Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
Unless explicitly stated, any brand names included in brackets next to a drug's generic name are there solely to aid searching and identification, and should not be considered to limit use to that specific brand.
Prophylaxis of acute renal, cardiac or hepatic transplant rejection (in combination with ciclsporin and corticosteroids) under specialist supervision
Also supported for use by consultants for the following specialties (unlicensed uses):
1. Rheumatology - Usually considered in active SLE or other serious connective tissue diseases and vasculitides 2. Gastroenterology – considered in very occasional inflammatory bowel disease patients and autoimmune hepatitis 3. Neurology – usually considered in myasthenia gravis as steroid sparing agent. 4. Respiratory a. idiopathic pulmonary fibrosis intolerant to azathioprine often awaiting lung transplant b. pulmonary vasculitides (Wegner’s granulomatosis, CSS and microscopic polyangitis)
Green - Drugs suitable for generalised use in accordance with position summary.
Inform primary care of need to prescribe using a TTO chart if in patient or Treatment Advice Note (TAN) if Outpatient.
Amber - these drugs require specialist initiation or recommendation
Amber Share Care - Drugs suitable for generalist use, in accordance with position summary, normally following 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.
Red - Drugs for specialist use only, in accordance with position summary. GP’s should not be asked to prescribe these products.
Red ULM - Unlicensed medicines for specialist use only, in accordance with position summary. GP’s should not be asked to prescribe these products.
Grey drugs - No formal commissioning position. Check appropriate CCG /NHSE commissioning list or contact CCG/NHSE Medicines Management team for advice. Fill in individual funding request for appropriate CCG/NHSE. This will need to be signed by the Chief Pharmacist and a copy of the relevant DTC submission attached.
Black - Drugs not routinely commissioned so should not usually be prescribed