for untreated, metastatic, non-squamous non-small-cell lung cancer

NICE TA600: Pembrolizumab with carboplatin and paclitaxel for untreated metastatic squamous non-small-cell lung cancer

APC traffic light status: RED

PERTUZUMAB420mg vialPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE through CDF.

NICE TA: neoadjuvant treatment of HER2-positive breast cancer

NICE TA509: Pertuzumab with trastuzumab and docetaxel for treating HER2-positive breast cancer

NICE TA569: Pertuzumab for adjuvant treatment of HER2-positive early stage breast cancer

APC traffic light status: RED

RITUXIMAB 

100mg/10ml concentrate for solution

500mg/50ml concentrate for solution

Truxima® currently provides the best value to the local health economy.

Prescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA193 -Rituximab for the treatment of relapsed or refractory chronic lymphocytic leukaemia

NICE TA174 – Rituximab for the first-line treatment of chronic lymphocytic leukaemia

NICE TA226 -Rituximab for the first-line maintenance treatment of follicular non-Hodgkin’s lymphoma

NICE TA243 – Rituximab for the first-line treatment of stage III-IV follicular lymphoma

NICE TA 561: Venetoclax with rituximab for previously treated chronic lymphocytic leukaemia

TA 627: Lenalidomide with rituximab for previously treated follicular lymphoma

APC traffic light status: RED

TRASTUZUMAB (Herceptin)120mg/ml solution for injection

150mg poweder for solution for infusion

Prescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE

NICE TA509: Pertuzumab with trastuzumab and docetaxel for treating HER2-positive breast cancer

NICE TA257: Lapatinib or trastuzumab in combination with an aromatase inhibitor for the first-line treatment of metastatic hormone-receptor-positive breast cancer that overexpresses HER2

TA632: Trastuzumab emtansine for adjuvant treatment of HER2-positive early breast cancer

APC traffic light status: RED

TRASTUZUMAB EMTANSINE100mg, 160mg powder for solution for infusionPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE/CDF

NICE TA458 – Trastuzumab emtansine for treating HER2-positive advanced breast cancer after trastuzumab and a taxane

APC traffic light status: RED

3 Cytotoxic Response Malignancy
BUSULFAN 2 mg TabletsAPC traffic light status: RED
CHLORAMBUCIL2 mg TabletsNICE TA343: Obinutuzumab in combination with chlorambucil for untreated chronic lymphocytic leukaemia

APC traffic light status: RED

CYCLOPHOSPHAMIDE 50mg Tablets

Injection 500mg Vials & 1g Vials

APC traffic light status: RED
DACARBAZINE200mg & 1g VialsAPC traffic light status: RED
ESTRAMUSTINE 140 mg CapsulesAPC traffic light status: RED
IFOSFAMIDE 1g & 2g InjectionAPC traffic light status: RED
LOMUSTINE 40 mg CapsulesAPC traffic light status: RED
MELPHALAN 2 mg Tablets

50 mg Injection

 

APC traffic light status: RED

TREOSULFAN1g, 5g powder for solution for injectionNICE TA640: Treosulfan with fludarabine for malignant disease before allogeneic stem cell transplant
ANTINEOPLASTIC DRUGS – Anthracyclines and Related drugs
DAUNORUBICIN 20 mg InjectionAPC traffic light status: RED
CYTARABINE with DAUNORUBICIN (Vyxeos)44mg/100mg powder for concentrate for solution for infusion vialsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA 552: Liposomal cytarabine–daunorubicin for untreated acute myeloid leukaemia

APC traffic light status: RED

DOXORUBICIN 2mg/ml  5ml Vials & 25ml VialsAPC traffic light status: RED
EPIRUBICIN 2mg/ml 5ml & 25ml VialsAPC traffic light status: RED
IDARUBICIN  5mg, 10mg & 25mg CapsulesAPC traffic light status: RED
ANTINEOPLASTIC DRUGS – Antimetabolites
CAPECITABINE 150mg & 500 mg TabletsPrescribed by Specialist Centre (Guildford)

APC traffic light status: RED

CLADRIBINE 10 mg InjectionPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE for multiple sclerosis.

NICE TA616: Cladribine for treating relapsing–remitting multiple sclerosis

Hairy Cell Leukaemia 

APC traffic light status: RED

CYTARABINE 100 mg /ml Injection

100 mg / 5ml Injection

APC traffic light status: RED
FLUDARABINE PHOSPHATE 10 mg Tablets

50 mg Injection

NICE TA29: Guidance on the use of fludarabine for B-cell chronic lymphocytic leukaemia

NICE TA119: Fludarabine monotherapy for the first-line treatment of chronic lymphocytic leukaemia

NICE TA640: Treosulfan with fludarabine for malignant disease before allogeneic stem cell transplant

APC traffic light status: RED

FLUOROURACIL 250mg Capsules

25mg / ml Injection
10ml, 20ml & 100ml Vials

50mg / ml Injection 10ml & 50ml Vials

 NICE TA212: Bevacizumab in combination with oxaliplatin and either fluorouracil plus folinic acid or capecitabine for the treatment of metastatic colorectal cancer

NICE TA307: Aflibercept in combination with irinotecan and fluorouracil-based therapy for treating metastatic colorectal cancer that has progressed following prior oxaliplatin-based chemotherapy

APC traffic light status: RED

GEMCITABINE 200mg & 1g InjectionNICE TA116: Gemcitabine for the treatment of metastatic breast cancer

NICE TA285: Bevacizumab in combination with gemcitabine and carboplatin for treating the first recurrence of platinum-sensitive advanced ovarian cancer

NICE TA389: Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer

APC traffic light status: RED

MERCAPTOPURINE 10mg & 50mg TabletsUsed for AcuteLymphLeuk (adults&children).

Azathioprine / 6-MU Shared Care [IBD] Unlicensed

APC traffic light status: AMBER

METHOTREXATEInjectionRheumatoid Aerthritis, Psoriatic arthritis, Psoriasis, Crohns disease APC traffic light status: AMBER
InjectionOncology (Intrathecal for CNS Lymphoma)

APC traffic light status: RED

PEMETREXEDPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA190: Pemetrexed for the maintenance treatment of non-small-cell lung cancer

NICE TA 557: Pembrolizumab with pemetrexed and platinum chemotherapy for untreated, metastatic, non-squamous non-small-cell lung cancer

APC traffic light status: RED

TIOGUANINE 40mg TabletsHaematology use only

Non-formulary for all other indications including IBD (off-label use)  – Non-formulary one off requests required.

APC traffic light status: RED

ANTINEOPLASTIC DRUGS – Cytotoxic Antibiotics & Related SubstancesNOTES
BLEOMYCIN 15000 Unit InjectionAPC traffic light status: RED
MITOMYCIN 40mg For Bladder InstillationAPC traffic light status: RED
PENTOSTATIN 10 mg InjectionAPC traffic light status: RED
ANTINEOPLASTIC DRUGS – Platinum CompoundsNOTES
CARBOPLATIN 10mg/ml Injection
15ml, 45ml & 60ml Vials
NICE TA 557: Pembrolizumab with pemetrexed and platinum chemotherapy for untreated, metastatic, non-squamous non-small-cell lung cancer

APC traffic light status: RED

CISPLATIN 1mg/ml Injection
50ml & 100ml Vials
NICE TA 557: Pembrolizumab with pemetrexed and platinum chemotherapy for untreated, metastatic, non-squamous non-small-cell lung cancer

APC traffic light status: RED

ANTINEOPLASTIC DRUGS – Podophyllotoxin DerivativesNOTES
ETOPOSIDE 50mg & 100mg Capsules

100 mg in 5ml Injection

APC traffic light status: RED
ANTINEOPLASTIC DRUGS – TaxanesNOTES
DOCETAXEL 80 mg in 2ml InjectionNICE TA101: Docetaxel for the treatment of hormone-refractory metastatic prostate cancer

APC traffic light status: RED

ANTINEOPLASTIC DRUGS – Vinca AlkaloidsNOTES
VINBLASTINE SULPHATE 10 mg InjectionAPC traffic light status: RED
VINCRISTINE SULPHATE 2 mg in 2ml VialAPC traffic light status: RED
VINDESINE 5mg InjectionAPC traffic light status: RED
VINORELBINE 10mg/ml  1ml & 5ml VialsUsed for LungCa & BreastCa.

APC traffic light status: RED

ANTINEOPLASTIC DRUGS – Other
ARSENIC TRIOXIDE10mg/10ml ampoulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA526: Arsenic trioxide for treating acute promyelocytic leukaemia

APC traffic light status: RED

ERIBULIN440micrograms/ml, 2ml injectionPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE through CDF.

NICE TA: locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens

APC traffic light status: RED

HYDROXYCARBAMIDE
(Hydroxyurea)
 500 mg CapsulesMyeloproliferative Disorders APC traffic light status: BLUE
PANOBINOSTAT10mg, 15mg, 20mg capsulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA 380: Panobinostat for treating multiple myeloma after at least 2 previous treatments

APC traffic light status: RED

PROCARBAZINE 50 mg Capsules.
3.1 Cystotoxic drug-induced side effects
DETOXIFYING DRUGS – Uroprotective Drugs
MESNA 400mg Tablets

100mg/ml  Injection
4ml & 10ml Amp

.
VITAMINS AND TRACE ELEMENTS – Folates
CALCIUM FOLINATE 15mg Tablets

10mg/ml 5ml & 10ml vials

.
3.1 Hyperuricaemia associated with cytotoxic drugs
DETOXIFYING DRUGS – Urate Oxidases
RASBURICASE 1.5mg, 7.5mg vials for infusionPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

APC traffic light status: RED

4 Hormone Responsive Malignancy
ANTINEOPLASTIC DRUGS – Anti-Androgens
ABIRATERONE ACETATE500mg tabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA 387: Abiraterone for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated

NICE TA 259: Abiraterone for castration-resistant metastatic prostate cancer previously treated with a docetaxel-containing regimen

APC traffic light status: BLUE

BICALUTAMIDE 50 mg, 150mg TabletsProstate cancer APC traffic light status: BLUE (no information sheet) 
ENZALUTAMIDE40mg CapsulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA316: Enzalutamide for metastatic hormone‑relapsed prostate cancer previously treated with a docetaxel‑containing regimen

NICE TA 337: Enzalutamide for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated

APC traffic light status: RED

FLUTAMIDE250 mg Tablets.
CYPROTERONE ACETATE 50 mg, 100mg TabletsBlue (no information sheet) for prostate cancer treatment

APC traffic light status: BLUE

OESTROGENS
DIETHYLSTILBESTROL 1 mg TabletsINTRON-A
PITUITARY AND HYPOTHALMIC HORMONES AND ANALOGUES – Anti-Gonadotrophin Releasing Hormones
DEGARELIX (Firmagon) 80mg & 120mg S/C InjectionRESTRICTED : UROLOGY Team only Patients with/at risk of spinal cord compression

SMC Restricted Approval Degarelix S/C injection every 28 days

NICE TA404: Degarelix for treating advanced hormone-dependent prostate cancer

APC traffic light status: BLUE

Somatostatin Analogues
LANREOTIDE 30mg Injection(LA)

60mg Injection (Autogel)

RESTRICTED Use. CONSULTANT Only

APC traffic light status: RED

OCTREOTIDE Injection 50mcg, 100mcg & 500mcg InjectionAPC traffic light status: RED
Progestogens
MEGESTROL ACETATE 40 mg, 160mg Tablets.
4.1 Hormone Receptive Breast Cancer
ANTINEOPLASTIC DRUGS – Anti-Oestrogens
FULVESTRANT250mg/5ml solution for injectionNICE TA239: Fulvestrant for the treatment of locally advanced or metastatic breast cancer (not recommended)

NICE TA503: Fulvestrant for untreated locally advanced or metastatic oestrogen-receptor positive breast cancer (not recommended)

TA 579: Abemaciclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy

NICE TA 593: Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer

APC traffic light status: RED

TAMOXIFEN 10 mg, 20 mg Tablets

10 mg in 5ml Syrup

.
HORMONE ANTAGONISTS AND RELATED AGENTS – Aromatase Inhibitors
ANASTROZOLE 1 mg TabletsAPC traffic light status: BLUE
EXEMESTANE 25 mg TabletsAPC traffic light status: BLUE
LETROZOLE 2.5 mg TabletsAPC traffic light status: BLUE
5 IMMUNOTHERAPY RESPONSIVE MALIGNANCY
IMMUNOSTIMULANTS – Interferons
INTERFERON ALFA-2b(rbe)
(INTRON-A)
 10 MU/ml Injection

Cartridges for Multidose Pen
15MU/ml, 25MU/ml, 50MU/ml
(Delivers 18MU, 30MU & 60MU doses respectively)

Prescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE Guidance (peginterferon-alfa, interferon-alfa & ribavirin) Chronic Hepatitis C)

APC traffic light status: RED

INTERFERON ALFA-2a(rba)

(ROFERON-A)

  Pre-filled Syringes
3MU, 4.5MU, 6MU
Prescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE Guidance (peginterferon-alfa, interferon-alfa & ribavirin) Chronic Hepatitis C)

APC traffic light status: RED

IMMUNOSUPPRESSANTS – Other
Bacillus Calmette-Guerin (BCG) (OncoTICE) Strain BAGS
For Bladder Instillation
IMMUNOSUPPRESSANTS – Thalidomide and Related Anologues
LENALIDOMIDE (REVLIMID)2.5mg, 5mg, 7.5mg, 15mg, 20mg & 25mg CapsulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA171 Lenalidomide for treatment of Multiple Myeloma
NHSE intent to treat letter v1.2
NICE CG Multiple Sclerosis

NICE TA505 – Ixazomib with lenalidomide and dexamethasone for treating relapsed or refractory multiple myeloma

NICE TA 586: Lenalidomide plus dexamethasone for multiple myeloma after 1 treatment with bortezomib

NICE TA 587: Lenalidomide plus dexamethasone for previously untreated multiple myeloma

NICE TA 322: Lenalidomide for treating myelodysplastic syndromes associated with an isolated deletion 5q cytogenetic abnormality

NICE TA 171: Lenalidomide for the treatment of multiple myeloma in people who have received at least 2 prior therapies

TA 627: Lenalidomide with rituximab for previously treated follicular lymphoma

APC traffic light status: RED

POMALIDOMIDETablets 1mg, 2mg, 3mg, 4mgPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA: Multiple myeloma previously treated with lenalidomide and bortezomib

APC traffic light status: RED

THALIDOMIDE25mg tablet, 50mg capsulePrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA228: Bortezomib and thalidomide for the first‑line treatment of multiple myeloma

APC traffic light status: RED

7 TARGET THERAPY RESPONSIVE MALIGNANCY
 BORTEZOMIB3.5mg vials for injectionPrescribing should be by an NHS specialist only, in line with NICE and/or local pathways. NHSE funded.

NICE TA129: Bortezomib monotherapy for relapsed multiple myeloma

NICE TA 573: Daratumumab with bortezomib and dexamethasone for previously treated multiple myeloma

APC traffic light status: RED

CARFILZOMIB10mg, 30mg, 60mg vialsPrescribing should be by an NHS specialist only, in line with NICE and/or local pathways. NHSE funded.

NICE  TA457 – Carfilzomib for previously treated multiple myeloma

APC traffic light status: RED

IXAZOMIB2.3mg, 3mg, 4mg capsulesPrescribing should be by an NHS specialist only, in line with NICE and/or local pathways. NHSE funded. IFR required.

NICE TA505 – Ixazomib with lenalidomide and dexamethasone for treating relapsed or refractory multiple myeloma

APC traffic light status: RED

ANTINEOPLASTIC DRUGS – Protein Kinase Inhibitors
 ABEMACICLIB 50mg, 100mg, 150mg tabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA 563: Abemaciclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer

TA 579: Abemaciclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy

APC traffic light status: RED

ALECTINIB150mg capsulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA536: Alectinib for untreated ALK-positive advanced non-small-cell lung cancer

APC traffic light status: RED

 BRIGATINIB 30mg, 90mg, 180mg tabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA 571: Brigatinib for treating ALK-positive advanced non-small-cell lung cancer after crizotinib

APC traffic light status: RED

BINIMETINIB15mg tabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA 562: Encorafenib with binimetinib for unresectable or metastatic BRAF V600 mutation-positive melanoma

APC traffic light status: RED

CERITINIB 150mg capsulePrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA500 – Ceritinib for untreated ALK-positive non-small-cell lung cancer

APC traffic light status: RED

CRIZOTINIB200mg, 250mg capsulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA529: Crizotinib for treating ROS1-positive advanced non-small-cell lung cancer

APC traffic light status: RED

DABRAFENIB

 

 50mg, 75mg capsulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NHSE Specialised Commissioning [DABRAFENIB] BRAF V600 melanoma

NICE TA 544: Dabrafenib with trametinib for adjuvant treatment of resected BRAF V600 mutation-positive melanoma

APC traffic light status: RED

DACOMITINIB15mg, 30mg, 45mg tabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA 595: Dacomitinib for untreated EGFR mutation-positive non-small-cell lung cancer

APC traffic light status: RED

DASATINIB20mg, 50mg, 80mg, 100mg, 140mg TabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA: Untreated CML

NICE TA: Imatinib-resistant or intolerant CML

APC traffic light status: RED

 ENCORAFENIB 50mg, 75mg capsulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA 562: Encorafenib with binimetinib for unresectable or metastatic BRAF V600 mutation-positive melanoma

APC traffic light status: RED

EVEROLIMUS5mg, 10mg TabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE through CDF.

NICE TA : with exemestane for treating advanced breast cancer after endocrine therap

APC traffic light status: RED

IBRUTINIB140mg TabletPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE through CDF.

NICE TA: Previously treated CLL and untreated CLL with 17p deletion or TP 53 mutation

NICE TA502: Ibrutinib for treating relapsed or refractory mantle cell lymphoma

NICE TA491 Ibrutinib for treating Waldenstrom’s macroglobulinaemia

APC traffic light status: RED

IDELALISIB100mg, 150mg tabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA604: Idelalisib for treating refractory follicular lymphoma

APC traffic light status: RED

IMATINIB 100mg, 400mg tabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA: Adjuvant treatment of GIST

NICE TA: Untreated CML

NICE TA: Imatinib-resistant or intolerant CML

APC traffic light status: RED

LAROTRECTINIB20mg/ml oral solutionPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE CDF.

NICE TA630: Larotrectinib for treating NTRK fusion-positive solid tumours

LENVATINIB4mg, 10mg capsulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine

NICE TA551: Lenvatinib for untreated advanced hepatocellular carcinoma

APC traffic light status: RED

LORLATINIB25mg, 100mg tabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

TA 628: Lorlatinib for previously treated ALK-positive advanced non-small-cell lung cancer

MIDOSTAURIN25mg CapsulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA523: Midostaurin for untreated acute myeloid leukaemia

APC traffic light status: RED

NERATINIB40mg tabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA612: Neratinib for extended adjuvant treatment of hormone receptor-positive, HER2-positive early stage breast cancer after adjuvant trastuzumab

APC traffic light status: RED

NILOTINIB150mg, 200mg CapsulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA: Untreated CML

NICE TA: Imatinib-resistant or intolerant CML

APC traffic light status: RED

PALBOCICLIB75mg, 100mg, 125mg CapsulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

 NICE TA495 – Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer

APC traffic light status: RED

PONATINIB15mg, 45mg tabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA 451: Ponatinib for treating chronic myeloid leukaemia and acute lymphoblastic leukaemia

APC traffic light status: RED

RIBOCICLIB 200mg tabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA496: Ribociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer

NICE TA 593: Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer

APC traffic light status: RED

 SORAFENIB 200mg tabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine

APC traffic light status: RED

ANTINEOPLASTIC DRUGS – Other
NIRAPARIB100mg capsulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA528: Niraparib for maintenance treatment of relapsed, platinum-sensitive ovarian, fallopian tube and peritoneal cancer

APC traffic light status: RED

RUCAPARIB200mg, 250mg, 300mg tabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA611: Rucaparib for maintenance treatment of relapsed platinum-sensitive ovarian, fallopian tube or peritoneal cancer

APC traffic light status: RED

OLAPARIB50mg capsulesPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

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

APC traffic light status: RED

VENETOCLAX10mg, 50mg, 100mg tabletsPrescribing should be by a specialist only, in line with NICE and/or local pathways. Commissioned by NHSE.

NICE TA487: Venetoclax for treating chronic lymphocytic leukaemia

NICE TA 561: Venetoclax with rituximab for previously treated chronic lymphocytic leukaemia

APC traffic light status: RED

MEDROXYPROGESTERONE Tablets 100 mg, 200 mg & 400 mg.

1. Gastro-Intestinal System | 2. Cardiovascular System | 3. Respiratory System | 4. Central Nervous System | 5. Antimicrobials | 6. Endocrine System | 7. Obstetrics, Gynaecology & Urology | 8. Malignant Disease & Immunosuppression | 9. Nutrition & Blood | 10. Musculoskelatal & Joint Diseases | 11. Opthalmology | 12. Ear, Nose & Oropharynx | 13. Dermatology | 14. Immunology & Vaccines | 15. Anaesthetics |  GP Centre Home