Formulary


	NHS Bath and North East Somerset, Swindon and Wiltshire CCG Royal United Hospitals Bath NHS Foundation Trust Great Western Hospitals NHS Foundation Trust Salisbury NHS Foundation Trust

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Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter

Notes:

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

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

Details...

08.02.02

Corticosteroids and other immunosuppressants

Ciclosporin
(Capsules)

Formulary

25mg, 50mg and 100mg 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.
RUH and SFT - Neoral

Tacrolimus
(Capsules)

Formulary

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.

Ciclosporin
(Capimune ^®Deximune^®Neoral^®)
(Capsules)

Formulary

25mg, 50mg and 100mg capsules
For SOLID organ transplant patients continue on brand specifed by the specialist.
Preparations are not interchangeable.
NHSE commissioner when ciclosporin used for solid organ transplants. Available from Specialist Centres ONLY.

Ciclosporin (Sandimmun^®)
(Injection)

Formulary

Tacrolimus
(AdoPORT ^®Prograf^®Advagraf^®)
(Capsules)

Formulary

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.

NICE TA481: Immunosuppressive therapy for kidney transplant in adults

NICE TA85: Renal transplantation - immuno-suppressive regimens (adults)

....

Non Formulary Items

Prednisolone
(Post- transplant)

Non Formulary

Prednisolone
(Immunosuppressant)

Non Formulary

Sirolimus (Rapamune^®)

Non Formulary

Non Formulary Except when used in accordance with NHSE Commissioning Policy for Solid Organ Transplants within specialist centres (not RUH SFT GWH)

Key

	Notes
	Section Title (top level)
	Section Title (sub level)
	First Choice item
	Non Formulary section
	Restricted Drug
	Unlicensed
	Display tracking information
	Link to adult BNF
	Link to SPCs
	Scottish Medicines Consortium

	Cytotoxic Drug
	Controlled Drug
	High Cost Medicine
	Cancer Drugs Fund
	NHS England
	Homecare
	CCG
	High Cost Drug Approval System

Traffic Light Status Information

Status	Description
	RED - Hospital only – to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.
	Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.
	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.
	These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.
	Suitable for patient to be directed to buy themselves
	Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.
	(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.
	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.