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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 9: Nutrition and blood - Full Chapter
09.01  Expand sub section  Anaemias and some other blood disorders
09.01.01  Expand sub section  Iron-deficiency anaemias
09.01.01.01  Expand sub section  Oral iron
 note 

Prescribers should prescribe the product with the lowest acquisition cost

Ferrous Fumarate (Fersaday)
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Formulary

Tablets: 210mg (68mg iron)
Syrup 140mg/5ml

 
   
Ferrous Sulphate
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Formulary

Tablets: 200mg (65mg elemental iron)

 
   
Sodium Feredetate (Sytron)
Formulary

Sugar-free elixir: 190mg/5ml (27.5mg elemental iron/5ml)

 
   
Ferric maltol (Feraccru)
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Formulary
Green +

Capsules: 30mg

 
   
09.01.01.01  Expand sub section  Iron and folic acid
09.01.01.01  Expand sub section  Compound iron preparations to top
09.01.01.02  Expand sub section  Parenteral iron
Ferric Carboxymaltose (Ferinject)
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Formulary
Red

Solution for injection: 100mg/2ml, 500mg/10ml

 
   
Iron Isomaltose 1000 (Diafer)
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Formulary
Red

Solution for injection: 50mg/ml

 
   
Iron Isomaltoside 1000 (Monofer)
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Formulary
Red

Solution for injection: 100mg/1ml (1ml,5ml, 10ml vials)

 
   
09.01.02  Expand sub section  Drugs used in megaloblastic anaemias
Folic Acid
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Formulary

Tablets: 400micrograms, 5mg
Oral solution: 2.5mg/5ml (sugar-free available)
unlicensed unlicensed Injection: 15mg/1ml

 
   
Hydroxocobalamin
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Formulary

Injection: 1mg/1ml

 
   
09.01.03  Expand sub section  Drugs used in hypoplastic, haemolytic, and renal anaemias
Eculizumab
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Formulary
Red
High Cost Medicine

Solution for infusion: 300mg

 
   
09.01.03  Expand sub section  Erythropoietin
Darbepoetin Alfa (Aranesp)
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Formulary
Red
High Cost Medicine

Prefilled syringes: 10, 15, 20,30, 40, 50, 60, 80, 100, 150, 300 micrograms
Sureclick pens: 20,40,60,80, 100, 150, 300micrograms

 
Link  NICE TA323: Erythropoiesis‑stimulating agents (epoetin and darbepoetin) for treating anaemia in people with cancer having chemotherapy
   
Epoetin beta (NeoRecormon)
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Formulary
Red
High Cost Medicine

Injection (pre-filled syringe): 500 units, 2,000 units, 3,000 units, 4,000 units, 5,000 units, 6,000 units, 10,000 units, 20,000 units, 30,000 units

 
Link  NICE TA 323: Erythropoiesis‑stimulating agents (epoetin and darbepoetin) for treating anaemia in people with cancer having chemotherapy
   
Methoxy Polyethylene Glycol-Epoetin Beta (Mircera)
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Formulary
Red
High Cost Medicine

Injection (pre-filled syringe): 30 micrograms/0.3 mL, 50 micrograms/0.3 mL, 75 micrograms/0.3 mL, 100 micrograms/0.3 mL, 120 micrograms/0.3 mL, 150 micrograms/0.3 mL, 200 micrograms/0.3 mL, 250 micrograms/0.3 mL, 360 micrograms/0.6 Ml

 
Link  NICE TA 323: Erythropoiesis‑stimulating agents (epoetin and darbepoetin) for treating anaemia in people with cancer having chemotherapy
   
Epoetin alfa (Eprex)
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Alternatives
Red
High Cost Medicine

Injection (pre-filled syringe): 1000, 2000, 3000, 4000, 5000, 6000, 8000, 10000, 20000, 30000, 40000units

 
Link  NICE TA 323: Erythropoiesis‑stimulating agents (epoetin and darbepoetin) for treating anaemia in people with cancer having chemotherapy
   
Epoetin Zeta
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Alternatives
Red

Injection (pre-filled syringe): 1000 units, 2000 units, 3000 units, 4000 units, 5000 units, 6000 units, 8000 units, 10000 units, 20000 units, 30000 units, 40000 units

 
Link  NICE TA 323: Erythropoiesis‑stimulating agents (epoetin and darbepoetin) for treating anaemia in people with cancer having chemotherapy
   
09.01.03  Expand sub section  Iron overload to top
Deferasirox (Exjade)
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Formulary
Red
High Cost Medicine

Tablets:  90mg, 180mg, 360mg

 
   
Desferrioxamine Mesilate
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Formulary
Red
High Cost Medicine

Injection: 500mg, 2g

 
   
09.01.04  Expand sub section  Drugs used in autoimmune thrombocytopenic purpura
Rituximab
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Formulary
Red

(1st line for ITP -Intravenous with oral Prednisolone or Dexamethasone)
Injection: 100mg, 500mg

 
   
Anagrelide (Xagrid)
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Formulary
Red

2nd line for ITP and patients at risk of essential thrombocythaemia
Capsules: 500micrograms

 
   
Avatrombopag
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Formulary
Red
 
Link  NICE TA 626: Avatrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure
   
Caplacizumab (Cablivi)
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Formulary
Red
High Cost Medicine
NHS England

Vial: powder and solvent for injection 10 mg

 
Link  NICE TA 667: Caplacizumab with plasma exchange and immunosuppression for treating acute acquired thrombotic thrombocytopenic purpura
   
Eltrombopag (Revolade)
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Formulary
Red
High Cost Medicine

1st line for ITP patients who require treatment for bleeding, profound thrombocytopenia or to cover surgery during the Covid-19 pandemic
3rd line for severe, refractory ITP – choice according to patient preference

Tablets: 25mg, 50mg, 75mg

 
Link  Interim Clinical Commissioning Policy: Thrombopoietin receptor agonists as first line therapy for new or relapsed immune thrombocytopenia in adults and children over the age of 1 year during the COVID-19 pandemic
Link  NICE TA 293: Eltrombopag for treating chronic immune (idiopathic) thrombocytopenic purpura (review of technology appraisal 205)
   
Lusutrombopag
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Formulary
Red

3mg film-coated tablets

Approved for use according to criteria in NICE TA617

 
Link  NICE TA 617: Lusutrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure
   
Romiplostim (Nplate)
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Formulary
Red
High Cost Medicine

1st line for ITP patients who require treatment for bleeding, profound thrombocytopenia or to cover surgery during the Covid-19 pandemic
3rd line for severe, refractory ITP – choice according to patient preference

Injection: 250 micrograms

 
Link  Interim Clinical Commissioning Policy: Thrombopoietin receptor agonists as first line therapy for new or relapsed immune thrombocytopenia in adults and children over the age of 1 year during the COVID-19 pandemic
Link  NICE TA 221: Thrombocytopenic purpura - romiplostim
   
09.01.05  Expand sub section  G6PD deficiency
09.01.06  Expand sub section  Drugs used in neutropenia
Filgrastim (Neupogen)
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Formulary
Red
High Cost Medicine

(1st line) Injection (Nivestim® - biosimilar): 12 million units (120 micrograms)/0.2mL, 30 million units (300 micrograms)/0.5mL, 48 million units (480 micrograms)/0.5mL


Injection (Neupogen®): 30 million units (300 micrograms)/mL


Injection (pre-filled pen, Neupogen® Singleject®): 30 million units (300 micrograms)/0.5mL, 48 million units (480 micrograms)/0.5 mL

 
   
Lenograstim (Granocyte)
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Formulary
Red
High Cost Medicine

(1st line for stem cell harvesting only)


Injection: 13.4 million-unit (105 micrograms), 33.6 million-unit (263 micrograms)

 
   
09.01.07  Expand sub section  Drugs used to mobilise stem cells
Plerixafor (Mozobil)
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Formulary
Red
High Cost Medicine

(2nd line for stem cell harvesting – needs Cancer Drugs Fund application)


Injection: 24 mg/1.2 mL

 
   
 ....
 Non Formulary Items
Compound iron preparations  (Givitol®)

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Non Formulary
 
Cyanocobalamin

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Non Formulary
 
Deferiprone  (Ferriprox)

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Non Formulary
High Cost Medicine
 
Efmoroctocog alfa  (Elocta)

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Non Formulary
 
Ferumoxytol Injection  (Rienso )

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Non Formulary
 
Cytotoxic Drug  Hydroxycarbamide  (Siklos)

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Non Formulary
 
Iron and Folic Acid  (Ferrograd Folic)

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Non Formulary
 
Iron and Folic Acid  (Pregaday)

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Non Formulary
 
Iron and Folic Acide  (Fefol®)

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Non Formulary
 
Iron and Folic Acide  (Galfer FA®)

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Non Formulary
 
Oxymetholone

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Non Formulary
 
Polysaccharide Iron Complex  (Miferex®)

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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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