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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
Notes:

Hameatology/Oncology related Prescribing Guidance

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

Haematology/Oncology related Shared Care Agreements

Please see our Shared Care Agreements page for all shared care agreements (SCAs) relating to this chapter.

 

 Details...
08.01  Cytotoxic drugs
08.01  Drugs for cytotoxic-induced side-effects
Calcium Folinate
(Injection)
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Formulary
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  • Folinic acid (as Calcium folinate) 7.5mg per 1ml
  • Chemotherapy induced mucositis and myelosuppression
 
 
Mesna
(Injection)
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Formulary
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  • 1m/10ml solution for injection
  • Chemotherapy induced neutropenic infection and nephrotoxicity
 
 
Mesna
(Tablets)
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Formulary
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  • 400mg or 600mg tablets
  • Chemotherapy induced neutropenic infection and nephrotoxicity
 
 
08.01.01  Alkylating drugs
Bendamustine
(Injection)
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Formulary
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High Cost Medicine
NHS England

 

 
Link  MHRA DSU: Bendamustine (Levact): increased risk of non-melanoma skin cancer and progressive multifocal encephalopathy (PML)
Link  NICE TA216: Bendamustine for CLL
Link  NICE TA649 Polatuzumab vedotin with rituximab and bendamustine for treating relapsed or refractory diffuse large B-cell lymphoma
 
Busulfan
(Tablets)
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Formulary
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  • 2mg tablets
 
 
Busulfan
(Injection)
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Formulary
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  • 60mg/10ml infusion
 
 
Cyclophosphamide
(Tablets)
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Formulary
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  • 50mg tablets
 
 
Cyclophosphamide
(Injection)
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Formulary
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  • 500mg,1g and 2g injection 
 
 
Ifosfamide
(Injection)
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Formulary
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  • 1g and 2g injection
 
 
Lomustine
(Capsules)
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Formulary
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  • 40mg capsules
 
 
Melphalan
(Tablets)
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Formulary
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  • 2mg tablets
 
 
Melphalan
(Injection)
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Formulary
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  • 50mg powder and solvent for injection
 
 
Chlormethine Hydrochloride (Mustine)
(Injection )
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Unlicensed Drug Unlicensed
traffic lightRed
  • 10mg powder for reconstitution
 
 
08.01.02  Anthracyclines and other cytotoxic antibiotics
Bleomycin
(Injection)
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Formulary
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  • 15,000 unit powder for injection
 
 
Dactinomycin
(Injection)
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Formulary
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  • 500microgram powder for reconstitution
 
 
Daunorubicin
(Injection)
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Formulary
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  • 20mg infusion
 
 
Doxorubicin
(Injection)
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Formulary
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  • 10mg/5ml, 50mg/25ml, 100mg/50ml and 200mg/100ml injection
 
 
Doxorubicin (Caelyx®)
(Liposomal injection)
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Formulary
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High Cost Medicine
NHS England
 
Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
 
Epirubicin
(Injection)
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Formulary
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  • 10mg/5ml and 50mg/25ml injection
  • 100mg/50ml, 200mg/100ml infusion
 
 
Idarubicin
(Injection and capsules)
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Formulary
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  • 5mg, 10mg and 25mg capsules
  • 5mg and 10mg injection
 
 
Mitomycin
(Injection)
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Formulary
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  • 2mg and 10mg injection
 
 
Mitoxantrone
(Injection)
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Formulary
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  • 20mg/10ml infusion
 
 
Pixantrone
(Injection)
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Formulary
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High Cost Medicine
NHS England
  • 29mg powder for infusion

 

 
Link  NICE TA306: Pixantrone monotherapy
 
08.01.03  Antimetabolites to top
Azacitidine
(Injection)
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Formulary
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High Cost Medicine
NHS England
  • 100mg injection
 
Link  NICE TA218: azacitidine for myelodysplastic syndromes
 
Capecitabine
(Tablets)
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Formulary
traffic lightRed
  • 150mg and 500mg tablets
 
Link  NICE TA100: Colon cancer (adjuvant) - capecitabine and oxaliplatin
Link  NICE TA191: Gastric cancer (advanced) - capecitabine
 
Cladribine
(Injection)
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Formulary
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High Cost Medicine
  • 10mg tablet
  • 10mg/10ml solution for infusion
  • 10mg/5ml solution for injection
  • For specialist use only in accordance with guidance from cancer network or NICE
 
Link  NICE TA616: Cladribine for treating relapsing–remitting multiple sclerosis
 
Cytarabine
(Injection)
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Formulary
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  • 100mg/5ml, 500mg/25ml, 1g/10ml, 2g/20ml and 500g/5ml injection
 
 
Fludarabine Phosphate (Injection)
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Formulary
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  • 50mg/2ml injection
 
Link  NICE TA119: Leukaemia (lymphocytic) - fludarabine
Link  NICE TA29: Leukaemia (lymphocytic) - fludarabine
 
Fludarabine Phosphate (Tablets)
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Formulary
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  • 10mg tablets
 
Link  NICE TA29: Leukaemia (lymphocytic) - fludarabine
 
Fluorouracil
(Injection)
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Formulary
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  • 250mg/10ml, 500ml/20ml, 500mg/10ml and 1g/20ml injection
  • 2.5mg/100ml, 2.5mg/50ml and 5mg/100ml infusion
  • For topical cream see chapter 13.8.1

 

 
 
Gemcitabine
(Injection)
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Formulary
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  • Various strengths of infusion
 
Link  NICE TA116: Breast cancer - gemcitabine
Link  NICE TA25: Pancreatic cancer - gemcitabine
Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
 
Mercaptopurine
(Tablets)
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Formulary
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  • 50mg tablets
  • Note: Only the 50mg strength tablets are included on the formulary for gastro indications in adults10mg strength tablets are unlicensed specials. Alternate dosing using 50mg/100mg should be considered where daily doses between 50 and 100mgs are required for adults.
  • For use in children see paediatric chapter
  • For use in Crohn's disease, see chapter 1
 
 
Methotrexate
(Tablets)
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Formulary
traffic lightRed

 

 
 
Pemetrexed
(Injection)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
 
Link  NICE TA135: Mesothelioma - pemetrexed disodium
Link  NICE TA181: Lung cancer (non-small cell, first line treatment) - pemetrexed
Link  NICE TA190: Lung cancer (non-small-cell) - pemetrexed (maintenance)
Link  NICE TA402: Pemetrexed maintenance treatment for non-squamous non-small-cell lung cancer after pemetrexed and cisplatin
 
Clofarabine
(Injection)
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Unlicensed Drug Unlicensed
traffic lightRed
High Cost Medicine
  • 20mg/20ml infusion
  • ONLY Approved for use in acute myeloblastic leukaemia in accordance with the criteria set out by the NHS England Cancer Drugs Fund

 

 

 
 
08.01.04  Vinca alkaloids and etoposide
Etoposide
(Injection)
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Formulary
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  • 100mg/5ml, 200mg/10ml and 500mg/25ml infusion
 
 
Etoposide
(Capsules)
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Formulary
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  • 50mg and 100mg capsules
 
 
Vinblastine Sulphate (Injection)
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Formulary
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  • 1mg/10ml solution for injection
 
 
Vincristine Sulphate (Injection )
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Formulary
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  • 1mg/1ml, 2mg/2ml and 5mg/5ml injection 
 
 
Vindesine Sulphate
(Injection)
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Formulary
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  • 5mg injection
 
 
Vinorelbine
(Capsules)
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Formulary
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  • 20mg, 30mg and 80mg capsules
 
 
Vinorelbine
(Injection)
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Formulary
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  • 10mg/1ml and 50mg/5ml infusion
 
 
08.01.05  Other antineoplastic drugs
Abemaciclib
(Tablets)
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Formulary
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High Cost Medicine
NHS England
  • 50mg, 100mg, 150mg film coated tablets
 
Link  NICE TA563: Abemaciclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
Link  NICE TA579: Abemaciclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy
 
Atezolizumab
(Injection)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
 
Link  NICE TA492: Atezolizumab for untreated locally advanced or metastatic urothelial cancer when cisplatin is unsuitable
Link  NICE TA520 : Atezolizumab for treating locally advanced or metastatic non-small-cell lung cancer after chemotherapy
Link  NICE TA525: Atezolizumab for treating locally advanced or metastatic urothelial carcinoma after platinum-containing chemotherapy
Link  NICE TA584: Atezolizumab in combination for treating metastatic non-squamous non-small-cell lung cancer
Link  NICE TA666: Atezolizumab with bevacizumab for treating advanced or unresectable hepatocellular carcinoma
 
Avelumab
(injection)
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Formulary
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  • 200mg/10ml concentrate for solution for infusion vials
  • For use in combination with axitinib in line with NICE TA645 [Not at SFT]
 
Link  NICE TA517: Avelumab for treating metastatic Merkel cell carcinoma
Link  NICE TA645 Avelumab with axitinib for untreated advanced renal cell carcinoma
 
Axitinib
(Tablets)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 1mg, 3mg, 5mg and 7mg tablets
 
Link  NICE TA333: Axitinib for advanced renal cell carcinoma
Link  NICE TA645 Avelumab with axitinib for untreated advanced renal cell carcinoma
 
Bosutinib
(Tablets)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
 
Link  NICE TA401: Bosutinib for previously treated chronic myeloid leukaemia
 
Brigatinib
(Tablets)
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Formulary
traffic lightRed
  • 30mg, 90mg and 180mg
 
Link  NICE TA571 :Brigatinib for treating ALK-positive advanced non-small-cell lung cancer after crizotinib
 
Cabozantinib
(Tablets)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 20mg, 40mg and 60mg tablets
 
Link  NICE TA542: Cabozantinib for untreated advanced renal cell carcinoma
 
Carfilzomib
(Injection)
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Formulary
traffic lightRed
NHS England
  • 10mg, 30mg and 60mg infusion
 
Link  NICE TA457 : Carfilzomib for previously treated multiple myeloma
Link  NICE TA657: Carfilzomib for previously treated multiple myeloma
Link  MHRA November 2019 - Carfilzomib (Kyprolis▼): risk of reactivation of hepatitis B virus
Link  MHRA August 2019 - Carfilzomib (Kyprolis▼): reminder of risk of potentially fatal cardiac events
 
Ceritinib
(Capsules)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 150mg capsules
 
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
 
Dabrafenib
(Capsules)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 50mg and 75mg capsules

 

 
Link  NICE TA321:Dabrafenib for BRAF V600 +ve 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 melanom
 
Daratumumab
(Injection)
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Formulary
traffic lightRed
High Cost Medicine

 

 
Link  MHRA Drug Safety Update (Aug 2019): Daratumumab (Darzalex¥): risk of reactivation of hepatitis B virus
 
Defibrotide
(Injection)
Restricted Drug Restricted
traffic lightRed
High Cost Medicine
NHS England
  • 200mg (80 mg/mL concentrate for solution for infusion)
  • For the treatment of veno-occlusive disease in accordance with treatment of possible hepatic veno-occlusive disease as noted in link below
  • Formulary at RUH for this indication
 
Link  Inotuzumab ozogamicin for treating relapsed or refractory B-cell acute lymphoblastic leukaemia
 
Durvalumab
(Injection)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 50 mg/mL concentrate for solution for infusion

 

 
Link  NICE TA578: Durvalumab for treating locally advanced unresectable non-small-cell lung cancer after platinum-based chemoradiation
 
Eribulin
(Injection)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 0.88mg/2ml solution for injection

 

 
Link  NICE TA423: Eribulin for treating locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens
 
Ibrutinib
(Capsules)
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Formulary
traffic lightRed
High Cost Medicine
 
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
 
Idelalisib
(Tablets)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 100mg and 150mg tablets
 
Link  NICE TA359: Chronic lymphocytic leukaemia - Idelalisib
 
Inotuzumab Ozogamicin (Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 1mg infusion

 

 
Link  NICE TA541: Inotuzumab ozogamicin for treating relapsed or refractory B-cell acute lymphoblastic leukaemia
 
Isatuximab
(injection)
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Formulary
traffic lightRed
  • 20mg/ml concentrate for solution for infusion vials
  • For use in combination with pomalidomide and dexamethasone for treating relapsed and refractory multiple myeloma in line with TA658.
    axitinib in line with NICE TA645
 
Link  NICE TA658: Isatuximab with pomalidomide and dexamethasone for treating relapsed and refractory multiple myeloma
 
Ixazomib
(Capsules)
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Formulary
traffic lightRed
High Cost Medicine
BlueTeq
  • 2.3mg, 3mg and 4mg capsules
  • To treat relapsed/defractory myeloma in combination with Lenalidomaide and Dexamethasone
  • To treat multple myeloma via the Cancer Drugs Fund
 
 
Lenvatinib
(Capsules)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 4mg and 10mg capsules
  • Different brand depending upon indication

 

 
Link  NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine
Link  NICE TA551: Lenvatinib for untreated advanced hepatocellular carcinoma
 
Lenvatinib with Everolimus
(Capsules)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 4mg and 10mg capsules
  • Different brand depending upon indication

 

 
Link  NICE TA498: Lenvatinib with everolimus for previously treated advanced renal cell carcinoma
 
Midostaurin
(Capsules)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 25mg capsules
 
Link  NICE TA523: Midostaurin for untreated acute myeloid leukaemia
 
Nintedanib
(Capsules)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 100mg and 150mg capsules

 

 
Link  NICE TA347 For treating locally advanced, metastatic or locally recurrant non-small-cell lung cancer
 
Palbociclib
(Capsules)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 75mg, 100mg and 125mg capsules

 

 
Link  NICE TA495 Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic brest cancer
Link  NICE TA619 Palbociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer
 
Panitumumab
(Injection)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 100mg/5ml and 400mg/20ml infusion

 

 
Link  NICE TA439 : Cetuximab and panitumumab for previously untreated metastatic colorectal cancer
 
Pembrolizumab
(Injection)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 100mg/4ml concentration for solution for infusion
  • 50mg powder for concentration for solution for infusion
  • Also available from NHS England Cancer Drugs Fund
  • NICE does not recommend pembrolizumab with axitinib for untreated advanced renal cell carcinoma (TA650).
 
Link  NICE TA357: Pembrolizumab for melanoma after 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
Link  NICE TA650: Pembrolizumab with axitinib for untreated advanced renal cell carcinoma (not recommended)
Link  NICE TA661: Pembrolizumab for untreated metastatic or unresectable recurrent head and neck squamous cell carcinoma
 
Polatuzumab vedotin
(Injection)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 140mg powder for concentrate for solution for infusion vials
  • For use in combination with rituximab and bendamustine in line with NICE TA649

 

 
Link  NICE TA649 Polatuzumab vedotin with rituximab and bendamustine for treating relapsed or refractory diffuse large B-cell lymphoma
 
Ponatinib
(Tablets)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 15mg, 30mg and 45mg tablets

 

 
Link  NICE TA451 : Ponatinib for treating chronic myeloid leukaemia and acute lymphoblastic leukaemia
 
Ruxolitinib
(Tablets)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 5mg, 10mg, 15mg and 20mg tablets
 
Link  NICE TA386: Ruxolitinib for treating disease-related splenomegaly or symptoms in adults with myelofibrosis
 
Trametinib
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 0.5mg and 2mg tablets

 

 
Link  MHRA: Trametinib (Mekinist¥): risk of gastrointestinal perforation and colitis
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
 
Trifluridine-tipiracil (Tablets )
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 15mg/6.14mg and 20mg/8.19mg tablets
 
Link  NICE TA405: Trifluridine–tipiracil for previously treated metastatic colorectal cancer
 
Venetoclax
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
 
Link  NICE TA561: Venetoclax with rituximab for previously treated chronic lymphocytic leukaemia
Link  NICE TA663: Venetoclax with obinutuzumab for untreated chronic lymphocytic leukaemia
 
08.01.05  Amsacrine
Amsacrine
(Injection)
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Formulary
traffic lightRed
  • 75mg/1.5ml solution for infusion ampoules and diluent
 
 
08.01.05  Arsenic trioxide
Arsenic Trioxide
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 10mg/10ml infusion
 
Link  NICE TA526: Arsenic trioxide for treating acute promyelocytic leukaemia
 
08.01.05  Bortezomib to top
Bortezomib
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
 
Link  NICE TA129: Multiple myeloma - bortezomib
Link  NICE TA228: 1st line treatment of multiple myeloma
Link  NICE TA311: Bortezomib for induction therapy in multiple myeloma
Link  NICE TA370: Bortezomib for previously untreated mantle cell lymphoma
 
08.01.05  Brentuximab vedotin
Brentuximab
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
 
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
Link  NICE TA577 Brentuximab vedotin for treating CD30-positive cutaneous T-cell lymphoma
Link  NICE TA641 Brentuximab vedotin in combination for untreated systemic anaplastic large cell lymphoma
 
08.01.05  Cetuximab
Cetuximab
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
 
Link  NICE TA145: Head and neck cancer - cetuximab
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
 
08.01.05  Dacarbazine and Temozolomide
Dacarbazine
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
  • 500mg and 1g infusion
  • 100mg and 200mg injection
 
 
Temozolomide
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 5mg, 20mg, 100mg, 140mg, 180mg and 250mg capsules

 

 
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
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
  • 25mg, 100mg and 150mg tablets
 
Link  NICE TA227: Lung cancer (non-small-cell) maintenance - erlotinib
Link  NICE TA258: Lung cancer (non-small-cell) 1st line- erlotinib
Link  NICE TA374: Erlotinib and gefitinib for treating non-small-cell lung cancer that has progressed after prior chemotherapy
 
08.01.05  Hydroxycarbamide to top
Hydroxycarbamide
(Capsules)
View adult BNF View SPC online
Formulary
  • Red  RUH 
  • Amber with Shared Care SFT and GWR
  • 500mg capsules
 
Link  3Ts Hydroxycarbamide Shared Care Document
Link  SFT Hydroxycarbamide Shared Care Document
 
08.01.05  Ipilimumab
Ipilimumab
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
 
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 TA400: Nivolumab in combination with ipilimumab for treating advanced melanoma
Link  MHRA Drug Safety Update (Jan 2019):Ipilimumab (Yervoy): reports of cytomegalovirus (CMV) gastrointestinal infection or reactivation
 
08.01.05  Pentostatin
Pentostatin
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
  • 10mg infusion

 

 
 
08.01.05  Platinum compounds
Carboplatin
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
  • 150mg/15ml, 450mg/45ml, 50mg/5ml and 600mg/60ml infusion
 
 
Cisplatin
(Injection)
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Formulary
traffic lightRed
  • 10mg/10ml, 50mg/50ml and 100mg/100ml infusion
 
 
Oxaliplatin
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
  • 50mg/10ml, 100mg/20ml and 200mg/40ml infusion
 
Link  NICE TA100: Colon cancer (adjuvant) - capecitabine and oxaliplatin
 
08.01.05  Procarbazine
Procarbazine
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
  • 50mg capsules

 

 
 
08.01.05  Protein kinase inhibitors to top
Afatinib
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 20mg, 30mg, 40mg and 50mg tablets
 
Link  NICE TA310: Afatinib for treating epidermal growth factor receptor mutation-positive locally advanced or metastatic non-small-cell lung cancer
 
Cabozantinib
(Oral)
View adult BNF View SPC online
Formulary
traffic lightRed
 
Link  NICE TA463 : Cabozantinib for previously treated advanced renal cell carcinoma
Link  NICE TA516: Cabozantinib for treating medullary thyroid cancer
Link  NICE TA542: Cabozantinib for untreated advanced renal cell carcinoma
 
Crizotinib
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England

 

 
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 cance
 
Dasatinib
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 20mg, 50mg, 80mg, 100mg and 140mg tablets

 

 
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
 
Entrecitinib
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 100mg, 200mg capsules 
  • Use in line with NICE TA643 and 644
 
Link  NICE TA 644 Entrectinib for treating NTRK fusion-positive solid tumours
Link  NICE TA643 Entrectinib for treating ROS1-positive advanced non-small-cell lung cancer
 
Everolimus (Afinitor®)
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 2.5mg, 5mg and 10mg tablets
  • Ensure correct brand is prescribed.

 

 
Link  NICE TA421: Everolimus with exemestane for treating advanced breast cancer after endocrine therapy
Link  NICE TA432: Everolimus 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 TA498: Lenvatinib with everolimus for previously treated advanced renal cell carcinoma
 
Everolimus (Votubia®)
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
BlueTeq
  • Only at RUH
  • 2.5mg, 5mg and 10mg tablets
  • Ensure correct brand is supplied
  • To be prescribed by specialist centres in accordance with NHSE commissioning policies
 
Link  Clinical Commissioning Policy: Everolimus for refractory focal onset seizures associated with tuberous sclerosis complex (ages 2 years and above)
Link  Clinical Commissioning Policy: Everolimus for refractory focal onset seizures associated with tuberous sclerosis complex (ages 2 years and above)
 
Gefitinib
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 250mg tablets
 
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
 
Gilteritinib
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 40mg tablets
  • Use in line with NICE TA642
 
Link  NICE TA642 Gilteritinib for treating relapsed or refractory acute myeloid leukaemia
 
Imatinib (Gilvec®)
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 100mg and 400mg tablets
  • Ensure correct brand supplied

 

 

 
Link  NICE TA326: Imatinib for the adjuvant treatment of gastrointestinal stromal tumours
 
Imatinib (Generic)
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 100mg and 400mg tablets
  • Also for treatment of Philadelphia Positive Guidelines ALL as per BCSH Guidelines

 

 
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
 
Nilotinib
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 150mg and 200mg capsules
 
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
 
Pazopanib
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 200mg and 400mg tablets
 
Link  NICE TA215: Pazopanib in renal cell cancer
 
Regorafenib
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 40mg tablets

 

 
Link  NICE TA488: Regorafenib for previously treated unresectable or metastatic gastrointestinal stromal tumours
Link  NICE TA555: Regorafenib for previously treated advanced hepatocellular carcinoma
 
Sorafenib
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 200mg tablets

 

 
Link  NICE TA474: Sorafenib for treating advanced hepatocellular carcinoma
Link  NICE TA535: Lenvatinib and sorafenib for treating differentiated thyroid cancer after radioactive iodine
 
Sunitinib
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 12.5mg, 25mg and 50mg capsules

 

 
Link  NICE TA169: Renal cell carcinoma - sunitinib
Link  NICE TA179: Gastrointestinal stromal tumours - sunitinib
Link  NICE TA449 : Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease
 
Tivozanib
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 890microgram and 1340microgram capsules

 

 
Link  NICE TA512: Tivozanib for treating advanced renal cell carcinoma
Link  Tivozanib for treating advanced renal cell carcinoma
 
Vemurafenib
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 240mg tablets
 
Link  NICE TA269: Vemurafenib for treating malignant melanoma
 
08.01.05  Taxanes
Cabazitaxel
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 60mg/1.5ml infusion
 
Link  NICE TA391: Cabazitaxel for hormone-relapsed metastatic prostate cancer treated with docetaxel
 
Docetaxel
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
  • Various concentrations of infusion
 
Link  NICE TA101: Prostate cancer (hormone-refractory) - docetaxel
Link  NICE TA109: Breast cancer (early) - docetaxel
 
Paclitaxel
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
  • Various strengths of concentration
 
Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
Link  NICE TA476: Paclitaxel as albumin-bound nanoparticles with gemcitabine for untreated metastatic pancreatic cancer
 
Paclitaxel (Abraxane®)
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 100mg infusion
 
Link  NICE TA476: Paclitaxel as albumin-bound nanoparticles with gemcitabine for untreated metastatic pancreatic cancer
 
08.01.05  Topoisomerase I inhibitors
Irinotecan hydrochloride
(Injection )
View adult BNF View SPC online
Formulary
traffic lightRed
  • 500mg/25ml, 300mg/15ml, 100mg/5ml and 40mg/2ml infusion
 
Link  MHRA Drug Safety Update (Mar 2019):Onivyde (irinotecan, liposomal formulations): reports of serious and fatal thromboembolic events
 
Topotecan
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
  • 4mg/4ml infusion

 

 
Link  NICE TA183: Cervical cancer (recurrent) - topotecan
Link  NICE TA389 - Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
 
Topotecan
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
  • 250microgram and 1mg capsules
 
Link  NICE TA184: Lung cancer (small-cell) - topotecan
 
08.01.05  Trabectedin
Trabectedin
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
  • 250microgram and 1mg infusion
 
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
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 420mg/14ml infusion

 

 
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
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 600mg/5ml injection  Herceptin®
  • 150mg and 420mg infusion Ontruzant®  
  • Prescribe by brand.  Biosimilar Ontruzant first line option

 

 
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
 
Trastuzumab emtansine
(Kadcyla®)
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 100mg and 160mg infusion

 

 
Link  NICE TA458 : Trastuzumab emtansine for treating HER2-positive advanced breast cancer after trastuzumab and a taxan
 
08.01.05  Tretinoin to top
Tretinoin
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
  • 10mg capsules
 
 
08.01.05  Vismodegib
08.02  Drugs affecting the immune response
Blinatumomab
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
 
Link  NICE TA450 : Blinatumomab for previously treated Philadelphia-chromosome-negative acute lymphoblastic leukaemia
 
08.02.01  Antiproliferative immunosuppressants
Azathioprine
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
  • 25mg and 50mg tablets
  • Chemotherapy/post transplant
 
 
Mycophenolate Mofetil
(Oral )
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
  • 250mg capsules
  • 500mg tablets
 
Link  Mycophenolate mofetil, mycophenolic acid: new pregnancy-prevention advice for women and men
 
08.02.02  Corticosteroids and other immunosuppressants
Ciclosporin
View adult BNF View SPC online
Formulary
traffic lightRed
  • 25mg, 50mg and 100mg capsules
  • 250mg in 5ml ampoules for intravenous infusion 
  • Preparations are not interchangeable and must be specified/clarified by prescriber
  • Prescribing responsibility for use in transplant indications (solid organ and bone marrow transplant) remains with specialised service managing transplant (NHSE commissioned)
  • TLS Red when used by secondary care services in non-transplant indications 
 
 
Tacrolimus
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
  • 500microgram, 1mg and 5mg capsules
  • Indicated for bone marrow stem cell transplant.
  • The brand to be dispensed should be specified by the prescriber due to differences in bioavailability.
  • Preparations are not interchangeable.
 
Link  Oral tacrolimus products: reminder to prescribe and dispense by brand name only
 
Tacrolimus
(AdoPORT ®Prograf®Advagraf®)
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • AdoPORT 500microgram, 750microgram, 1mg, 2mg and 5mg capsules
  • Prograf 500micrograms, 1mg, and 5mg capsules 
  • Advagraf 500microgram, 1mg, 3mg, 5mg modified release capsules
  • For SOLID organ transplant patients continue on brand specifed by the specialist prescriber.
  • Preparations are not interchangeable.
  • NHSE commissioner when tacrolimus used for solid organ transplants. Available from Specialist Centres ONLY.

 

 

 

 
 
08.02.03  Anti-lymphocyte monoclonal antibodies to top
Alemtuzumab
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 12mg/1.2ml infusion
 
Link  Feb 2020 MHRA DSU - Lemtrada▼ (alemtuzumab): updated restrictions and strengthened monitoring requirements following review of serious cardiovascular and immune-mediated reactions
Link  NICE TA312: Alemtuzumab for relapsing‑remitting multiple sclerosis
Link  MHRA Drug Safety Update (May 2019):Lemtrada (alemtuzumab) and serious cardiovascular and immune-mediated adverse reactions
 
Obinutuzumab
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
 
Link  NICE TA343: Obinutuzumab with chlorambucil for CLL
Link  NICE TA513:Obinutuzumab for untreated advanced follicular lymphoma
 
Ocrelizumab
(injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 300mg vial
 
Link  NICE TA533: Ocrelizumab for treating relapsing–remitting multiple sclerosis
Link  NICE TA585: Ocrelizumab for treating primary progressive multiple sclerosis
 
Rituximab (Truxima)
(injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 100mg/10ml and 500mg/50ml infusion
  • Prescribe by Brand Biosimilar First Line
 
Link  NICE TA 137 Rituximab for the treatment of relapsed or refractory stage III or IV follicular non-Hodgkin’s lymphoma
Link  NICE TA 243 Rituximab for the first-line treatment of stage III-IV follicular lymphoma
Link  NICE TA174 Rituximab for the first-line treatment of chronic lymphocytic leukaemia
Link  NICE TA193 Rituximab for the treatment of relapsed or refractory chronic lymphocytic leukaemia (TA193)
Link  NICE TA226 Rituximab for the first-line maintenance treatment of follicular non-Hodgkin’s lymphoma
Link  NICE TA649 Polatuzumab vedotin with rituximab and bendamustine for treating relapsed or refractory diffuse large B-cell lymphoma
 
Rituximab (MabThera®)
(Subcutaneous injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 1400mg/11.7ml injection
  • For single agent maintenance for follicular lymphoma according to NHSE Circular SSC 1434 July 2014
  • Prescribe by Brand
 
 
08.02.04  Other immunomodulating drugs
Dimethyl fumarate
(Oral)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 120mg and 240mg capsules
  • NB Tecfidera brand only licensed for Multiple Sclerosis
  • Check full blood counts before prescribing dimethyl fumarate and then every 6 to 12 months. Stop treatment immediately if progressive multifocal leukoencephalopathy is suspected.
 
Link  NICE TA320: Dimethyl fumarate for multiple sclerosis
Link  MHRA DSU Jan 2021 Dimethyl fumarate (Tecfidera): updated advice on the risk of progressive multifocal leukoencephalopathy (PML) associated with mild lymphopenia
Link  MHRA DSU Mar 2015 Dimethyl fumarate (Tecfidera): fatal PML in an MS patient with severe, prolonged lymphopenia
 
Dinutuximab
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 20mg/4.5ml infusion
  • Only for use in line with NHSE commissioning (see link below)

 

 

 
Link  NICE TA538: Dinutuximab beta for treating neuroblastoma
 
Fingolimod
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 0.5mg capsules
 
Link  NICE TA254: Fingolimod for highly active relapsing remitting multiple sclerosis
Link  Clinical Commissioning Policy: Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)
Link  EMC Risk Minimisation materials: Gilenya (fingolimod)
Link  MHRA DSU Jan 2021 Fingolimod (Gilenya): updated advice about the risks of serious liver injury and herpes meningoencephalitis
Link  MHRA DSU Sep 2019 Fingolimod (Gilenya): increased risk of congenital malformations; new contraindication during pregnancy and in women of childbearing potential not using effective contraception
Link  MHRA DSU Dec 2017 Fingolimod (Gilenya): new contraindications in relation to cardiac risk
Link  MHRA DSU Dec 2017 Fingolimod (Gilenya): updated advice about risk of cancers and serious infections
 
Lenalidomide
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
 
Link  Immunomodulatory drugs and pregnancy prevention: temporary advice for management during coronavirus (COVID-19)
Link  Lenalidomide (Revlimid): risk of serious hepatic adverse drug reactions – routine monitoring of liver function now recommended
Link  Lenalidomide: risk of thrombosis and thromboembolism
Link  NICE TA 322 Lenalidomide for treating myelodysplastic syndromes associated with an isolated deletion 5q cytogenetic abnormality
Link  NICE TA 586 Lenalidomide plus dexamethasone for multiple myeloma after 1 treatment with bortezomib
Link  NICE TA171: Lenalidomide for the treatment of multiple myeloma in people who have received at least 2 prior therapies
Link  NICE TA587 Lenalidomide plus dexamethasone for previously untreated multiple myeloma
 
Niraparib
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
 
 
Nivolumab
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
 
Link  Oct 2019 - reports of cytomegalovirus (CMV) gastrointestinal infection or reactivation
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
Link  NICE TA655: Nivolumab for advanced squamous non-small-cell lung cancer after chemotherapy
 
Olaparib
(Oral)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 50mg capsules
  • NB other strengths exist these are not formulary

 

 
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
Link  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
 
Osimertinib
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 40mg and 80mg tablets
 
Link  NICE TA 653: Osimertinib for treating EGFR T790M mutation-positive advanced non-small-cell lung cancer
Link  NICE TA654: Osimertinib for untreated EGFR mutation-positive non-small-cell lung cancer
 
Panobinostat
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 10mg, 15mg and 20mg capsules
 
Link  NICE TA380: Panobinostat for treating multiple myeloma after at least 2 previous treatments
 
Pegaspargase
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 3,750mg/5ml injection
 
Link  NICE TA408: Pegaspargase for treating acute lymphoblastic leukaemia
 
Pomalidomide
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
 
Link  Immunomodulatory drugs and pregnancy prevention: temporary advice for management during coronavirus (COVID-19)
Link  NICE TA388: Pomalidomide for myeloma
Link  NICE TA427: Pomalidomide for multiple myeloma previously treated with lenalidomide and bortezomib
 
Siponimod
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 250 microgram and 2mg film coated tablets
 
Link  NICE TA656: Siponimod for treating secondary progressive multiple sclerosis
 
Teriflunomide
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 14mg tablets
 
Link  Clinical Commissioning Policy: Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)
Link  NICE TA303: Teriflunomide for relapsing remitting MS
 
Thalidomide
(Capsules)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 50mg capsules
 
Link  Immunomodulatory drugs and pregnancy prevention: temporary advice for management during coronavirus (COVID-19)
Link  NICE TA228: Bortezomib and thalidomide for the first‑line treatment of multiple myeloma
 
08.02.04  Interferon Alfa
Peginterferon Alfa (Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 90microgram/0.5ml, 135microgram/0.5ml and 180microgram/0.5ml pre-filled syringes
 
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
 
Peginterferon Alfa (Injection )
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
  • 90microgram/0.5ml, 135microgram/0.5ml and 180microgram/0.5ml pre-filled syringes
  • For the treament of leukaemia and lymphoma in accordance with cancer network guidelines
  • For the treatment of Myeloproliferative Neoplasms e.g Essential Thrombocythaemia, Polycythaemia after hydroxycarbamide or anagralide.
 
 
08.02.04  Interferon beta
Interferon Beta
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 30microgram/0.5ml pre-filled (6 million units) syringes
 
Link  Clinical Commissioning Policy: Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)
Link  NICE TA527 Beta interferons and glatiramer acetate for treating multiple sclerosis
 
Interferon Beta
(Extavia®)
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • Extavia® 250 microgram/ml powder and solvent for solution for injection
  • After reconstitution, each ml contains 250 microgram (8.0 million IU) of recombinant interferon beta-1b
 
Link  Clinical Commissioning Policy: Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)
Link  NICE TA527 Beta interferons and glatiramer acetate for treating multiple sclerosis
 
Interferon Beta (Rebif®)
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 22micrgoram/0.5ml and 8.8microgram/0.2ml cartridges and pre-filled pens/syringes
  • 44microgram/0.5ml cartridges and pre-filled pens/syringes
 
Link  Clinical Commissioning Policy: Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)
Link  NICE TA527: Beta interferons and glatiramer acetate for treating multiple sclerosis
 
Peginterferon Beta-1a (Injection )
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 63microgram/0.5ml, 94microgram/0.5ml and 125microgram/0.5ml pre-filled pens
 
Link  Clinical Commissioning Policy: Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)
Link  Link NICE TA527: Beta interferons and glatiramer acetate for treating multiple sclerosis
 
08.02.04  Glatiramer acetate
Glatiramer Acetate
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 20mg/1ml and 40mg/1ml injection
 
Link  Clinical Commissioning Policy: Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)
Link  NICE TA527 Beta interferons and glatiramer acetate for treating multiple sclerosis
 
08.02.04  Lenalidomide, pomalidomide, and thalidomide to top
Clarithromycin
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightRed
  • RUH only
  • Used in combination with lenalidomide and pomalidomide as per DTC899
  • 250mg and 500mg tablets
 
 
08.02.04  Mifamurtide
Mifamurtide
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
  • 4mg infusion
  • When used in line with NICE TA235 (as below) and initiated by specialist centres ONLY 

 

 
Link  NICE TA235: Osteosarcoma - mifamurtide: guidance
 
08.02.04  Natalizumab
Natalizumab
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 300mg/15ml infusion
 
Link  Clinical Commissioning Policy: Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)
Link  NICE TA127: Multiple sclerosis - natalizumab
 
08.03  Sex hormones and hormone antagonists in malignant disease
08.03.01  Oestrogens
Diethylstilbestrol
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightAmber
  • 1mg and 5mg tablets
 
 
08.03.02  Progestogens to top
Medroxyprogesterone Acetate
(Tablets )
View adult BNF View SPC online
Formulary
traffic lightAmber
  • 2.5mg, 5mg, 10mg, 100, 200mg and 400mg tablets
  • Specialist initiation only for endometrial cancer
 
 
Megestrol Acetate
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightAmber
  • 160mg tablets
  • Specialist initiation only for endometrial cancer.
 
 
Norethisterone
(Tablets)
View adult BNF View SPC online
Formulary
traffic lightAmber
  • 350microgram and 5mg tablets
  • Specialist initiation only for endrometrial cancer.
 
 
08.03.03  Androgens
08.03.04  Hormone antagonists
08.03.04.01  Breast cancer
Anastrozole
(Tablets)
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Formulary
traffic lightAmber
  • 1mg tablets
 
 
Exemestane
(Tablets)
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Formulary
traffic lightAmber
  • 25mg tablets
 
 
Fulvestrant (Faslodex®)
View adult BNF View SPC online
Formulary
traffic lightRed
  • 250mg/5ml pre-filled syringes
  • Commissioned by CDF in in combination with abemaciclib , palbciclib or ribociclib for treating hormone receptor-positive, HER2-negative advanced breast cancer (TA579/593/619). NICE does not recommend for treatment of locally advanced or metastatic breast cancer (TA239/503).
 
Link  NICE TA579: Abemaciclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy
Link  NICE TA593: Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer
Link  NICE TA619: Palbociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer
Link  NICE TA239: Fulvestrant for the treatment of locally advanced or metastatic breast cancer (not recommended)
Link  NICE TA503: Fulvestrant for untreated locally advanced or metastatic oestrogen-receptor positive breast cancer (not recommended)
 
Ibandronic Acid
(50mg Tablet)
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Formulary
traffic lightAmber with Shared Care
  • Patients from RUH and GWH only -Adjuvant bisphosphonates for breast cancer (see shared care agreement). Under review for SFT.
  • For use by oncology only.
  • Ibandronic Acid 'off label' indication
  • Tablets 50mg daily

 

 
Link  RUH/GWH Shared care agreement - adjuvant therapy for postmenopausal patients
 
Letrozole
(Tablets)
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Formulary
  • 2.5mg tablet 

  • Amber - For treatment of breast cancer.

  • Red - For the second-line treatment of patients with anovulatory infertility unresponsive to Clomifene at RUH and GWH only. Not included for this indication on the formulary at SFT.
 
 
Ribociclib
(Tablets)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 200mg tablets
 
Link  NICE TA496: Ribociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
Link  NICE TA593 Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer
 
Tamoxifen
(Tablets)
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Formulary
traffic lightAmber
  • 10mg, 20mg and 40mg tablets
 
 
08.03.04.02  Prostate cancer and gonadorelin analogues
Radium-223 dichloride (Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
 
Link  NICE TA412: Radium-223 dichloride for treating hormone-relapsed prostate cancer with bone metastases
 
08.03.04.02  Gonadorelin analogues to top
Goserelin Acetate
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Formulary
traffic lightAmber
  • 3.6 mg Implant - 1 monthly (Zoladex®)
  • 10.8mg Implant - 3 monthly (Zoladex LA ®)
  • For locally advanced,non-metastatic prostate cancer, as an alternative to surgical castration, or metastatic prostate cancer within the product licence.
 
 
Leuprorelin Acetate (Injection )
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Formulary
traffic lightAmber
  • 3.75mg pre-filled syringes (Prostap® SR DCS) - one month injection
  • 11.25mg pre-filled syringes (Prostap® 3 DCS)  - 3 month injection
  • For locally advanced, non-metastatic prostate cancer, as an alternative to surgical castration, or metastatic prostate cancer as per the licensed indication
  • Lutrate® has been discontinued (Jun 19)
 
 
Triptorelin
(Injection)
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Formulary
traffic lightAmber
  • Triptorelin acetate 3mg SR - 1 monthly injection (Decapeptyl®)
  • Triptorelin acetate Depot - 1 monthly injection (Gonapeptyl®)
  • Triptorelin pamoate 11.25mg SR - 3 monthly Injection (Decapeptyl®)
  • Triptorelin pamoate 22.5mg SR - 6 monthly injection (Decapeptyl®)
  • Consider a switch to 6 monthly preparation for anyone high risk for COVID-19 and currently receiving a 1 month or 3 monthly LHRH in line with guidance below.
  • For locally advanced, non-metastatic prostate cancer, as an alternative to surgical castration, or metastatic prostate cancer within the product licence.
 
Link  BSW CCG Managing male patients with prostate cancer on LHRH analogues during COVID-19 pandemic
 
Degarelix
(Injection)
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Formulary
traffic lightRed
  • 80mg and 120mg infusion
 
Link  NICE TA404: Degarelix for treating advanced hormone-dependent prostate cancer
 
08.03.04.02  Anti-androgens
Abiraterone
(Tablets)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 500mg tablets
 
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
(Tablets)
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Formulary
traffic lightAmber
  • 50mg and 150mg tablets
 
 
Buserelin
(Nasal spray)
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Formulary
traffic lightAmber
  • 100microgram and 150microgram nasal spray
 
 
Cyproterone
(Tablets)
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Formulary
traffic lightAmber
  • 50mg and 100mg tablets
 
Link  June 2020 - Cyproterone acetate: new advice to minimise risk of meningioma
 
Darolutamide
(Tablets)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 300mg tablets
 
Link  NICE TA660: Darolutamide with androgen deprivation therapy for treating hormone-relapsed non-metastatic prostate cancer
 
Enzalutamide
(Tablets)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 40mg tablets
 
Link  NICE TA316: Enzalutamide for prostate cancer
Link  NICE TA377: Enzalutamide for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated
 
08.03.04.03  Somatostatin analogues
Octreotide
(Short acting Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
  • 50microgram/1ml, 100microgram/1ml
  • Also see palliative care chapter for use in management of high output stomas and fistulas 
 
 
Octreotide
(Sandostatin Lar®)
(Long Acting Injection)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • Amber Swindon - relief of symptoms associated with acromegaly
  • 10mg, 20mg and 30mg injection
  • Commissioned by NHS England, as per agreed Trust Guidelines. Use product with lowest procurement cost
  • Carcinoid Syndrome and Neuroendocrine Tumours
  • For the treatment of acromegaly
 
 
Lanreotide
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
NHS England
  • Amber Swindon - relief of symptoms associated with acromegaly
  • Commissioned by NHS England, as per agreed Trust Guidelines. Use product with lowest procurement cost.
  • 60mg/0.5ml, 90mg/0.5ml and 120mg/0.5ml pre-filled syringe
  • Carcinoid Syndrome and Neuroendocrine Tumours
  • For the treatment of acromegaly
 
 
Lutetium (177Lu) oxodotreotide
(Lutathera)
(Injection)
View adult BNF View SPC online
Formulary
traffic lightRed
High Cost Medicine
 
Link  NICE TA539: Lutetium (177Lu) oxodotreotide for treating unresectable or metastatic neuroendocrine tumours
 
 ....
 Non Formulary Items
Anamorelin

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Non Formulary
 
Anamorelin

View adult BNF View SPC online
Non Formulary
 
Carmustine
(Implant)

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Non Formulary
Red
  • 7.7mg implant
  • Non Formulary except when used within a specialist centre as per NICE TA
Link  NICE TA121: Glioma (newly diagnosed and high grade) - carmustine implants and temozolomide
 
Chlorambucil (Leukeran®)
(Tablets)

View adult BNF View SPC online
Non Formulary
Red
  • 2mg tablets
 
Dexrazoxane

View adult BNF View SPC online
Non Formulary
High Cost Medicine

For anthracycline extravasation

 
Disodium Levofolinate
(Lvofolinic acid )

View adult BNF View SPC online
Non Formulary
 
Ethinylestradol
(Cancer)

View adult BNF View SPC online
Non Formulary
 
Fampridine

View adult BNF View SPC online
Non Formulary
High Cost Medicine
 
Flutamide

View adult BNF View SPC online
Non Formulary
 
Interferon Alfa
(Roferon-A®)

View adult BNF View SPC online
Non Formulary
High Cost Medicine
  • DISCONTINUED

 

  • Pre-filled syringes 3 million / 4.5 million / 6 million International Units interferon alfa-2a* per 0.5 millilitres
  • For the treament of leukaemia and lymphoma in accordance with cancer network guidelines
  • For the treatment of Myeloproliferative Neoplasms e.g Essential Thrombocythaemia, Polycythaemia after hydroxycarbamide or anagralide.
 
Mycophenolate Sodium

View adult BNF View SPC online
Non Formulary
 
Neratinib

Non Formulary
 
Olaratumab (Lartruvo®)

View adult BNF View SPC online
Non Formulary
High Cost Medicine

Discontinued

 
Oxaliplatin

View adult BNF View SPC online
Non Formulary
Red
 
Padeliporfin

View adult BNF View SPC online
Non Formulary
Link  NICE TA546: Padeliporfin for untreated localised prostate cancer
 
Prednisolone
(Post- transplant)

View adult BNF View SPC online
Non Formulary
 
Prednisolone
(Immunosuppressant)

View adult BNF View SPC online
Non Formulary
 
Raltitrexed

View adult BNF View SPC online
Non Formulary
Red
 
Rociletinib

View adult BNF View SPC online
Non Formulary
 
Sirolimus (Rapamune®)

View adult BNF View SPC online
Non Formulary
High Cost Medicine
  • Non Formulary Except when used in accordance with NHSE Commissioning Policy for Solid Organ Transplants within specialist centres (not RUH SFT GWH)
 
Sonidegib (Odomzo®)

View adult BNF View SPC online
Non Formulary
 
Thiotepa

View adult BNF View SPC online
Non Formulary
 
Tioguanine

View adult BNF View SPC online
Non Formulary
Red
 
Treosulfan

View adult BNF View SPC online
Non Formulary

Commissioned as per national guidance in combination with Fludarabine in line with NICE TA640. Condition not treated at GWH/RUH/SFT

Link  NICE TA 640 Treosulfan with fludarabine for malignant disease before allogeneic stem cell transplant
 
Vismodegib
(Capsules)

View adult BNF View SPC online
Non Formulary
Red
High Cost Medicine
  • 150mg capsule
  • Not recommended by NICE

 

Link  NICE TA489: Vismodegib for treating basal cell carcinoma
 
Vosaroxin (Qinprezo)

View adult BNF View SPC online
Non Formulary
High Cost Medicine
 
  
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 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
Blueteq
High Cost Drug Approval System

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.  

netFormulary