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Cumulative Update SOUTHAMPTON JOINT FORMULARY CUMULATIVE UPDATE This document is a cumulative list summarising changes to the Southampton Joint Formulary. To check the current status of a medicine please refer to www.southamptonformulary.nhs.uk Date Drug and formulation Colour BNF Comments Action status section 17/7/19 Triamcinolone with Green 13.04 Removed from formulary as Remove chlortetracycline discontinued Feb 2017. ointment (Aurecort) 17/7/19 Lenalidomide capsules Red 8.2.4 TA586: Lenalidomide plus Add (Revlimid) dexamethasone for multiple myeloma after 1 treatment with bortezomib TA587: Lenalidomide plus dexamethasone for previously untreated multiple myeloma 19/6/19 PARI O-PEP; Aerobika; Amber 3.12 For initiation by specialist Add Acapella Choice physiotherapist or respiratory oscillating positive clinician only. For airways expiratory pressure clearance in selected patients devices with chronic sputum- producing lung disease, e.g. cystic fibrosis, bronchiectasis, COPD. All follow up and monitoring of patients, and routine replacement of devices to be carried out in secondary care. Primary care prescribing on FP10 only when required for urgent supply of additional/replacement device (Drug Tariff listed approved appliances). PARI O-PEP 1st choice, Aerobika 2nd, Acapella 3rd. [Note: all other OPEP devices (e.g. Flutter, RC-Cornet, LungFlute) non-formulary – for use in exceptional circumstances only]. Date Drug and formulation Colour BNF Comments Action status section 19/6/19 Mepivacaine 3% Red 15.2 For specialist use only in Add injection [Scandonest Solent Sexual Health Service. Plain] For selected patients as intra- cervical block to facilitate insertion of intra-uterine contraception (off-label use) in accordance with FSRH guidance. 19/6/19 Epimax Paraffin-free Green 13.2.1 Restricted - for use only in Add ointment patients intolerant to paraffin- containing products. Note: MHRA safety warnings re: fire risks also apply to paraffin-free emollients. 19/6/19 Diclofenac sodium 75mg Red 15.1.4.2 Restricted to paediatric Amend in 3ml inj theatresNote: MHRA only, safety or forwarnings adults re: if fireketorolac risks also injection apply to not paraffin - available. Referfree emollients. to product information or Medusa IV guide for instructions on administration. Must be diluted and buffered prior to administration by IV infusion. Not suitable for IV bolus. Use in children is off label. 19/6/19 Glycopyrronium - 1.2 May be continued in existing Remove 320micrograms/ml oral patients. solution [Sialanar] 1mg/5ml oral solution preferred for new patients. 19/6/19 Glycopyrronium Amber 1.2 For severe sialorrhoea in Add Bromide 1mg/5ml oral children and adolescents with solution chronic neurological disorders. 19/6/19 Rosuvastatin tabs Green 2.12 Reserved for use in patients Add requiring high intensity statin unable to tolerate/unsuitable for atorvastatin or high dose simvastatin 19/6/19 Hyaluronic acid gel Red 7.5 For localised use in the uterus Amend only, for prevention of adhesions. Use products registered as medical devices (i.e. CE marked) or medicines only, e.g. Hyalobarrier®; Hyaregen®; Materegen®. Date Drug and formulation Colour BNF Comments Action status section 19/6/19 Tafamidis caps Red 2.14 Specialist use only. NHS Add [Vyndaqel] England specialised commissioning for treatment of transthyretin amyloid cardiomyopathy in adults in Trusts providing specialised amyloidosis services. Available via MHRA EAMS application for eligible patients. Not routinely stocked at UHS. If required, liaise with lead divisional pharmacist. 19/6/19 Trientine caps/tabs Red 9.8.1 Specialist use only. For Add treatment of Wilson's disease in accordance with NHS England Clinical Commissioning Policy. Not routinely stocked at UHS. If required please liaise with divisional lead pharmacist. [N.B. Available as trientine dihydrochloride 300mg capsules and trientine tetrahydrochloride (Cuprior) 150mg tablets. NHS England confirm that both formulations will be commissioned] 19/6/19 Durvalumab inj Red 8.1.5 NICE TA578: for locally Add [Imfinzi] advanced unresecatble non- small-cell lung cancer after platinum-based chemoradiation 19/6/19 Ocrelizumab inj Red 8.2.4 NICE TA585: for treating Amend [Ocrevus] primary progressive multiple scerosis 19/6/19 Atezolizumab infusion Red 8.1.5 NICE TA584: for treating Amend metastatic non-squamous non-small-cell lung cancer (in combination) 19/6/19 Ertugliflozin tabs Green 6.1.2.3 NICE TA583: with metformin Amend and a DPP-4 inhibitor for treating type 2 diabetes 19/6/19 Inotersen inj [Tegsedi] Red 9.8.1 NICE HST9: for treating Add hereditary transthyretin amyloidosis Date Drug and formulation Colour BNF Comments Action status section 13/6/19 Burosumab inj Red 9.8.1 NICE HST8: for treating X- Add [Crysvita] linked hypophosphataemia in children and young people. UHS is a specialist centre. 22/5/19 Nivolumab inj Red 8.1.5 NICE TA581: for untreated Amend advanced renal cell carcinoma, with ipilimumab. Available through Cancer Drugs Fund, only if conditions in the managed access agreement are followed. 22/5/19 Abemaciclib tabs Red 8.1.5 NICE TA579: for HR+, HER2- Amend advanced breast cancer (with fulvestrant after endocrine therapy). Available through Cancer Drugs Fund. 22/5/19 Brentuximab vedotin inj Red 8.1.5 NICE TA577: for CD-30+ Amend cutaneous T-cell lymphoma 22/5/19 Conestat alfa inj Red 3.4.3 For treatment of acute severe Add [Ruconest] attacks in hereditary angioedema due to C1 inhibitor deficiency/dysfunction in accordance with NHS England Specialised Clinical Commissioning policy only (Ref NHSCB/B09/P/b). 22/5/19 Mexiletine caps Red 10.2.2 For the treatment of myotonia Add [Namuscla] in patients with non- dystrophic myotonic disorders. Specialised commissioning. Remains amber for cardiology patients (unlicensed) – section 2.3.2 24/4/19 Pertuzumab inj Red 8.1.5 NICE TA569: for adjuvant Amend treatment of HER 2-positive early stage breast cancer 24/4/19 Brigatinib tabs Red 8.1.5 NICE TA571: for ALK-positive Add advanced non-small cell lung cancer after crizotinib 24/4/19 Ertugliflozin tabs Green 6.1.2.3 NICE TA572: for type 2 Add diabetes, as monotherapy or with metformin Date Drug and formulation Colour BNF Comments Action status section 24/4/19 Daratumumab infusion Red 8.1.5 NICE TA573: for previously Amend treated multiple myeloma, with bortezomib and dexamethasone (Cancer Drugs Fund) 24/4/19 Certolizumab pegol Red 13.5.3 NICE TA574: for moderate to Amend severe plaque psoriasis 24/4/19 Tildrakizumab inj Red 13.5.3 NICE TA575: for moderate to Add [Ilumetri] severe plaque psoriasis 24/4/19 Ciclosporin eye drops Amber 11.4.2 Ophthalmologist initiation Add [Verkazia] only. Prescribe by brand name (different licensed indication to Ikervis brand). 24/4/19 Lixisenatide inj 6.1.2.3 No longer recommended by Remove UHS diabetes team for new patients. May be continued in established patients. 24/4/19 Semaglutide inj Green 6.1.2.3 Add [Ozempic] 25/3/19 Safinamide tabs Red 4.9.1 Supported by DPC June 2018 Add – awaiting shared care guidance. Added to formulary as ‘red’ in interim. Restricted use for late-stage Parkinson’s Disease and motor fluctuations where treatment with rasagiline/selegiline and entacapone has failed/not tolerated. 20/3/19 Ulipristal tabs [Esmya] Red 6.7.2 Amended from amber to red Amend in view of MHRA safety update Aug 2018 20/3/19 Abemaciclib tabs Red 8.1.5 NICETA563: for previously Add [Verzenios] untreated, HR-positive, HER2- negative, locally advanced or metastatic breast cancer 20/3/19 Encorafenib caps Red 8.1.5 NICE TA562: with binimetinib Add [Braftovi] for unresectable or metastatic BRAF V600 mutation-positive melanoma 20/3/19 Venetoclax tabs Red 8.1.5 NICE TA561: with rituximab Amend for previously treated CLL 20/3/19 Benralizumab inj Red 3.4.2 NICE TA565: for severe Add [Fasenra] eosinophilic asthma Date Drug and formulation Colour BNF Comments Action status section 20/3/19 Latanoprost with timolol Amber 11.6 Added ‘unit dose eye drops’ Amend eye drops/unit dose eye (Fixapost) as preservative- drops free option for combination prostaglandin analogue/beta- blocker (more cost effective than tafluprost/timolol or bimatoprost/timolol). Use restricted to patients allergic/intolerant of preservatives or high risk of developing allergy since generic (preservative- containing) latanoprost/timolol remain significantly lower cost. 20/3/19 Cobicistat tablets Red 5.3.1 Specialist only, in line with Add (Tybost); NHSE Clinical Commissioning Cobicistat/elvitegravir/e Policy F03/P/b mtricitabine/tenofovir disoproxil fumarate tablets (Stribild); Cobicistat/darunavir/em tricitabine/tenofovir alafenamide fumarate tablets (Symtuza) 27/2/19 Grass pollen allergen Red 3.4.2 Specialist allergy clinics only Add extract (Grazax®) inj 27/2/19 Lais® 1,000 AU Red 3.4.2 Unlicensed (available by Add sublingual tablets import). Specialist allergy clinics only, for use when licensed alternatives are not suitable 27/2/19 Progesterone Green 6.4.1.2 For oral administration as HRT Add (micronised) 100mg (Utrogestan®) capsules Date Drug and formulation Colour BNF Comments Action status section 27/2/19 Lidocaine medicated See 4.7.3 Restricted use. Amend plaster 5% comme Green for use in patients who nts have been treated in line with NICE CG173: Neuropathic pain, but are still experiencing pain associated with previous herpes zoster infection (post-herpetic neuralgia) (licensed indication). Amber for chronic neuropathic pain/focal neuralgia ['off label' use] in exceptional circumstances only (e.g. other treatment options have failed or cannot be used due to co-morbidities) in a co- operation arrangement with chronic pain or cancer care/palliative care specialist teams as per DPC Chronic Pain Prescribing Guidelines or Wessex Palliative Care Guidelines. Red for use in rib fracture pain (section 15.02). 27/2/19 Diclofenac oral Red 10.1.1 Unlicensed special. Restricted Add suspension 50mg in 5ml use - short term use for postoperative analgesia in children.
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