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Sunderland Joint Formulary
NHS Sunderland Clinical Commissioning Group
South Tyneside and Sunderland NHS Foundation Trust
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 Formulary Chapter 13: Skin - Full Chapter
13.05.03  Expand sub section  Drugs affecting the immune response
Adalimumab
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First Choice
Red
High Cost Medicine

40mg injection (prefilled syringe)

 
ApremilastBlack Triangle (Otezla)
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Formulary
Red
High Cost Medicine
 
Link  MHRA Drug Safety Update (Jan 2017) Apremilist (Otezla) risk of suicidal thoughts and behaviour
Link  NICE TA419 Apremilist for treating moderate to severe plaque psoriasis.
Link  NICE TA433 Apremilast for treating active psoriatic arthritis
   
Brodalumab ▼Black Triangle
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Formulary
Red

210mg solution in pre-filled syringe

 
Link  NICE TA511 Brodalumab for treating moderate to severe plaque psoriasis
   
Certolizumab Pegol
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Formulary
Red

200mg/ml soln in pre-filled pen or syringe

 

 
Link  NICE TA574: Certolizumab pegol for treating moderate to severe plaque psoriasis
   
Certolizumab pegol
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Formulary
Red

Indicated for treating moderate to severe plaque psoriasis as per NICE recommendations

 
   
Ciclosporin
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Formulary
Amber

 

Note this SCA has not been approved Sunderland and South Tyneside APC or transfer of care.

 
   
DupilumabBlack Triangle
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Formulary
Red

300mg/2ml soln for inj in pre-filled syringe

 

 

 
Link  NICE TA534: Dupilumab for treating moderate to severe atopic dermatitis
   
EtanerceptBlack Triangle
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Formulary
Red
High Cost Medicine

25mg, 50mg  injection (Enbrel & Benapali)

 

 

 

 
Link  NICE TA103: Psoriasis - efalizumab and etanercept
Link  NICE TA199 Etanercept, infliximab and adalimumab for the treatment of psoriatic arthritis
Link  NICE TA455 Adalimumab, etanercept and usterkinumab for treating plaque psoriasis in childen and young people
Link  NTAG April 2016 The Northern (NHS) Treatment Advisory Group recommends the use of etanercept biosimilar Benepali as an option for use in adults where the originator product (Enbrel) would normally be prescribed.
   
Guselkumab▼Black Triangle
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Formulary
Red

100mg/1ml pre-filled syringe

 
Link  NICETA521 Guselkumab for treating moderate to severe plaque psoriasis
   
Hydroxychloroquine
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Formulary
Amber

Tablets: 200 mg 

 
   
Infliximab Black Triangle
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Formulary
Red
High Cost Medicine

100mg injection (Remicade, Inflectra & Remsima)

 
Link  NICE TA134: Infliximab for psoriasis
   
IxekizumabBlack Triangle
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Formulary
Red

80mg solution for injection prefilled pen

Approved for the treatment of moderate to severe plaque psoriasis in adults in line with NICE

 

 
Link  NICE TA442 Ixekizumab for treating moderate tosever plaque psoriasis
   
Cytotoxic Drug Methotrexate
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Formulary
Amber
 
   
Pimecrolimus (Elidel)
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Formulary
Green +

1% cream

 
Link  NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
   
RisankizumabBlack Triangle
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Formulary
Red

75mg prefilled pen

Risankizumab is recommended as an option for treating plaque psoriasis in adults, only if:

  • the disease is severe, as defined by a total Psoriasis Area and Severity Index (PASI) of 10 or more and a Dermatology Life Quality Index (DLQI) of more than 10 and

  • the disease has not responded to other systemic treatments, including ciclosporin, methotrexate and phototherapy, or these options are contraindicated or not tolerated and

  • the company provides the drug according to the commercial arrangement.

 
Link  NICE TA 596: Risankizumab for treating moderate to severe plaque psoriasis
   
SecukinumabBlack Triangle
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Formulary
Red
High Cost Medicine

150 microgram prefilled pen and syringe.

 
Link  NICE TA350: Secukinumab for treating moderate to severe plaque psoriasis
   
Tacrolimus (Protopic)
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Formulary
Green +

Ointment 0.03% & 0/1%

 
Link  NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
   
Tildrakizumab
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Formulary
Red

Indicated for treating moderate to severe plaque psoriasis as per NICE

 
Link  NICE TA 575: Tildrakizumab for treating moderate to severe plaque psoriasis
   
Tildrakizumab
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Formulary
Red

100mg solution for injection in prefilled syringe

NICE TA575 Tildrakizumab for treating moderate to severe plaque psoriasis

 
   
Ustekinumab
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Formulary
Red
High Cost Medicine

Pre-filled syringe: 45 mg/0.5 mL and 90 mg/1 mL

Vial: 45 mg/0.5 mL

 
Link  NICE TA180: Psoriasis - ustekinumab
Link  NICE TA340: Ustekinumab for treating active psoriatic arthritis
Link  NICE TA455: Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
   
 ....
 Non Formulary Items
Cytotoxic Drug  Azathioprine

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Non Formulary
 
Efalizumab  (Raptiva)

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Non Formulary
 
Cytotoxic Drug  Methotrexate

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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
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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