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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 8: Malignant disease and immunosuppression - Full Chapter
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08.02.02  Expand sub section  Corticosteroids and other immunosuppressants
Antithymocyte immunoglobulin (horse)
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Formulary
Red

unlicensedunlicensed Injection: 250mg in 5ml -NETAG approved for aplastic anaemia in adults

 
   
Antithymocyte immunoglobulin (rabbit)
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Formulary
Red
High Cost Medicine

Injection: 25mg injection
– used in the management of transplant rejection

 
   
Basiliximab (Simulect)
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Formulary
Red
High Cost Medicine

Vial for preparing IV infusion: 20mg


-approved for limited use in adult renal translplant patients with high risk of acute organ rejection


-approved for severe graft versus host disease post haematopoietic stem cell transplantation


 

 
Link  NICE TA 481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA 482: Immunosuppressive therapy for kidney transplant in children and young people
   
Ciclosporin (Neoral)
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Formulary
Amber
High Cost Medicine

Capsules: 10mg, 25mg, 50mg & 100mg
Sugar free oral solution (oily): 100mg in 1ml

 
   
Ciclosporin (Sandimmun)
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Formulary
Amber

Original oral formulations Sandimmun supplied on request for patients who cannot take Neoral
unlicensedunlicensed Capsules: 25mg & 100mg
Sugar-free oral solution (oily): 100mg in 1ml

 
   
Ciclosporin (Sandimmun)
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Formulary
Red

IV Infusion: 50mg in 1ml & 250mg in 5ml concentrate (oily)

 
   
Cytotoxic Drug Sirolimus
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Formulary
Amber
High Cost Medicine

Tablets: 1mg & 2mg
Oral solution: 1mg per ml

 
Link  NICE TA 482: Immunosuppressive therapy for kidney transplant in children and young people
   
Tacrolimus
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Formulary
Amber

500 microgram Capsules: 1mg & 5mg (Prograf & Adoport)
unlicensedunlicensed Oral suspension: 5mg/5mL  
RED - Concentrate for preparing IV infusion: 5mg in 1 ml
- approved for renal transplantation in children and adolescents in line with NICE

 

MR Capsules (Advagraf): 500microgram, 1mg, 3mg & 5mg
- only approved for use for prophylaxis of organ rejection in kidney and liver transplantation. Advagraf® is approved for use in patients who are currently prescribed Prograf, and de novo patients should be prescribed Adoport®.

 

MR tablets (Envarsus): 750microgram, 1mg, 4mg
- approved for the treatment of renal and liver transplant patients who are suffering from neurotoxicity with other formulations or for patients requiring large doses of tacrolimus.

 
Link  NICE TA 482: Immunosuppressive therapy for kidney transplant in children and young people
   
 ....
 Non Formulary Items
Belatacept  (Nulojix)

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Non Formulary
High Cost Medicine
 
Daclizumab  (Zenapax)

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Non Formulary
 
Modigraf

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Non Formulary
 
Prednisolone

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Non Formulary
 
Prednisolone

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Non Formulary
 
Prograf

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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
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
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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