Lancashire and South Cumbria
Formulary
 
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13 Skin

This chapter of the formulary is under continual development, please let the team know if you have any comments about the contents: mlcsu.lscformulary@nhs.net. 

For more information about the formulary development process, please see: https://www.lancsmmg.nhs.uk/lancashire-and-south-cumbria-icb-formulary-development/

13-05-03 Drugs affecting the immune response

Abrocitinib Cibinqo®
Formulary

Tablets 50mg - for treating moderate to severe atopic dermatitis

Tablets 100mg - for treating moderate to severe atopic dermatitis

Tablets 200mg - for treating moderate to severe atopic dermatitis

Link  NICE TA814: Abrocitinib, tralokinumab or upadacitinib for treating moderate to severe atopic dermatitis

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Adalimumab Biosimilars avaliable
Formulary

S/C injection 40mg pre-filled syringe, pre-filled pen

Consultant dermatologist or specilaist initiation only

Tertiary centre only for hidradenitis suppurativa

Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

Link  MHRA: Tumour necrosis factor alpha inhibitors
Link  NICE TA392: Adalimumab for treating moderate to severe hidradenitis suppurativa
Link  NICE TA455: Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
Link  NIE TA146: Adalimumab for the treatment of adults with psoriasis

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Apremilast Otezla®
Formulary

Tablets 10mg, 20mg, 30mg

Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

Link  MHRA: Apremilast (Otezla ▼): risk of suicidal thoughts and behaviour
Link  NICE TA419: Apremilast for treating moderate to severe plaque psoriasis
Link  NICE TA433: Apremilast for treating active psoriatic arthritis

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Azathioprine
Formulary

Tablets 25mg, 50mg
Unlicensed indication
Consultant dermatologist or specilaist initiation only
See section 10.1.3

Link  LSCMMG: Shared care guideline - Azathioprine

Cytotoxic Drug  Amber 2 View adult BNF  View SPC online  View childrens BNF
Baricitinib
Formulary

Film-coated tablets 2mg, 4mg

Red Treatment of atopic dermatitis

Do Not Prescribe Treatment of alopecia areata

Link  NICE TA681: Baricitinib for treating moderate to severe atopic dermatitis
Link  NICE TA926: Baricitinib for treating severe alopecia areata

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Bimekizumab Bimzelx®
Formulary

Pre-filled pen/syringe 160mg

Usually supplied to patients via a homecare delivery company

Link  NICE TA723: Bimekizumab for treating moderate to severe plaque psoriasis

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Brodalumab Kyntheum®
Formulary

Solution for injection pre-filled syringes 210mg/1.5ml 

Link  NICE TA511: Brodalumab for treating moderate to severe plaque psoriasis

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Ciclosporin
Formulary

Consultant dermatologist or specilaist initiation only

To be prescribed generically for dermatology patients

See section 10.1.3

Link  LSCMMG: Shared care guideline - Ciclosporin

Amber 2 View adult BNF  View SPC online  View childrens BNF
Deucravacitinib SOTYKTU
Formulary

Film coated tablets 6mg

 

Red NICE TA907: Deucravacitinib for treating moderate to severe plaque psoriasis

 

 

Link  NICE TA907: Deucravacitinib for treating moderate to severe plaque psoriasis

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Dupilumab Dupixent®
Formulary

Pre-filled syringe 300mg/2ml solution for injection

Do Not Prescribe NICE TA648: Dupilumab for treating chronic rhinosinusitis with nasal polyps (terminated appraisal)

Do Not Prescribe NICE TA955: Dupilumab for treating moderate to severe prurigo nodularis

Link  MHRA: Dupilumab (Dupixent▼): risk of ocular adverse reactions and need for prompt management
Link  NICE TA534: Dupilumab for treating moderate to severe atopic dermatitis
Link  NICE TA955: Dupilumab for treating moderate to severe prurigo nodularis

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Etanercept Biosimilars avaliable
Formulary

S/C injection 50mg pre-filled syringe, pre-filled pen

Consultant dermatologist or specilaist initiation only
Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

Link  MHRA: Tumour necrosis factor alpha inhibitors
Link  NICE TA103: Etanercept and efalizumab for the treatment of adults with psoriasis
Link  NICE TA455: Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people

Red View adult BNF  View SPC online  View childrens BNF  HCD
Guselkumab Tremfya®
Formulary

Solution for injection in pre-filled pen 100mg/1ml

Link  NICE TA521: Guselkumab for treating moderate to severe plaque psoriasis

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Infliximab Biosimilars avaliable
Formulary

Intravenous infusion 100mg

Consultant dermatologist or specilaist initiation only

REQUIRES BLUETEQ APPROVAL

Link  MHRA: Tumour necrosis factor alpha inhibitors
Link  NICE TA134: Infliximab for the treatment of adults with psoriasis

Red View adult BNF  View SPC online  View childrens BNF  HCD
Lebrikizumab
Formulary

NHSE commissioned for children / young adults aged 12-18 years

Link  NICE TA986: Lebrikizumab for treating moderate to severe atopic dermatitis in people 12 years and over

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Methotrexate
Formulary

Consultant dermatologist or specialist initiation only


Methotrexate should be prescribed once weekly as a single dose on the same day each week. If oral methotrexate is prescribed only use the 2.5 mg strength

Link  LSCMMG: Shared care guideline - Methotrexate

Cytotoxic Drug  Amber 2 View adult BNF  View SPC online  View childrens BNF
Omalizumab
Formulary

Chronic spontaneous urticaria.

unlicensed Unlicensed use of omalizumab for severe chronic inducible urticarias.

Link  LSCMMG: Omalizumab
Link  NICE TA339: Omalizumab for previously treated chronic spontaneous urticaria

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Pimecrolimus 1% Elidel®
Formulary

Cream 30g, 60g, 100g

Link  NICE TA82: Tacrolimus and pimecrolimus for atopic eczema

Amber 0 View adult BNF  View SPC online  View childrens BNF
Risankizumab Skyrizi®
Formulary

solution for injection pre-filled syringes, solution for injection pre-filled pen 150mg/mL

Red BlueTeqNICE TA888 Risankizumab for previously treated moderately to severely active Crohn's disease - see link below

Link  NICE TA596: Risankizumab for treating moderate to severe plaque psoriasis
Link  NICE TA803: Risankizumab for treating active psoriatic arthritis after inadequate response to DMARDs

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Ritlecitinib
Formulary

Severe alopecia areata

Link  BAD: Professional guidance supplementary to NICE TA958
Link  NICE TA958: Ritlecitinib for treating severe alopecia areata in people 12 years and over

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Secukinumab Cosentyx®
Formulary

150mg pre-filled syringe

Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

Approved as Red Traffic Light  for palmoplantar psoriasis - off-label use

Link  NICE TA350: Secukinumab for treating moderate to severe plaque psoriasis
Link  NICE TA445: Certolizumab pegol and secukinumab for treating active psoriatic arthritis after inadequate response to DMARDs
Link  NICE TA734: Secukinumab for treating moderate to severe plaque psoriasis in children and young people

Red View adult BNF  View SPC online  View childrens BNF  HCD
Tacrolimus  Protopic®
Formulary

Ointment 0.03%, 0.1% 30g, 60g

Consultant dermatologist or specilaist initiation only

Link  LSCMMG: Position Statement Prescribing of Oral Tacrolimus
Link  MHRA: Tacrolimus ointment (Protopic): possible risk of malignancies including lymphomas and skin cancers
Link  NICE TA82: Tacrolimus and pimecrolimus for atopic eczema

Amber 0 View adult BNF  View SPC online  View childrens BNF
Tildrakizumab Ilumetri®
Formulary

Solution for injection pre-filled syringes 100mg/1ml

Link  NICE TA575: Tildrakizumab for treating moderate to severe plaque psoriasis

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Tralokinumab Adtralza®
Formulary

Pre-filled syringe 150 mg solution for injection - for treating moderate to severe atopic dermatitis - see link below

Link  NICE TA814: Abrocitinib, tralokinumab or upadacitinib for treating moderate to severe atopic dermatitis

Red View adult BNF  View SPC online  View childrens BNF
Upadacitinib  Rinvoq®
Formulary

Prolonged release tablets 15mg

 

Link  MHRA: Janus kinase (JAK) inhibitors: new measures to reduce risks of major cardiovascular events, malignancy, venous thromboembolism, serious infections and increased mortality
Link  NICE TA814: Abrocitinib, tralokinumab or upadacitinib for treating moderate to severe atopic dermatitis
Link  NICE768: Upadacitinib for treating active psoriatic arthritis after inadequate response to DMARDs

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Ustekinumab Stelara®
Formulary

Injection 45mg, 90mg pre-filled syringe

Consultant dermatologist or specilaist initiation only
Usually supplied to patients by a home delivery company

REQUIRES BLUETEQ APPROVAL

Link  NICE TA180: Ustekinumab for the treatment of adults with moderate to severe psoriasis
Link  NICE TA455: Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people

Red View adult BNF  View SPC online  View childrens BNF  HCD