netFormulary North of Tyne, Gateshead and North Cumbria NHS
Area Prescribing Committee Formulary  
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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
08.01  Cytotoxic drugs
Pegaspargase 3750iu vial
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Formulary
Red
 
Link  NICE TA408: Pegaspargase for treating acute lymphoblastic leukaemia
   
08.01  Side-effects of cytotoxic drugs
08.01  Drugs for cytotoxic-induced side-effects
Calcium Folinate
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Formulary
Red
  • Approved for methotrexate-induced mucositis and myelosuppression. The following formulations are approved:
    • 15mg tablets.
    • 3mg, 15mg, 30mg, and 300mg injections
    • A calcium folinate 1mg per ml mouthwash can be prepared if needed.unlicensedunlicensed

 
   
Dexrazoxane  (Savene®)
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Formulary
Red
  • For use in line with NECN extravasation.
 
   
Mesna
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Formulary
Red
  • Approved formulations include 1gram in 10ml injection and 400mg tablets.
 
   
Glucarpidase
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Unlicensed Drug Unlicensed
Red
  • Approved for the urgent treatment of methotrexate-induced renal
    dysfunction.
 
Link  NHS England: Glucarpidase for the urgent treatment of methotrexateinduced renal dysfunction
   
08.01.01  Alkylating drugs
Cytotoxic Drug Bendamustine
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Formulary
Red
  • Approved for the first line treatment of CLL (Binet stage B or C) in, patients for whom fludarabine combination chemotherapy is not appropriate in line with NICE. 
  • NECDAG approved for use in combination with rituximab for patients with CLL not fit for FCR chemotherapy and not fit for alemtuzumab. 
  • Approved for Low Grade Non-Hodgkins Lymphoma in line with NICE - not recommended for (low grade) non-Hodgkin's lymphoma that is refractory to rituximab or a rituximab-containing regimen NICE.
 
Link  NICE TA216: Bendamustine for CLL
   
Cytotoxic Drug Busulfan
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Formulary
Red
  • Approved formulations include:
    • 2mg tablets;
    • 25mg capsules (unlicensedunlicensed);
    • 60mg in 10ml injection.

 
   
Cytotoxic Drug Carmustine
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Formulary
Red
  • Approved formualtions include 100mg injection and 7.7mg implants.
  • Approved for newly diagnosed glioblastoma multiforme (GBM) in line with NICE.
 
Link  NICE TA121: Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide
   
Cytotoxic Drug Chlorambucil
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Formulary
Red
 
   
Cytotoxic Drug Cyclophosphamide
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Formulary
Red
 
   
Estramustine Phosphate
(UNDER REVIEW)
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Formulary
Red
 
   
Cytotoxic Drug Ifosfamide
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Formulary
Red
 
   
Cytotoxic Drug Lomustine
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Formulary
Red
  • Note: 10mg capsules are unlicensedunlicensed.
 
   
Cytotoxic Drug Melphalan
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Formulary
Red
 
   
Thiotepa
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Formulary
Red
 
   
Treosulfan
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Formulary
Red
 
   
08.01.02  Anthracyclines and other cytotoxic antibiotics to top
Cytotoxic Drug Bleomycin
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Formulary
Red
  • Also approved for use in intralesional sclerotherapy in the treatment of low-flow vascular lesions. unlicensedunlicensed indication
 
   
Cytotoxic Drug Dactinomycin
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Formulary
Red
 
   
Cytotoxic Drug Daunorubicin
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Formulary
Red
  • The following formualtions are approved:
    • 20mg injection;
    • 10mg, 15mg, 35mg;
    • 40mg prefilled syringes.

 
   
Cytotoxic Drug Doxorubicin
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Formulary
Red
  • Doxorubicin 50mg injection - includes use with DC Beads for use in transcatheter arterial chemoembolisation (TACE) therapy in patients with hepatocellular cancer. 
  • Doxorubicin 20mg & 50mg pegylated liposomal injection - approved for second-line (or subsequent) treatment in advanced ovarian cancer in line with NICE. 
  • Approved for the treatment of recurrent ovarian cancer in line with NICE.
 
Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
   
Cytotoxic Drug Epirubicin
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Formulary
Red
  • Note: epirubicin 100mg injection is unlicensedunlicensed.
 
   
Cytotoxic Drug Idarubicin
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Formulary
Red
  • Approved formulations include:
    • 5mg and 10mg capsules;
    • 10mg injection.

 
   
Cytotoxic Drug Mitomycin
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Formulary
Red
  • Also approved for treatment in combination with 5-Fluorouracil for bladder cancer concurrent with radiotherapy.
  •  Mitomycin 0.04% preservative free eye drops  are also approved for useGreen Traffic Light - this is unlicensedunlicensed.
 
   
Cytotoxic Drug Mitoxantrone
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Formulary
Red
 
   
Cytotoxic Drug Pixantrone
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Formulary
Red
  • Approved as a possible treatment for adults with multiply relapsed or refractory aggressive non-Hodgkin's B cell lymphoma if they have previously been treated with rituximab and they are having third- or fourth-line treatment in line with NICE. 
 
Link  NICE TA306: Pixantrone monotherapy
   
08.01.03  Antimetabolites
Cytotoxic Drug Azacitidine
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Formulary
Red
  • Approved for myelodysplastic syndromes, CLL and AML - in line with NICE guidance.
 
Link  NICE TA218: Azacitidine for myelodysplastic syndromes
Link  NICE TA399: Azacitidine for treating acute myeloid leukaemia with more than 30% bone marrow blasts
   
Cytotoxic Drug Capecitabine
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Formulary
Red
  • Only approved for use in accordance with NICE guidance.
  • Approved in combination with gemcitabine following surgery for pancreatic cancer in line with NHS England Clinical Commissioning Policy
 
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  NHS England SSC1959 - Clinical Commissioning Policy: Gemcitabine and capecitabine following surgery for pancreatic cancer (all ages)
   
Cytotoxic Drug Cladribine
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Formulary
Red
  • 10mg in 10ml solution for preparing infusions; 2mg in 1ml subcutaneous injection 
  • Approved for Hairy cell leukaemia only.

  • 10mg tablets
  • Approved for treating highly active multiple sclerosis in adults in line with NICE
 
Link  NICE TA493: Cladribine tablets for treating relapsing–remitting multiple sclerosis
   
Cytotoxic Drug Cytarabine
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Formulary
Red
  • A cytarabine 50mg vial - intrathecal injection (cytarabine encapsulated in liposomes) is also approved for use. 
 
   
Cytotoxic Drug Daunorubicin/cytarabine (Vyxeos®)
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Formulary
Red
High Cost Medicine
NHS England
  • Daunorubicin 44mg/cytarabine 100mg powder for solution for infusion
  • Approved for untreated acute myeloid leukaemia in line with NICE
 
Link  NICE TA 552: Liposomal cytarabine–daunorubicin for untreated acute myeloid leukaemia
   
Cytotoxic Drug Fludarabine Phosphate
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Formulary
Red
  • Approved for the second line therapy of B-cell CLL in line with NICE.
  • Note: fludarabine is not approved for monotherapy in the first line treatment of CLL - this is in line with NICE.
 
Link  NICE TA119: Fludarabine monotherapy for the first-line treatment of chronic lymphocytic leukaemia
Link  NICE TA29: Guidance on the use of fludarabine for B-cell chronic lymphocytic leukaemia
   
Cytotoxic Drug Fluorouracil
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Formulary
Red
  • A fluorouracil 10mg in 0.4ml subconjunctival injection (unlicensedunlicensed) is also approved for use. 
  • FOLFIRINOX is approved for the management of selected patients with inoperable pancreatic cancer in patients with performance status 0-1.
 
   
Cytotoxic Drug Gemcitabine
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Formulary
Red
  • Approved in combination with paclitaxel for metastatic breast cancer in line with NICE. 
  • NECDAG approved for the second line treatment of women with partially platinum – sensitive, platinum resistant or platinum refractory advanced ovarian cancer (To be used when liposomal doxorubicin [Caelyx] is unavailable). 
  • Approved for pancreatic cancer in line with NICE. 
  • Approved for the treatment of recurrent ovarian cancer in line with NICE.
  • Approved in combination with capecitabine following surgery for pancreatic cancer in line with NHS England Clinical Commissioning Policy
 
Link  NICE TA25: Guidance on the use of gemcitabine for the treatment of pancreatic cancer
Link  NICE TA116: Gemcitabine for the treatment of metastatic breast cancer
Link  NICE TA389: Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
Link  NHS England SSC1959 - Clinical Commissioning Policy: Gemcitabine and capecitabine following surgery for pancreatic cancer (all ages)
   
Cytotoxic Drug Mercaptopurine
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Formulary
Red
  • A mercaptopurine 20mg in 1ml suspension (unlicensedunlicensed) is also approved for use. 
  • Note: when prescribed for inflammatory bowel disease. Amber Traffic Light
 
   
Cytotoxic Drug Methotrexate
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Formulary
Red
  • approved formulations:
    • Methotrexate 2.5mg tablets
    • Methotrexate 10mg in 5ml oral solution. unlicensedunlicensed
    • Methotrexate injections (various strengths) – including prefilled syringes.
    • Methotrexate 5mg in 2ml intrathecal injection.
  • Note: when used in chronic inflammatory conditions, e.g. Crohn’s disease, rheumatoid arthritis.Amber Traffic Light
 
   
Cytotoxic Drug Pemetrexed
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Formulary
Red
  • Approved for:
    • Mesothelioma in line with NICE (funding has to be agreed on an individual patient basis if treatment is not in line with NICE).
    • Combination with cisplatin for the first line treatment of locally advanced or metastatic NSCLC (non-squamous cell histology) in line with NICE.
    • Maintenance treatment of locally advanced or metastatic NSCLC (non-squamous cell histology) in line with NICE.
    • Maintenance treatment of non-squamous non-small lung cancer after pemetrexed and cisplatin in line with NICE and NHS England Commissioning Policy.

  • Note: pemetrexed is not approved for locally advanced or metastatic NSCLC as per NICE. 
 
Link  NICE TA124: Pemetrexed for the treatment of non-small-cell lung cancer
Link  NICE TA135: Pemetrexed for the treatment of malignant pleural mesothelioma
Link  NICE TA181: Pemetrexed for the first-line treatment of non-small-cell lung cancer
Link  NICE TA190: Pemetrexed for the maintenance treatment of non-small-cell lung cancer
Link  NICE TA402: Pemetrexed maintenance treatment for non-squamous non-small-cell lung cancer after pemetrexed and cisplatin
   
Cytotoxic Drug Tegafur with Uracil
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Formulary
Red
  • Approved for metastatic colorectal cancer in line with NICE.
 
Link  NICE TA61: Guidance on the use of capecitabine and tegafur with uracil for metastatic colorectal cancer
   
Cytotoxic Drug Tioguanine
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Formulary
Red
  • 50mg in 1ml suspension is also approved.unlicensedunlicensed
 
   
Trifluridine and tipiracil
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Formulary
Red
  • Approved for previously treated metastatic colorectal cancer in adults in line with NICE and NHS England Commissioning Policy (SSC1662). 
 
Link  NICE TA 405 - Trifluridine–tipiracil for previously treated metastatic colorectal cancer
   
08.01.04  Vinca alkaloids and etoposide
Cytotoxic Drug Etoposide
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Formulary
Red
  • The following formulations are approved for use:
    • 50mg capsules & 100mg capsules;
    • 100mg in 5ml injections;
    • 500mg in 25ml injections.

 
   
Cytotoxic Drug Vinblastine Sulphate
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Formulary
Red
 
   
Cytotoxic Drug Vincristine Sulphate
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Formulary
Red
 
   
Cytotoxic Drug Vindesine Sulphate
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Formulary
Red
 
   
Cytotoxic Drug Vinorelbine
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Formulary
Red
  • The following formulations are approved for use:
    • 20mg & 30mg capsules;
    • 10mg in 1ml injections;
    • 50mg in 5ml injections.

 
   
08.01.05  Other antineoplastic drugs
Atezolizumab
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Formulary
Red
High Cost Medicine
NHS England
  • 1200mg/20mL concentrate for solution for infusion
  • Approved for treating locally advanced or metastatic non-small-cell lung cancer (NSCLC) in adults who have had chemotherapy (and targeted treatment if they have an EGFR- or ALK‑positive tumour). CDF
  • Approved for the treatment of adult patients with locally advanced or metastatic urothelial carcinoma after disease progression following one prior platinum-containing chemotherapy regimen. CDF 
 
   
Carfilzomib (Kyprolis®)
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Formulary
Red
NHS England
  • 10mg, 30mg & 60mg powder for solution for infusion
  • Approved for use in previously treated multiple myeloma in line with NICE and NHSE Commissioning Policy
 
Link  NICE TA457 Carfilzomib for previously treated multiple myeloma
   
Cytotoxic Drug Dinutuximab beta (Qarziba®)
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Formulary
Red
High Cost Medicine
NHS England
  • 20mg/4.5mL concentrate for solution for infusion
  • Approved for the treatment of high-risk neuroblastoma in people aged 12 months and over in line with NICE
 
Link  NICE TA 538: Dinutuximab beta for treating neuroblastoma
   
Cytotoxic Drug Eribulin (Halaven®)
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Formulary
Red
High Cost Medicine
  • Approved for the treatment of locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens  in accordance with NICE and NHS England Commissioning Policy
 
Link  NICE TA423: Eribulin for treating locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens
   
Cytotoxic Drug Gemtuzumab ozogamicin (Mylotarg®)
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Formulary
Red
  • Approved for untreated acute myeloid leukaemia in line with NICE
 
Link  NICE TA545: Gemtuzumab ozogamicin for untreated acute myeloid leukaemia
   
Idelalisib
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Formulary
Red
High Cost Medicine
NHS England
  • Approved in combination with rituximab for the treatment of:
    • Untreated chronic lymphocytic leukaemia in adults with a 17p deletion or TP53 mutation; NICE or
    • Chronic lympocytic leukaemia in adults when the disease has been
      treated but has relapsed within 24 months NICE.
 
Link  NICE TA359: Chronic lymphocytic leukaemia - Idelalisib
   
Cytotoxic Drug Inotuzumab ozogamicin (Besponsa®)
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Formulary
Red
High Cost Medicine
NHS England
BlueTeq
  • Approved for treating relapsed or refractory CD22-positive B-cell precursor acute lymphoblastic leukaemia in adults in line with NICE
 
Link  NICE TA541: Inotuzumab ozogamicin for treating relapsed or refractory B-cell acute lymphoblastic leukaemia
   
Nivolumab
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Formulary
Red
High Cost Medicine
  • For the treatment of locally advanced or metastatic squamous nonsmall cell lung cancer (NSCLC) after prior chemotherapy in adults.
  • Approved for the treatment of advanced (unresectable or metastatic) melanoma in adults in line with NICE.
  • Approved in combination with ipilimumab for treating advanced melanoma in line with NICE and NHS England Commissioning Policy (SSC1664)
  • Approved for the treatment of advanced renal cell carcinoma in adults in line with NICE and NHS England Commissioning Policy
  • Approved for the treatment of relapsed of refractory classical Hodgkin lymphoma in line with NICE and NHS England Commissioning Policy 
 
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
   
Olaparib 50mg capsules
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Formulary
Red
High Cost Medicine
NHS England
  • Approved for the maintenance treatment of BRCA 1 or 2 mutated, relapsed, platinum-sensitive ovarian, fallopian tube and peritoneal cancer in people whose relapsed disease has responded to platinum-based chemotherapy in line with NICE.
 
Link  NICE TA381: Olaparib for maintenance treatment of relapsed, platinum-sensitive, BRCA mutation-positive ovarian, fallopian tube and peritoneal cancer after response to second-line or subsequent platinum-based chemotherapy
   
Olaratumab (Lartuvo®)
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Formulary
Red
High Cost Medicine
  • 10 mg/mL concentrate for solution for infusion
  • Approved for the treatment of advanced soft tissue sarcoma in combination with doxorubicin in line with NICE
 
Link  NICE TA465 Olaratumab in combination with doxorubicin for treating advanced soft tissue sarcoma
   
Cytotoxic Drug Panobinostat
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Formulary
Red
  • Approved in combination with bortezomib and dexamethasone as an option for the treatment of multiple myeloma in line with NICE.
 
Link  NICE TA380: Panobinostat for treating multiple myeloma after at least 2 previous treatments
   
Pembrolizumab
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Formulary
Red
  • Approved for the treatment of advanced melanoma after disease
    progression with ipilimumab in accordance with NICE. 
  • Approved for the treatment of advanced melanoma not previously treated with ipilimumab in accordance with NICE.
  • Approved for treating PD-L1-positive non-small-cell lung cancer
  • Approved for treating PD-L1-positive metastatic non-small-cell lung cancer
 
Link  NICE TA357: Pembrolizumab for treating advanced melanoma after disease progression with 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 TA531: Pembrolizumab for untreated PD-L1-positive metastatic non-small-cell lung cancer
   
Cytotoxic Drug Talimogene laherparepvec
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Formulary
Red
  • Approved for the treatment of unresectable metastatic melanoma in line with NICE and NHS England Commissioning Policy (SSC1679).
 
Link  NICE TA410: Talimogene laherparepvec for treating unresectable metastatic melanoma
   
Venetoclax
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Formulary
Red
  • Approved for the treatment of adult patients with chronic lymphocytic leukaemia (CLL) in the presence of 17p deletion or TP53 mutations, and who are unsuitable for or have failed a B-cell receptor pathway inhibitor; and for the treatment of adult patients with CLL in the absence of 17p deletion ot TP53  mutation, and who are unsuitable for or have failed both chemo-immunotherapy and a B-cell receptor pathway inhibitor in line with MHRA Early Access to Medicines Scientific Opinion.
  • Approved in combination with rituximab for treating chronic lymphocytic leukaemia in adults who have had at least 1 previous therapy in line with NICE
 
Link  Early Access to Medicines Scientific Opinion - Public Assessment Report
Link  NICE TA561: Venetoclax with rituximab for previously treated chronic lymphocytic leukaemia
   
Picibanil
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Unlicensed Drug Unlicensed
Red
 
   
Streptozocin
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Unlicensed Drug Unlicensed
Red
  • Named patient supply only.
 
   
08.01.05  Amsacrine
Cytotoxic Drug Amsacrine
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Formulary
Red
 
   
08.01.05  Arsenic trioxide to top
Cytotoxic Drug Arsenic Trioxide
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Formulary
Red
  • NECDAG approved relapsed or refractory acute promyelocytic leukaemia (APL).
 
   
08.01.05  Bevacizumab
08.01.05  Bexarotene
08.01.05  Bortezomib
Cytotoxic Drug Bortezomib
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Formulary
Red
  • Approved for:
    • Relapsed multiple myeloma in line with in line with NICE.
    • Combination with an alkylating agent and a corticosteroid for the first-line treatment of multiple myeloma in line with NICE. 
    • Induction therapy for multiple myeloma in line with NICE.
    • Treatment of adults with mantle cell lymphoma that has not been treated before, if haemotopoietic stem cell transplantation is not suitable, in line with NICE.

 
Link  NICE TA129: Multiple myeloma - bortezomib
Link  NICE TA228: Bortezomib and thalidomide for the first‑line treatment of multiple myeloma
Link  NICE TA311: Bortezomib for induction therapy in multiple myeloma before high-dose chemotherapy and autologous stem cell transplantation
Link  NICE TA370: Bortezomib for previously untreated mantle cell lymphoma
   
08.01.05  Brentuximab vedotin
Brentuximab vedotin (Adcetris®)
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Formulary
High Cost Medicine
  • 50mg powder for concentrate for solution for infusion
  • Approved for the treatment of relapsed or refractory systemic anaplastic large cell lymphoma in line with NICE and NHS England Commissioning Policy.
  • Approved for the treatment of CD30-positive Hodgkin lymphoma in patients:
    • if they have already had autologous stem cell transplant
    • if they have already had at least 2 previous therapies when autologous stem cell transplant or multi-agent chemotherapy are not suitable. CDF

 

 
Link  NICE TA478 Brentuximab vedotin for treating relapsed or refractory systemic anaplastic large cell lymphoma
Link  NICE TA524 Brentuximab vedotin for treating CD30-positive Hodgkin lymphoma
   
08.01.05  Cetuximab to top
Cetuximab
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Formulary
Red
  • Approved for the first-line treatment of metastatic colorectal cancer in combination with FOLFOX in line with NICE (monotherapy or combination chemotherapy is not recommended for the treatment of people with metastatic colorectal cancer that has progressed after first-line chemotherapy -  as per NICE). 
  • NECDAG approved for K-RAS wild type metastatic colorectal cancer; second line use in combination with chemotherapy in patients that have progressed on previous chemotherapy; third line use as a single agent in patients who have failed oxaliplatin- and irinotecan based therapy and who are intolerant to irinotecan. 
  • Approved for locally advanced squamous cell carcinoma of the head and neck in line with NICE. 
  • Approved for previously untreated metastatic colorectal cancer in line with NICE.
  • Approved for the treatment of metastatic and/or recurrent squamous cell carcinoma of the head and neck (oral cavity only) in line with NICE and NHS England Commissioning Policy
  • Note: cetuximab is not approved in combination with platinum-based chemotherapy for recurrent and/or metastatic squamous cell cancer of the head and neck as per NICE.
 
Link  NICE TA145: Cetuximab for the treatment of locally advanced squamous cell cancer of the head and neck
Link  NICE TA176: Cetuximab for the first-line treatment of metastatic colorectal cancer
Link  NICE TA242: Cetuximab for the treatment of metastatic colorectal cancer after first-line chemotherapy: monotherapy or combination chemotherapy
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 (oral cavity)
   
08.01.05  Dacarbazine and Temozolomide
Cytotoxic Drug Dacarbazine
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Formulary
Red
 
   
Cytotoxic Drug Temozolomide
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Formulary
Red
  • Approved for the treatment of recurrent malignant glioma in line with NICE.
  • Approved for newly diagnosed glioblastoma multiforme (GBM) in line with NICE.
 
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)
   
08.01.05  Erlotinib
Erlotinib
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Formulary
Red
  • Also approved for second line use, as an alternative to docetaxel, in NSCLC in line with NICE.
  • Monotherapy not approved for maintenance after platinum chemotherapy in advanced or metastatic NSCLC NICE.
  • Approved for the treatment of locally advanced or metastatic nonsmall-cell lung cancer that has already been treated with non-targetted chemotherapy because of delayed confirmation of epidermal growth factor receptor tyrosine kinase (EGFR-TK) mutation status if; their cancer tests positive for EGFR-TK mutation; it is not know if the cancer is EGFR-TK mutation- positive because of problems with the test, and the cancer is very likely to be EGFR-TK mutation-positive and it responds to the first 2 cycles of treatment with erlotinib - in line with NICE.
 
Link  NICE TA227: Erlotinib monotherapy for maintenance treatment of non-small-cell lung cancer
Link  NICE TA258: Erlotinib for the first-line treatment of locally advanced or metastatic EGFR-TK mutation-positive non-small-cell lung cancer
Link  NICE TA374: Erlotinib and gefitinib for treating non-small-cell lung cancer that has progressed after prior chemotherapy
   
08.01.05  Hydroxycarbamide
Cytotoxic Drug Hydroxycarbamide
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 100mg tablets
  • 500mg capsules
  • 500mg in 5ml suspension (unlicensedunlicensed) is also approved
 
   
08.01.05  Imatinab
08.01.05  Ipilimumab to top
Ipilimumab
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Approved for previously treated advanced melanoma in line with NICE.
  • Approved for previously untreated advanced melanoma in line with NICE.

 
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 TA357: Pembrolizumab for treating advanced melanoma after disease progression with ipilimumab
Link  NICE TA400: Nivolumab in combination with ipilimumab for treating advanced melanoma
   
08.01.05  Mitotane
Mitotane
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
08.01.05  Panitumumab
Panitumumab (Vectibix®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • Approved for previously untreated metastatic colorectal cancer in line with NICE.
 
Link  NICE TA439 Cetuximab and panitumumab for previously untreated metastatic colorectal cancer
   
08.01.05  Pentostatin
Cytotoxic Drug Pentostatin (Nipent®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
08.01.05  Platinum compounds
Cytotoxic Drug Carboplatin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Cytotoxic Drug Cisplatin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Cytotoxic Drug Oxaliplatin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Approved for Dukes C colon cancer in combination with 5-fluorouracil
    and folinic acid in line with NICE.
  • Approved for advanced and metastatic colorectal cancer in line with NICE.
 
Link  NICE TA100: Capecitabine and oxaliplatin in the adjuvant treatment of stage III (Dukes’ C) colon cancer
   
08.01.05  Porfimer sodium and temoporfin to top
08.01.05  Procarbazine
Cytotoxic Drug Procarbazine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
08.01.05  Protein kinase inhibitors
Afatinib
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
  • Approved as a possible treatment for adults with locally advanced or metastatic non-small-cell lung cancer if their cancer tests positive for the epidermal growth factor receptor tyrosine kinase (EGFR-TK) mutation and they have not had an EGFR-TK inhibitor before NICE and additional NHS England criteria.
 
Link  NICE TA310: Afatinib for treating epidermal growth factor receptor mutation-positive locally advanced or metastatic non-small-cell lung cancer
   
Axitinib
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Formulary
Red
High Cost Medicine
NHS England
  • Approved as treatment for adults with advanced renal cell carcinoma when tyrosine kinase inhibitors or cytokines have not worked in line with NICE.
 
Link  NICE TA333: Axitinib for treating advanced renal cell carcinoma after failure of prior systemic treatment
   
Bosutinib (Bosulif®)
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Formulary
Red
High Cost Medicine
NHS England
  • Approved as an option for the treatment of chronic, accelerated blast phase Philidephia chromosome positive chronic myeloid leukaemia in adults when they have previously had 1 or more tyrosine kinase inhibitor and imatinib, nilotinib and dasatanib are not appropriate in line with NICE.
 
Link  NICE TA401: Bosutinib for previously treated chronic myeloid leukaemia
   
Cytotoxic Drug Brigatinib (Alunbrig®)
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Formulary
Red
High Cost Medicine
NHS England
BlueTeq
  • Approved for treating anaplastic lymphoma kinase (ALK)-positive advanced non-small-cell lung cancer (NSCLC) in adults who have already had crizotinib in line with NICE.
 
Link  NICE TA571: Brigatinib for treating ALK-positive advanced non-small-cell lung cancer after crizotinib
   
Cabozantinib (Cometriq®)
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Formulary
Red
High Cost Medicine
NHS England
  • Approved for use in the treatment of renal cell carcinoma in line with NICE and NHS England Commissioning Policy
  • Approved for the treatment of medullary thyroid cancer in line with NICE and NHS England Commissioning Policy
  • Approved for use in untreated advanced renal cell carcinoma in line with NICE and NHS England Commissioning Policy
 
Link  NICE TA 542: Cabozantinib for untreated advanced renal cell carcinoma
Link  NICE TA463 Cabozantinib for previously treated advanced renal cell carcinoma
Link  NICE TA516: Cabozantinib for treating medullary thyroid cancer
   
Ceritinib
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Formulary
Red
High Cost Medicine
NHS England
  • Approved for use in previously treated anaplastic lymphoma kinase positive non-small-cell-lung cancer in line with NICE and NHS England Commissioning Policy.
  • Approved for untreated ALK-positive non-small-cell lung cancer in line with NICE and NHS England Commissioning Policy
 
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
   
Crizotinib
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Formulary
Red
High Cost Medicine
  • Approved in accordance with NICE and NHS England Commissioning Policy.
 
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
   
Dabrafenib  (Tafinlar®)
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Formulary
Red
NHS England
  • Approved for the treatment of unresectable or metastatic BRAF V600 mutation-positive melanoma in line with NICE 
 
Link  NICE TA321: Dabrafenib for treating unresectable or metastatic BRAF V600 mutation‑positive 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
   
Dasatinib (Sprycel®)
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Formulary
Red
  • Approved for use in accordance with NICE and NHS Commissioning Policy
 
Link  NICE TA241: CML where treatment with imatinib has failed
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
   
Cytotoxic Drug Encorafenib (Braftovi®)
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Formulary
Red
High Cost Medicine
NHS England
  • Approved in combination with binimetinib for treating unresectable or metastatic BRAF V600 mutation-positive melanoma in adults in line with NICE
 
Link  NICE TA562: Encorafenib with binimetinib for unresectable or metastatic BRAF V600 mutation-positive melanoma
   
Everolimus (Afinitor®, Votubia®)
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Formulary
Red
  • 2.5mg, 5mg & 10mg tablets (Votubia®)
    • Approved for the treatment of angiomyolipomas associated with tuberous sclerosis in accordnace with NHS England Commissioning Policy.
    • Approved for the treatment of subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex in accordnace line with NHS England Commissioning Policy.

  • 5mg & 10mg tablets (Afinitor®)
    • Approved, in combination with exemestane, for the treatment of advanced human epidermal growth factor receptor 2 (HER2)-negative, hormone-receptor-positive breast cancer in postmenopausal women in accordance with NICE.
    • Approved for the treatment of advanced breast cancer after endocrine therapy in line with NICE.
    • Approved for the treatment of advanced renal cell carcinoma after previous treatment in line with NICE.
    • Approved for the treatment of unresectable or metastatic neuroendocrine tumours in people with progressive disease in line with NICE and NHS England Commissioning Policy

 
Link  Clinical Commissioning Policy Statement: Everolimus (Votubia®) for treatment of angiomyolipomas associated with tuberous sclerosis
Link  Clinical Commissioning Policy: Everolimus for subependymal giant cell astrocytoma (SEGA) associated with tuberous sclerosis complex
Link  NICE TA421: Everolimus with exemestane for treating advanced breast cancer after endocrine therapy
Link  NICE TA432: Everolimus (Afinitor) 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  NICE TA219: Everolimus for the second-line treatment of advanced renal cell carcinoma (Superceded by NICE TA432)
   
Gefitinib
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Formulary
Red
  • Approved for first line use in locally advanced or metastatic NSCLC in line with NICE.
 
Link  NICE TA192: Lung cancer (non-small-cell, first line) - gefitinib
Link  NICE TA374: Erlotinib and gefitinib for treating non-small-cell lung cancer that has progressed after prior chemotherapy
   
Ibrutinib (Imbruvica®)
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Formulary
Red
High Cost Medicine
NHS England
  • Approved for previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation in line with NICE and NHS Commissioning Policy.
  • Approved for treating relapsed or refractory mantle cell lymphoma in line with NICE and NHS England Commissioning Policy if:
    • they have had only 1 previous line of therapy
 
Link  NICE TA429: Ibrutinib for previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation
Link  NICE TA502: Ibrutinib for treating relapsed or refractory mantle cell lymphoma
   
Imatinib
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Formulary
Red
NHS England
  • Approved for the first-line management of people with KIT (CD117)- positive unresectable and/or KIT (CD117)-positive metastatic gastrointestinal stromal tumours (GISTs) in line with NICE. 
  • Approved for the adjuvant treatment of gastrointestinal stromal tumours (GISTs) after surgery when there is a high risk relapse of tumour NICE. 
  • Approved for Philadelphia-chromosome-positive CML in the accelerated phase or with blast crisis in line with NICE.
  • A standard-dose imatinib is recommended as an option for the first-line treatment of adults with chronic phase Philadelphia-chromosomepositive CML in line with NICE.
 
Link  NICE TA209: Imatinib for the treatment of unresectable and/or metastatic gastrointestinal stromal tumours
Link  NICE TA326: Imatinib for the adjuvant treatment of gastrointestinal stromal tumours
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
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Formulary
Red
 
Link  NICE TA257: in combination with an aromatase inhibitor for HER2 positive metastatic breast cancer
   
Lenvatinib (Kisplyx®)
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Formulary
Red
High Cost Medicine
NHS England
  • 4mg & 10mg capsules
  • Approved with everolimus for previously treated advanced renal cell carcinoma in line with NICE
  • Approved to the treatment of differentiated thyroid cancer after radioactive iodine in line with NICE
  • Approved for untreated advanced hepatocellular carcinoma in line with NICE
 
Link  NICE TA 535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine
Link  NICE TA 551: Lenvatinib for untreated advanced hepatocellular carcinoma
Link  NICE TA498: Lenvatinib with everolimus for previously treated advanced renal cell carcinoma
   
Nilotinib
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Formulary
Red
NHS England
  • Approved for the first-line treatment of adults with chronic phase Philadelphia-chromosome-positive CML in line with NICE and NHS Commissioning Policy
 
Link  NICE TA241: Dasatinib, nilotinib and high dose imatinib for CML
Link  NICE TA251: Dasatinib, nilotinib and imatinib for first line treatment of 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 untreated chronic myeloid leukaemia
   
Nintedanib
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Approved for the treatment of locally advanced, metastatic or locally recurrent non-small-cell lung cancer who have previously been treated been with first-line chemotherapy in accordance with NICE.
  • Approved for treating idiopathic pumonary fibrosis in line with NICE
 
Link  NICE TA347: Recurrent non-small-cell lung cancer
Link  NICE TA379: Nintedanib for treating idiopathic pulmonary fibrosis
   
Pazopanib
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Formulary
Red
  • Approved for advanced renal cell carcinoma in line with NICE
 
Link  NICE TA215: Pazopanib in renal cell cancer
   
Ponatinib (Iclusig®)
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Formulary
Red
High Cost Medicine
  • 15mg, 30mg & 45mg film-coated tablets
  • Approved for the treatment of chronic myeloid leukaemia and acute lymphoblastic leukaemia in line with NICE and NHS England Commissioning Policy
 
Link  NICE TA451 Ponatinib for treating chronic myeloid leukaemia and acute lymphoblastic leukaemia
   
Cytotoxic Drug Regorafenib (Stivarga® )
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
BlueTeq
  • 40mg tablets
  • Approved for treating unresectable or metastatic gastrointestinal stromal tumours in adults whose disease has progressed on, or who are intolerant to, prior treatment with imatinib and sunitinib in line with NICE and NHS England Commissioning Policy 
  • Approved for treating advanced hepatocellular carcinoma in adults who have had sorafenib in line with NICE
 
Link  NICE TA 488: Regorafenib for previously treated unresectable or metastatic gastrointestinal stromal tumours
Link  NICE TA555: Regorafenib for previously treated advanced hepatocellular carcinoma
   
Ruxolitinib
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Formulary
Red
  • Approved for the treatment of disease-related splenomegaly or symptoms in adults with primary myelofibrosis, post polycythaemia vera myelofibrosis or post essential thrombocythaemiaa myelofibrosis, only in people with intermediate-2 or high-risk disease in line with NICE.
 
Link  NICE TA386: Ruxolitinib for treating disease-related splenomegaly or symptoms in adults with myelofibrosis
   
Sorafenib (Nexavar®)
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Formulary
Red
High Cost Medicine
  • 200mg tablets
  • Approved for treatment of advanced hepatocellular carcinoma only for people with Child-Pugh grade A liver impairment in line with NICE and NHS Commissioning Policy
  • Approved for the treatment of differentiated thyroid cancer after radioactive iodine in line with NICE
 
Link  NICE TA 535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine
Link  NICE TA474 Sorafenib for treating advanced hepatocellular carcinoma
   
Sunitinib
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Formulary
Red
High Cost Medicine
NHS England
  • Approved for gastrointestinal stromal tumours (GISTs) in line with NICE. 
  • Approved for advanced and/or metastatic renal cell carcinoma in line with NICE.
  • Sunitinib not approved for second line use in advanced and/or metastatic renal cell carcinoma NICE.
  • Approved for the treatment of unresectable or metastatic neuroendocrine tumours in people with progressive disease in line with NICE and NHS England Commissioning Policy
 
Link  NICE TA169: Sunitinib for the first-line treatment of advanced and/or metastatic renal cell carcinoma
Link  NICE TA179: Sunitinib for the treatment of gastrointestinal stromal tumours
Link  NICE TA449 Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease
   
Trametinib
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
  • Approved in combination with dabrafenib for the treatment of unresectable or metastatic melanoma in line with NICE and NHS England Commissioning Policy.
 
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
   
Vemurafenib
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Formulary
Red
  • Approved melanoma (BRAF V600 mutation positive, unresectable metastatic) in line with NICE.
 
Link  NICE TA269: Vemurafenib for treating malignant melanoma
Link  NICE TA414: Cobimetinib in combination with vemurafenib for treating unresectable or metastatic BRAF V600 mutation-positive melanoma
   
08.01.05  Taxanes
Cytotoxic Drug Cabazitaxel
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Approved for the treatment of hormone relapsed metastatic prostate cancer treated with with docetaxel in line with NICE.
 
Link  NICE TA391: Cabazitaxel for hormone-relapsed metastatic prostate cancer treated with docetaxel
   
Cytotoxic Drug Docetaxel
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Formulary
Red
  • Approved for early node-positive breast cancer in line with NICE. 
  • Approved for hormone refractory metastatic prostate cancer in line with NICE.
 
Link  NICE TA101: Docetaxel for the treatment of hormone-refractory metastatic prostate cancer
Link  NICE TA109: Docetaxel for the adjuvant treatment of early node-positive breast cancer
   
Cytotoxic Drug Paclitaxel
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Formulary
Red
  • The following formulations are approved:
  • 30mg in 5ml, 100mg in 16.7ml, and 150mg in 25ml concentrate for preparing IV infusion.
  • Approved for the treatment of recurrent ovarian cancer in line with NICE.
 
Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
   
Cytotoxic Drug Paclitaxel - Albumin Bound Formulation (Abraxane®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Note: Abraxane® 5mg in 1ml powder for suspension for infusion is restricted for use within its current license for metastatic breast cancer patients who cannot tolerate standard taxanes. 
  • Approved in combination with a platinum-based compound or platinum-based therapy alone (cisplatin or carboplatin) for first line therapy in ovarian cancer in line with NICE.
  • Approved in combination with a platinum-based drug (carboplatin or cisplatin) for second-line (or subsequent) therapy in ovarian cancer in line with NICE
  • Approved metastatic breast cancer in line with NICE.
  • Abraxane is not recommended for the adjuvant treatment of women with early node-positive breast cancer NICE.
  • Approved in combination with gemcitabine for untreated metastatic pancreatic cancer in line with NICE and NHS England Commissioning Policy as of 5th December 2017
 
Link  NICE TA360: Pancreatic cancer - paclitaxel with gemcitabine
Link  NICE TA476 Paclitaxel as albumin-bound nanoparticles with gemcitabine for untreated metastatic pancreatic cancer
   
08.01.05  Topoisomerase I inhibitors
Cytotoxic Drug Irinotecan Hydrochloride
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Cytotoxic Drug Topotecan
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Formulary
Red
  • Approved for relapsed NSCLC in line with NICE.
  • Approved for recurrent or stage IVB cervical cancer in line with NICE.
  • Approved for second-line (or subsequent) treatment in advanced ovarian cancer in line with NICE.
  • Approved for the treatment of recurrent ovarian cancer in line with NICE.
 
Link  NICE TA183: Topotecan for the treatment of recurrent and stage IVB cervical cancer
Link  NICE TA184: Topotecan for the treatment of relapsed small-cell lung cancer
Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
   
08.01.05  Trabectedin to top
Cytotoxic Drug Trabectedin
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Formulary
Red

Approved for the treatment of recurrent ovarian cancer in line with NICE.

 
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
Pertuzumab (Perjeta®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
BlueTeq
  • Approved for the neoadjuvant treatment of HER2-positive breast cancer in line with NICE and NHS Commissioning Policy
  • Approved with trastuzumab and docetaxel for treating HER2-positive breast cancer in line with NICE and NHS Commissioning Policy
  • Approved for adjuvant treatment of HER2-positive early stage breast cancer in line with NICE
 
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
Link  NICE TA569: Pertuzumab for adjuvant treatment of HER2-positive early stage breast cancer
   
Trastuzumab
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Formulary
Red
  • Approved for metastatic or locally advanced inoperable gastric cancers in line with NICE.
  • Approved for early stage HER2-positive breast cancer in line with NICE.
  • Approved for advanced HER2-positive breast cancer in line with NICE.
  • Note: trastuzumab is not recommended in combination with an aromatase inhibitor for the first-line treatment in postmenopausal women with metastatic hormonereceptor- positive breast cancer that overexpresses HER2 - in line with NICE.
  • Trastuzumab 600mg subcutaneous injection is approved by NHS England for HER2-positive breast cancer in line with NECN guidance.
 
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 TA34: Breast cancer - trastuzumab
   
Cytotoxic Drug Trastuzumab emtansine (Kadcyla®)
(S/C injection)
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Formulary
Red
High Cost Medicine
  • 100mg & 160mg powder for concentrate for solution for infusion
  • Approved for the treatment of HER2-positive advanced breast cancer after trastuzumab and a taxane in line with NICE and NHS England Commissioning Policy
 
Link  NICE TA458 Trastuzumab emtansine for treating HER2-positive advanced breast cancer after trastuzumab and a taxane
   
08.01.05  Tretinoin
Tretinoin
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
08.01.05  Vismodegib
08.02  Drugs affecting the immune response
 note 

Shared care guidelines are available for:

Blinatumomab (Blincyto®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 38.5 micrograms powder for concentrate and solution for solution for infusion
  • Approved for use in previously treated Philadelphia-chromosome-negative acute lymphosblastic leukaemia in line with NICE and NHS England Commissioning Policy
 
Link  NICE TA450 Blinatumomab for previously treated Philadelphia-chromosome-negative acute lymphoblastic leukaemia
   
08.02  Immunosuppressant therapy to top
08.02.01  Antiproliferative immunosuppressants
Cytotoxic Drug Azathioprine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Amber
  • An azathioprine 50mg in 5ml suspension (unlicensedunlicensed) is also available.
 
   
Mycophenolate Mofetil
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Amber
 
Link  NICE TA85: Immunosuppressive therapy for renal transplantation in adults
   
Mycophenolate Sodium (Myfortic®)
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Formulary
Amber
  • Approved as second-line therapy in patients who do not tolerate mycophenolate mofetil.
 
   
08.02.02  Corticosteroids and other immunosuppressants
Ciclosporin (Neoral®)
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Formulary
Amber
  • Neoral® is the preferred product for most indications.
  • Approved formulations include:
    • 10mg, 25mg, 50mg, and 100mg capsules;
    • 100mg in 1ml sugar free oral solution (oily).

 
   
Cytotoxic Drug Sirolimus
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Formulary
Amber
  • Approved for renal transplantation in children and adolescents in line with NICE.
 
   
Cytotoxic Drug Tacrolimus
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Formulary
Amber

Approved tacrolimus formulations include:

  • 500 microgram, 1mg & 5mg capsules (Prograf® & Adoport®).
  • 1mg in 1ml oral suspension (unlicensedunlicensed) - this replaces 0.5mg/ml oral
    suspension. 
  • 5mg in 1 ml concentrate for preparing IV infusion - approved for renal transplantation in children and adolescents in line with NICE.
  • 500microgram, 1mg, 3mg & 5mg MR capsules (Advagraf®) approved for use for prophylaxis of organ rejection in kidney and liver transplantation. Advagraf® is also approved for use in patients who are currently prescribed Prograf®, and de novo patients should be prescribed Adoport®.
  • 750microgram, 1 mg and 4 mg m/r tablets (Envarsus®)
    • approved for the treatment of renal and liver transplant patients who are suffering from neurotoxicity with other formulations or for patients requiring large doses of tacrolimus. 

 
   
Antithymocyte immunoglobulin (horse)  (Thymoglobuline®)
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Alternatives
Red
  • NETAG approved for aplastic anaemia in adults (unlicensedunlicensed).
 
   
Antithymocyte immunoglobulin (rabbit)  (Thymoglobuline®)
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Red
High Cost Medicine
  • Used in the management of transplant rejection.
 
   
Basiliximab
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Alternatives
Red
  • Approved for limited use in adult renal transplant patients with high risk of acute organ rejection.
  • Approved for severe graft versus host disease post haematopoietic stem cell transplantation.
  • Approved for induction therapy in renal transplantation in children and adolescents in with combinations that include ciclosporin in line with NICE.
 
Link  NICE TA85: Immunosuppressives in renal transplant (Adults)
Link  NICE TA99: Immunosuppressives in renal transplant (Children)
   
Cytotoxic Drug Ciclosporin (Sandimmun®)
(Capsules & SF Solution)
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Amber
  • Approved Sandimmun® formulations include:
    • 50mg in 1ml & 250mg in 5ml concentrate (oily) for IV infusion. Red Traffic Light
    • 25mg & 100mg capsules (unlicensedunlicensed). Amber Traffic Light
    • 100mg in 1ml sugar-free oral solution (oily). Amber Traffic Light

  • Note: original oral formulations Sandimmun® supplied on request for patients who cannot take Neoral®.
 
   
08.02.03  Anti-lymphocyte monoclonal antibodies
Alemtuzumab
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
NHS England
  • Alemtuzumab 30mg in 1ml concentrate for IV infusion is approved for use in, lymphocytic leukaemia & prevention of graft vs. host disease in bone marrow transplant patients, and high-risk kidney and pancreas transplantation.
  • Alemtuzumab 12mg in 1.2ml concentrate for IV infusion is approved for treating adults with active relapsing– remitting multiple sclerosis in line with NICE and NHS England commissioning policy. 
 
Link  NICE TA312: Alemtuzumab for relapsing‑remitting multiple sclerosis
   
Obinutuzumab
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • Approved for use in chronic lymphocytic leukaemia in combination with chlorambucil in patients who have co-morbitities that make full‑dose fludarabine‑based therapy unsuitable for them, only if bendamustine‑based therapy is not suitable and the company provides obinutuzumab with the discount agreed in the patient access scheme in line with NICE (subject to NHS England funding).
  • Approved for the treatment of rituximab-refractory follicular lymphoma in combination bendamustine in line with NICE and NHS England Commissioning Policy
 
Link  NICE TA343: Obinutuzumab with chlorambucil for CLL
Link  NICE TA472 Obinutuzumab with bendamustine for treating follicular lymphoma refractory to rituximab
   
Ocrelizumab (Ocrevus®)
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Formulary
Red
High Cost Medicine
NHS England
BlueTeq
  • Approved for the treatment of relapsing-remitting multiple sclerosis in line with NICE

     

 
Link  NICE TA 533: Ocrelizumab for treating relapsing–remitting multiple sclerosis
   
Ofatumumab
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Approved for use in chronic lymphocytic leukaemia in combination with chlorambucil if the person is ineligible for fludarabine‑based therapy and bendamustine is not suitable and the company provides ofatumumab with the discount agreed in the patient access scheme in line with NICE (subject to NHS England funding)
 
Link  NICE TA344: Ofatumumab with chlorambucil or bendamustine for CLL
   
Rituximab
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • NICE have approved rituximab for the following indications:
  • First line use in NHL in combination with CHOP.
  • Maintenance therapy in follicular NHL that has responded to first line induction therapy with rituximab in combination with chemotherapy.
  • Stage III and IV follicular lymphoma in previously untreated people.
  • Replased or refractory follicular NHL.
  • Post-transplant lymphoproliferative disease.
  • First line use in CLL in combination with fludarabine and cyclophosphamide. 
  • Combination with fludarabine and cyclophosphamide for relapsed or refractory CLL.
  • Autoimmune haematological conditions (where conventional treatments have failed)
  • Autoimmune haemolytic anaemia (AIHA), Evans syndrome, pure red cell aplasia (PRCA), & thrombocytopenia purpura (TTP).
  • Combination with bendamustine for first line use in CLL (Binet stage B or C) in patients for whom fludarabine combination chemotherapy is not appropriate.
  • Vasculitis (including Wegener’s granulomatosis in adults and children) that has not responded adequately to conventional treatment (e.g. corticosteroids, cyclophosphamide) in line with NICE and additional NHS England criteria.
  • NECDAG have approved rituximab for the following indications:
  • Treatment of NLPHL
  • Newly diagnosed mantle cell NHL in patients aged
  • In combination with bendamustine for patients with CLL not fit for FCR chemotherapy or for patients who relapse within 2 years of FCR chemotherapy and not fit for alemtuzumab.
  • Salvage chemotherapy for patients relapsing > 12 months post 1st line therapy with R-CHOP.
  • Standard NHL induction regimen in patients who cannot be given an anthracycline. Rituximab with other chemotherapy regimens is an alternative treatment option e.g. DECC, CVP for this group of patients, as part of their first line therapy. Also in addition to the MACOP-B regimen for the small number of young patients with DLBCL, subtype Primary Mediastinal B cell Lymphoma.
  • Treatment of Hairy Cell Leukaemia (HCL) or  HCL varian (HCL-v) who:
    - relapse early after purine analogue therapy (< 2 years post treatment)
    - are refractory to purine analogues.
  • NTAG have approved rituximab for the following indications:
  • Treatment of immune (idiopathic) thrombocytopenic purpura (ITP) in adults and children.
  • NHS England have approved rituximab for the following indications:
  • Treatment of immunobullous disease
  • Steroid Sensitive Nephrotic Syndrome in Children
  • Steroid Resistant Nephrotic Syndrome in Children
  • Acquired Haemophilia
  • Cytopenia Complicating Primary Immunodeficiency
  • Maintenance single agent therapy in FL, mantle cell lymphoma, marginal zone lymphoma and lymphoplasmacytic lymphoma in line with (SSC1434) - 1.4g solution for sc injection.
  • Second line treatment for anti-NMDAR auto-immune encephalitis (all ages)
  • Treatment of refractory myasthenia gravis in a specialised neuroscience
    centre


For musculoskeletal indications see chapter 10

 
Link  NTAG - Treatment Appraisal Decision Summary
   
08.02.04  Other immunomodulating drugs
Daclizumab (Zinbryta®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • 150mg subcutaneous injection
  • Approved for the treatment of highly active relapsing-remitting mutiple sclerosis that has failed to respond to other treatment in adults in line with NICE and NHS England Commissioning Policy. 
  • Subject to restricted use by EMA
 
Link  EMA Supporting Document restricting access to daclizumab
Link  NICE TA441 Daclizumab for treating relapsing–remitting multiple sclerosis
   
08.02.04  Interferon Alfa to top
Interferon Alfa-2b
(IntronA)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
Interferon Alfa-2b (Roferon-A®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
 
   
Peginterferon Alfa (Pegasys®, ViraferonPeg®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Approved  for hepatitis B and C in accordance with NICE guidelines and NHS England Commissioning Policies. 
 
Link  NICE TA106: Hepatitis C - peginterferon alfa & ribavirin
Link  NICE TA200: Hepatitis C - peginterferon alfa & ribavirin
Link  NICE TA300: Hepatitis C - peginterferon alfa
Link  NICE TA75: Hepatitis C - pegylated interferons, ribavirin & alfa interferon
Link  NICE TA96: Hepatitis B - peginterferon alfa
   
08.02.04  Interferon beta
Interferon Beta (Avonex®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
Homecare
 
   
Interferon Beta (Betaferon®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
Homecare
 
   
Interferon beta (Extavia®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
Homecare
 
   
Interferon Beta (Rebif®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
Homecare
 
Link  NICE TA32: Beta interferon and glatiramer acetate for the treatment of multiple sclerosis
   
Peginterferon Beta-1a (Plegridy®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
Homecare
 
   
08.02.04  Interferon gamma
08.02.04  Aldesleukin
08.02.04  BCG bladder instillation
BCG 81mg vial (connaught)
(bladder instillation)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
 
   
08.02.04  Canakinumab to top
08.02.04  Dimethyl fumarate
Dimethyl fumarate (Tecfidera®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
Homecare
  • Approved as a option for treating adults with active relapsing-remitting multiple sclerosis that isn’t highly active or rapidly evolving severe relapsing-remitting multiple sclerosis NICE and NHS England Commissioning Policy. 
 
Link  Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)
Link  NICE TA320: Dimethyl fumarate for multiple sclerosis
   
08.02.04  Fingolimod
Fingolimod
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
Homecare
  • Approved for the treatment of highly active relapsing–remitting multiple sclerosis in line with NICE and NHS England Commissioning Policy.
  • Approved for patients who have progressed on glatiramer acetate and for those patients who are at high risk of progressive multifocal leukoencephalopathy (PML) in line with NHS EnglandClinical Commissioning Policy.
 
Link  Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)
Link  NICE TA254: Fingolimod for highly active relapsing remitting multiple sclerosis
   
08.02.04  Glatiramer acetate
Glatiramer Acetate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
Homecare
  • Approved for treating multiple sclerosis in line with NICE and NHS Engand commissioning policy.
 
Link  NICE CG32: Beta interferon and glatiramer acetate for the treatment of multiple sclerosis
Link  Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)
   
08.02.04  Histamine
08.02.04  Lenalidomide, pomalidomide, and thalidomide to top
Lenalidomide
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Approved for multiple myeloma in line with NICE - approved for myelodysplastic syndrome with 5q deletion in line with NICE (subject to NHS England funding).
 
Link  NICE TA322: Lenalidomide for treating myelodysplastic syndromes associated with an isolated deletion 5q cytogenetic abnormality
   
Pomalidomide (Imnovid®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • For the treatment of multiple myeloma previously treated with lenalidomide and bortezomib in line with NICE and NHS Commissioning Policy
 
Link  NICE TA427: Pomalidomide for multiple myeloma previously treated with lenalidomide and bortezomib
   
Thalidomide
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Approved in combination with an alkylating agent and a corticosteroid for the first-line treatment of multiple myeloma in line with NICE. 
  • Approved for the treatment of bleeding from bowel angiodysplasia in patients with an inherited/acquired bleeding disorder on specialist advice only.
  • Approved for the treatment of severe epistaxis as a result of hereditary haemorrhagic telangiectasia (HHT) who have failed all other treatments.
 
Link  NICE TA228: Bortezomib and thalidomide for the first‑line treatment of multiple myeloma
   
08.02.04  Mifamurtide
Mifamurtide
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Approved for high-grade resectable non-metastatic osteosarcoma in line with NICE.
 
Link  NICE TA235: Osteosarcoma - mifamurtide: guidance
   
08.02.04  Natalizumab
Natalizumab
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
Homecare
  • Approved for rapidly evolving severe relapsing remitting multiple sclerosis in line with NICE and NHS England commissioning policy.
 
Link  Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)
Link  NICE TA127: Natalizumab for the treatment of adults with highly active relapsing–remitting multiple sclerosis
   
08.02.04  Teriflunomide
Teriflunomide
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
Homecare
  • Approved as a option for treating adults with active relapsing-remitting multiple sclerosis that isn’t highly active or rapidly evolving severe relapsing-remitting multiple sclerosis NICE and NHS England Commissioning Policy.
 
Link  Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)
Link  NICE TA303: Teriflunomide for treating relapsing–remitting multiple sclerosis
   
08.03  Sex hormones and hormone antagonists in malignant disease
08.03.01  Oestrogens to top
Diethylstilbestrol
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • Should be initiated with specialist advice.
 
   
08.03.02  Progestogens
Medroxyprogesterone Acetate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Approved formualtion include 100mg, 200mg, and 400mg tablets. 
  • Medroxyprogesterone acetate 500mg in 2.5ml injection is also approved. Green Traffic Light
 
   
Megestrol Acetate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
 
   
Norethisterone
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
 
   
08.03.03  Androgens
08.03.04  Hormone antagonists
08.03.04.01  Breast cancer
Abemaciclib (Verzenios®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
BlueTeq
  • Approved as an options for treating locally advanced or metastatic, hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer as first endocrine-based therapy in adults in line with NICE
 
Link  NICE TA 563: Abemaciclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
   
Anastrozole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
 
   
Exemestane
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
 
   
Letrozole
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
 
   
Palbociclib (Ibrance®)
View adult BNF View SPC online View SMC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
  • 75mg, 100mg & 125mg capsules
  • Approved for use with an aromatase inhibitor for the treatment of previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer in line with NICE and NHS England Commissioning Policy
 
Link  NICE TA495: Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
   
Ribociclib (Kisqali®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
NHS England
  • 200mg tablets
  • Approved for use with an aromatase inhibitor for the treatment of previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer in line with NICE and NHS England Commissioning Policy
 
Link  NICE TA496: Ribociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
   
Tamoxifen
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
  • Approved formulations include:
    • 10mg and 20mg tablets;
    • 10mg in 5ml sugar free oral solution.

 
   
08.03.04.02  Prostate cancer and gonadorelin analogues to top
Radium-223 dichloride
(Xofigo®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • Provided by radiotherapy department in accordance with NICE
 
Link  NICE TA376: Radium-223 dichloride for treating hormone-relapsed prostate cancer with bone metastases
Link  NICE TA412: Radium-223 dichloride for treating hormone-relapsed prostate cancer with bone metastases
   
08.03.04.02  Gonadorelin analogues
 note 

Clinicians are encouraged to prescribe the least expensive product that is clinically appropriate.

Goserelin
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green plus
  • Approved formulations include 3.6mg and 10.8mg implants.
 
Leuprorelin Acetate
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green plus
  • Approved formulations include leuprorelin 3.75mg & 11.25mg prefilled syringes.
 
Triptorelin
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green plus
  • Approved formulations include triptorelin 3mg, 11.25mg and 22.5mg IM injection.
 
Degarelix
View adult BNF View SPC online View childrens BNF  Track Changes
First Choice
Green plus
  • Approved formulations include 80mg and 120mg vials (with diluent).
  • Approved for the first line treatment of advanced hormone dependant prostate cancer with a PSA > 20ng/l at presentation 
    • -approved as an option for treating advanced hormone-dependent prostate cancer in people with spinal metastases in line with NICE.

 
Buserelin
(Prostate)
View adult BNF View SPC online View childrens BNF  Track Changes
Alternatives
Green plus
  • Approved formulations include:
    • 5mg in 5ml injection;
    • 150 microgram metered dose nasal spray.

 
   
08.03.04.02  Anti-androgens
Abiraterone
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • Approved for castration-resistant metastatic prostate cancer in line with NICE.
  • Approved for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated in line with NICE and NHS England Commissioning Policy.
 
Link  NICE TA259: Abiraterone for castration resistant prostate cancer
Link  NICE TA387:Abiraterone for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated
   
Bicalutamide
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus

Initiate with specialist advice.

 
   
Cyproterone
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
 
   
Enzalutamide
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Approved for use in adults with metastatic hormone-relapsed prostate cancer, who have not had chemotherapy in line with NICE.
 
Link  NICE TA316: Enzalutamide for prostate cancer
Link  NICE TA377: Enzalutamide for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated
   
Flutamide
(UNDER REVIEW)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green plus
 
   
08.03.04.03  Somatostatin analogues
Lanreotide
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
  • Approved formulation include lanreotide 30mg long-acting injection and lanreotide 60mg, 90mg, and 120mg autogel injections.
    Existing patients 
    Green Traffic Light  for acromegaly, neuroendocrine tumour and carcinoid. 
    New patients
    Red Traffic Light  for acromegaly, neuroendocrine tumour and carcinoid.
 
   
Octreotide
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
  • Approved formulations include octreotide 50microgram, 100microgram, and 500 microgram in 1ml, and 1mg in 5ml injections, and octreotide 10mg, 20mg and 30mg long-acting injections.
    Existing patients 
    Green Traffic Light  for acromegaly, neuroendocrine tumour and carcinoid. 
    New patients
    Red Traffic Light  for acromegaly, neuroendocrine tumour and carcinoid.
  • Green Traffic Light Approved for the management of GI secretions in end of life care
 
   
Pasireotide (Signifor®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
High Cost Medicine
  • Approved for the treatment of Cushing’s disease in line with NHS England Policy.
 
Link  Clinical Commissioning Policy: Pasireotide diaspartate: an injectable medical therapy for the treatment of Cushings’ Disease
   
 ....
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
click to search medicines.org.uk
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

Red

Drugs for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician and the drug should be supplied through the hospital throughout the duration of treatment. In some very exceptional circumstances (e.g. due to distance from the hospital, storage, supply or mobility/transport problems) it may be appropriate for the GP to be asked to prescribe a Red drug. This should be negotiated on an individual patient basis and should only be done with the GP’s prior informed agreement where the roles of the GP and hospital services are clearly defined and agreed. The GP should not feel under pressure to prescribe in these circumstances.   

Amber

Drugs initiated by hospital specialist, but where continuing treatment by GPs may be appropriate under a shared care arrangement. The specialist should send the GP a copy of the shared care agreement to sign. The GP should sign the shared care agreement, or indicate they do not want to be part of such an agreement, and return a copy back to the specialist. Shared care guidelines are available or are being developed for most of the drugs listed as Amber. If no shared care guideline is available, the hospital specialist should provide the patient’s GP with sufficient information and support to allow treatment to be continued and managed safely in primary care.  

Green plus

Drugs normally recommended or initiated by hospital specialist, but where the provision of an information leaflet may be appropriate to facilitate continuing treatment by GPs. Many of these information sheets are in the process of development.  

Green

Drugs where prescribing by GPs is appropriate. Drugs not classified as Red, Amber or Green Plus (formerly blue in North of Tyne) are generally classified as ‘Green’ by default. The Green drugs listed here include those products normally initiated by hospital specialists where there was a need for discussion and debate as to the category in which they should be placed.  

netFormulary