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City Hospitals Sunderland NHS Foundation Trust
 
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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
08.01.02  Expand sub section  Anthracyclines and other cytotoxic antibiotics
Cytotoxic Drug Bleomycin
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Formulary
Red

Injection: 15,000 units (strength formerly expressed as 15mg)
-unlicensedunlicensed also approved for use in intralesional sclerotherapy in the treatment of low-flow vascular lesions – unlicensed indication

 
   
Cytotoxic Drug Dactinomycin
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Formulary
Red

Injection: 500 microgram

 
   
Cytotoxic Drug Daunorubicin
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Formulary
Red

Injection: 20mg
Prefilled syringes: 10mg, 15mg, 35mg & 40mg

 
   
Cytotoxic Drug Doxorubicin Hydrochloride
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Formulary
Red

Injection: 50mg
- includes use with DC Beads for use in transcatheter arterial chemoembolisation (TACE) therapy in patients with hepatocellular cancer

Pegylated liposomal injection: 20mg & 50mg
-approved for the treatment of recurrent ovarian cancer in line with NICE

 
Link  NICE TA 389: Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
   
Cytotoxic Drug Epirubicin hydrochloride
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Formulary
Red

Injections: 50mg
unlicensedunlicensed Injection: 100mg  

 
   
Cytotoxic Drug Idarubicin Hydrochloride
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Formulary
Red

Capsules: 5mg & 10mg
Injection: 10mg

 
   
Cytotoxic Drug Mitomycin
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Formulary
Red

Injection: 10mg, 20mg & 40mg
- Also approved for treatment in combination with 5-Fluorouracil for bladder cancer concurrent with radiotherapy.

 
   
Cytotoxic Drug Mitomycin
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Formulary
Green +

unlicensedunlicensed Preservative free eye drop: 0.04% preservative free eye drops

 
   
Cytotoxic Drug Mitoxantrone
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Formulary
Red

Injection: 20mg in 10ml

 
   
Cytotoxic Drug Pixantrone
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Formulary
Red
High Cost Medicine

Injection: 29mg powder for reconstitution injection
-approved as a possible treatment for adults with multiply relapsed or refractory aggressive non-Hodgkin's B cell lymphoma if they have previously been treated with rituximab and they are having third- or fourth-line treatment NICE

 
Link  NICE TA306: Pixantrone monotherapy for treating multiply relapsed or refractory aggressive non-Hodgkin's B‑cell lymphoma
   
 ....
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
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Link to adult BNF
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Link to SPCs
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

Traffic Light Status Information

Status Description

Red

Drugs for hospital use or use by a specialist within specialist centre only. Initiation and monitoring of treatment should remain under the total responsibility of the appropriate hospital clinician or specialist. These drugs should only be prescribed under the direct supervision of that clinician or specialist and are not suitable for shared care arrangements. The drug should be supplied via the hospital or specialist centre for the duration of treatment.   

Amber

These are specialist drugs which must be initiated by secondary care specialist prescribers, but with the potential to transfer prescribing to primary care within written and agreed shared care protocols and according to the agreed process for transfer of care. For these drugs, in order to ensure patient safety, some aspects of care must remain with the specialist due to their complexity e.g. monitoring of disease or drug response. Other more routine aspects can be transferred to the GP e.g. monitoring of adverse effects and supply of the medicine. The specific responsibilities of the specialist and GP are defined in the shared care agreement for each drug. Shared care agreements are still under development for some amber drugs. Until these are available, it would be expected that any shared care request from secondary care to a GP would be accompanied by written information which defines prescribing and monitoring responsibilities. The hospital specialist should also provide the GP with enough information and support to allow the safe transfer and ongoing management of prescribing into primary care.   

Green +

Drugs which should usually be initiated in secondary care, or by a specialist clinician, but can be safely maintained in primary care with very little or no monitoring required. In some cases there may be a further restriction for use outlined - these will be defined in each case.  

Green

These are defined as new and established drugs, which may be prescribed, initiated, changed or maintained on FP10 by the GP and, if appropriate, discontinued without recourse to secondary care. N.B. DRUGS NOT IDENTIFIED IN THE FORMULARY BY A RED, AMBER OR GREEN+ SYMBOL ARE CLASSIFIED AS GREEN.   

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