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Royal United Hospitals Bath NHS Foundation Trust
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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...
08.03.04.01  Expand sub section  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)
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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
 
 
 ....
 Non Formulary Items
Neratinib

Non Formulary
 
  
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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