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 Formulary Chapter 9: Nutrition and blood - Full Chapter
Notes:

Nutrition/Blood related Prescribing Guidance

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

Nutrition/Blood related Shared Care Agreements

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

 

Self-care

Many of the products in this chapter are available for purchase over-the-counter, and patients are encouraged to self-care, with the support of their community pharmacist, in the first instance.

For further information on self-care & the NHS, please refer to https://www.england.nhs.uk/medicines/conditions-for-which-over-the-counter-items-should-not-routinely-be-prescribed/

 Details...
09.01.04  Expand sub section  Drugs used in autoimmune thrombocytopenic purpura
Eltrombopag 
(Tablet)
View adult BNF View SPC online
Third Choice
Red
High Cost Medicine
CCG
Homecare
BlueTeq
  • 25mg, 50mg
  • See MHRA Drug Safety Update July 18 for information on reports of interferance with bilirubin and creatinine
  • Third line options can be considered for patients with symptoms lasting longer than 12 months in whom first and second line treatment options have failed and there are on-going complications from their thrombocytopenia OR where second-line options are contra-indicated.
 
Link  BSW Treatment Pathway for adult patients with immune (idiopathic) thrombocytopaenia purpura (ITP) Nov 2018
Link  MHRA July 18 Eltrombopag (Revolade): reports of interference with bilirubin and creatinine test results
Link  NICE TA293: Eltrombopag for treating chronic ITP
   
Romiplostim 
(Injection)
View adult BNF View SPC online
Third Choice
Red
High Cost Medicine
CCG
Homecare
BlueTeq
  • 250microgram
  • Third line options can be considered for patients with symptoms lasting longer than 12 months in whom first and second line treatment options have failed and there are on-going complications from their thrombocytopenia OR where second-line options are contra-indicated.
  • The CCG needs to be notified of dose increases over 500 micrograms (2 vials) of romiplostim by submitting a new Blueteq form.
 
Link  BSW Treatment pathway for adult patients with immune (idiopathic) thrombocytopenic purpura (ITP) Nov 2018
Link  NICE TA221: Thrombocytopenic purpura - romiplostim
   
Lusutrombopag 
(Tablets)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
CCG
BlueTeq
  • 3mg film-coated tablets
  • Short-term use for treating severe thrombocytopenia in adults with chronic liver disease needing a planned invasive procedure following NICE TA617.
 
Link  NICE TA617 Lusutrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure Jan 2020
   
Rituximab (Truxima)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
CCG
  • 100mg/10ml and 500mg/50ml infusion
  • Prescribe by Brand Biosimilar First Line
  • Also for the treatment of ITP in accordance with the BSW ITP guidelines
 
Link  BSW Treatment pathway for adult patients with immune (idiopathic) thrombocytopenic purpura (ITP) Nov 2018
   
Anagrelide 
(Capsule)
View adult BNF View SPC online
Formulary
Red
  • 500 microgram
  • For the treatment of essential thrombocythaemia
 
   
 ....
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

Red

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

Amber

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

Amber 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.  

Green

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

Self

Suitable for patient to be directed to buy themselves  

Grey

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

Black

Not currently used. We intend to include this TLS in future to highlight where a decision has been made by either or both the local or national NHS not to routinely commission this preparation for its licensed indications. Do not prescribe.  

Red 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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