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 Formulary Chapter 14: Immunological products and vaccines - Full Chapter
Notes:

Prescribing Guidance

Please see our Prescribing Guidelines page for all prescribing guidance relating to this chapter.

Shared Care Agreements

There are no Shared Care Agreements relating to this chapter.

 

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14.05  Expand sub section  Immunoglobulins
14.05  Expand sub section  Normal immunoglobulin
 note 

NHSE Updated Commissioning Criteria for the use of therapeutic immunoglobulin (Ig) in immunology, haematology, neurology and infectious diseases in England January 2019

For indications not covered by above guidance:

Clinical guidelines for immunoglobulin use (second edition update) 2011

Human normal immunoglobulin
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High Cost Medicine
NHS England
BlueTeq
  • Commissioned by NHS England in line with 'Updated Commissioning Criteria for the use of therapeutic immunoglobulin (Ig) in immunology, haematology, neurology and infectious diseases in England (January 2019)'. For indications not covered by these commissioning criteria, commissioning is in line with the 'DoH Clinical Guidelines for Immunoglobulin Use (second edition update, July 2011)'.
  • Note: Guidance from NHS England (October 2017) states that the recommended dose of IVIg for the treatment of ITP is a single dose of 1g/kg. A repeat dose of 1g/kg should only be considered at day 7 if there is a failure to achieve a haemostatically adequate platelet count (approval from the local immunoglobulin approval panel is required if earlier use is contemplated in cases of exceptional clinical circumstances such as active mucosal bleeding or the need for emergency surgery).
  • Prescribe by brand. Various brands available.
  • NOTE Subgam is the HNIG to use when Tetanus IG is unavailable but indicated as per national guidance. See link below.
 
Link  NHSE National demand management programme for immunoglobulin database
Link  PHE Tetanus July 2019 Guidance on the management of suspected tetanus cases and on the assessment and management of tetanus-prone wounds
 
14.05  Expand sub section  Specific immunoglobulins
14.05  Expand sub section  Anti-D (Rho) immunoglobulin
14.05  Expand sub section  Interferons to top
14.05.01  Expand sub section  Normal immunoglobulin
 note 

 

14.05.02  Expand sub section  Disease-specific immunoglobulins
14.05.03  Expand sub section  Anti-D (Rho) immunoglobulin
 ....
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Traffic Light Status Information

Status Description

Traffic LightRed

RED - Hospital only to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.  

Traffic LightAmber

Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.  

Traffic LightAmber with Shared Care

Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.  

Traffic LightGreen

These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.  

Traffic LightSelf

Suitable for patient to be directed to buy themselves  

Traffic LightGrey

Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.   

Traffic LightBlack

(In use from Oct 2020) Used where a decision has been made by the BSW APC not to routinely commission this preparation for its licensed indications. Do not prescribe.   

Traffic LightRed Specialist Centre

Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.  

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