Lancashire and South Cumbria
Formulary
 
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8 Malignant disease and immunosuppression

The majority of systemic anti-cancer therapies are not listed in this formulary as they are included in either the Lancashire and South Cumbria Cancer Alliance SACT protocols or the Cancer Drugs Fund list, produced by NHSE. 

08-01-03 Antimetabolites

Cladribine Mavenclad®
Formulary

Tablets 10mg

For treatment of relapsing - remitting multiple sclerosis

Link  MHRA: Cladribine (Mavenclad): new advice to minimise risk of serious liver injury
Link  NICE TA616: Cladribine for treating relapsing–remitting multiple sclerosis

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Fluorouracil
Formulary

Cream 5% (Efudix) cream may be initiated by consultant or SpR - Green  for actinic keratosis and treatment of superficial pre-malignant skin lesions, see section 13.8.1.

For the treatment of small superficial basal-cell carcinomas in adults.


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Mercaptopurine
Formulary

Tablets 50mg

Amber 2 When used for Crohn's and ulcerative colitis, see section 01.05.03.

Mercaptopurine has been confused with mercaptamine; care must be taken to ensure the correct drug is prescribed and dispensed.

Link  LSCMMG: Shared care guideline: Mercaptopurine

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Methotrexate
Formulary

Tablets 2.5mg
Injection 50mg/2mL, 1g/10mL

Amber 2  When used as an immunosuppressant - see section 10.1.3

Link  LSCMMG: Shared care guideline: Methotrexate
Link  MHRA: Methotrexate once-weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing
Link  MHRA: Methotrexate: advise patients to take precautions in the sun to avoid photosensitivity reactions

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