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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...
08.02.02  Expand sub section  Corticosteroids and other immunosuppressants
Ciclosporin
(Capsules)
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Formulary
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  • 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)
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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
 
Ciclosporin
(Capimune DeximuneNeoral)
(Capsules)
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Formulary
traffic lightRed
High Cost Medicine
NHS England
  • 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)
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Formulary
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  • Infusion 50mg/ml
 
 
Tacrolimus
(AdoPORT PrografAdvagraf)
(Capsules)
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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.

 

 

 

 
 
 ....
 Non Formulary Items
Prednisolone
(Post- transplant)

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Non Formulary
 
Prednisolone
(Immunosuppressant)

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Non Formulary
 
Sirolimus (Rapamune)

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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)
 
  
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
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Link to adult BNF
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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.  

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