Treatment of immuno-oncology induced colitis/diarrhoea after failure of steroid treatment.

Treatment of immuno-oncology induced colitis/diarrhoea after failure of steroid treatment.

Injection 20mg, 40mg

2mg and 5mg strengths are for use in ophthalmology.

Powder and solvent for intravesical solution 40mg

Intravesical administration for relapse prevention in adults with superficial urinary bladder carcinoma after transurethral resection.

Tablets 10mg

For treatment of relapsing - remitting multiple sclerosis

Tablets 50mg

 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.

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

  When used as an immunosuppressant - see section 10.1.3

Capsules 230microgram, 460microgram, 920 microgram

Capsules 231mg

Powder for concentrate for solution for infusion 11mg

Specialist centre only

Tablets 25mg, 50mg

 Inflammatory bowel disease, Rheumatic diseases, Dermatology.

 Myasthenia Gravis.

Primary care prescribers are advised not to take on prescribing of these medicines unless they have been adequately informed by letter of their responsibilities with regards monitoring, side effects and interactions and are happy to take on the prescribing responsibility. A copy of locally approved shared care guidelines should accompany this letter which outlines these responsibilities. Primary care prescribers should then tell secondary care of their intentions as soon as possible by letter so that arrangements can be made for the transfer of care.

 Transplant rejection.

See section 01.05.03 and 13.05.03.

Capsules 250mg

Tablets 500mg
Oral suspension 1g/5mL

 Cellcept^® for transplant patients only.
 Generic prescribing for dermatology use.

 Complex pain syndrome.

Hard Capsules, 10mg

Capsules 25mg, 50mg, 100mg
Liquid 100mg/1mL
Concentrate for intravenous infusion 50mg/1mL

Prescribe by brand name for transplant patients.

For use in other indications see sections 01.05.03, 10.01.03, and 11.11.

Solution for infusion. Each 20 mL vial contains 1 080 mg of pegcetacoplan.

Tablets 1mg, 5mg
e/c tablets 2.5mg

25mg tablets are classified as 
 
There is no evidence that e/c prednisolone reduces the risk of gastrointestinal side effects. Uncoated tablets should be prescribed first line together with a PPI if necessary.

Also see sections 10.01.02.02, 06.03.02, 01.05.02, 11.04.01.

Brand name prescribing essential

For prophylaxis of graft rejection

Dailiport modified release oral capsules are recommended for all patients who are newly prescribed modified release tacrolimus for transplant rejection – RAG status RED for new patients
Please note:
Dailiport modified release capsules are not bioequivalent to Adoport immediate release capsules and do not replace Adoport capsules.
Existing patients using Advagraf modified release capsules will remain on Advagraf and are not routinely switched to Dailiport. If a prescriber considers that switching a patient to a different brand of oral tacrolimus would be of benefit, the change requires careful supervision and therapeutic monitoring by an appropriate specialist.

See section 13.05.03 for use in dermatology.

Capsules 7.9mg

Concentrate for solution for infusion vials 12mg/1.2ml

For treating relapsing-remitting multiple sclerosis.

Tertiary centre only.

All anti-lymphocyte monoclonal antibodies should be given under the supervision of an experienced specialist, in an environment where full resuscitation facilities are immediately available.

Concentrate for solution for infusion 300mg/10ml
Solution for injection 920mg

All anti-lymphocyte monoclonal antibodies should be given under the supervision of an experienced specialist, in an environment where full resuscitation facilities are immediately available.

Only commissioned from a recognised MS Centre with Specialist Nurse support.

Concentrate for intravenous infusion 20 mg/mL,5-mL vial ,50-mL vial

Only commissioned from a recognised MS Centre with Specialist Nurse support.

Concentrate for intravenous infusion 100mg/10mL, 500mg/50mL

Truxima®  First choice rituximab for new patients.
MabThera®

For NICE guidelines relating to rituximab please consult the National funding /access decisions section of rituximab's BNF entry.

Also see sections 09.01.03, 09.01.04 and 10.01.03

Capsules e/c 120mg, 240mg

Also see section 13.05.02.

Capsules 500 micrograms

Solution for injection pre-filled pens  63micrograms/0.5ml, 94micrograms/0.5ml 

Tablets 2mg, 3mg, 4mg, 5mg, 6mg, 7mg, 8mg, 9mg, 10mg

Tablets 0.25mg, 2mg

Intron A prefilled multidose pen 30million units in 1.2mL

Roferon-A prefilled syringes 3 million units, 4.5 million units and 9 million units in 0.5mL

90micrograms, 135micrograms, 180micrograms solution for injection in pre-filled syringe

For the treatment of myleoproliferative neoplasms (See attached NHSE interim clinical commissioning policy).

For the treatment of myleoproliferative neoplasms (See attached NHSE interim clinical commissioning policy).

pre-filled syringe 20mg/1ml, 40mg/1ml

Concentrate for intravenous infusion 20mg/mL (15mL vial)

Pre-filled syringe 150mg

All anti-lymphocyte monoclonal antibodies should be given under the supervision of an experienced specialist, in an environment where full resuscitation facilities are immediately available.

Tablets 1mg, 5mg

Tablets 10micrograms, 50micrograms, 1mg

See section 06.04.01.01.

Tablets 2.5mg, 5mg, 10mg,100mg

See section 06.04.01.02.

Tablets 40mg (unlicensed), 160mg

Tablets 5mg

See section 06.04.01.02 and 07.03.02.01.

Tablets 1mg

Approved as hormonal treatment for early breast cancer (in line with NICE TA112) and for primary prevention of breast cancer in postmenopausal women at moderate or high risk.

Tablets 25mg

Breast cancer.

Tablets 2.5mg

Breast cancer.

Tablets 10mg, 20mg
Liquid 10mg/5mL

For treating premenopausal women at high risk of breast cancer unless they have a past history or may be at increased risk of thromboembolic disease or endometrial cancer.

Hormone-sensitive prostate cancer.

Injection 80mg, 120mg

Treatment of adult male patients with advanced hormonedependent prostate cancer - patients without spinal metastases.

Degarelix should be recommended/initiated by specialist services– AMBER0 recommendation.

Degarelix is recommended as an alternative to lutenising hormone releasing hormone agonists (LHRH) for treatment of adult male patients with advanced hormone-dependent prostate cancer without spinal metastases ONLY in the following circumstances:

where LHRH analogues or concomitant anti-androgens are contra-indicated.
in patients on androgen deprivation therapy who have a significant cardiac history/severe cardiac disease.
very significant, symptomatic metastatic disease, and locally advanced disease to shrink the metastases.
impending bladder outlet obstruction due to prostate cancer.

Degarelix for treating advanced hormone-dependent prostate cancer (NICE TA404).

Tablets 50mg, 150mg

Tablets 50mg, 100mg

See section 06.04.02 for non-oncology indications.

Implant 3.6mg (Zoladex®)
Implant 10.8mg (Zoladex® LA)

See section 06.07.02 for non-oncology indications.

Injection 11.25mg (Prostap® 3)
Injection 3.75mg (Prostap® SR)

See section 06.07.02 for non-oncology indications.

3-mg vial, 11.25-mg vial, 22.5-mg vial

See section 06.07.02 for non-oncology indications.

Pre-filled syringe 60mg, 90mg, 120mg (Depot)

Unlicensed use in non-acute treatment of recurrent gastrointestinal bleeding disorders (including angiodysplasia, small bowel dysplasia, gastric antral vascular ectasia, haemorrhagic telangiectasia)

Patients should be reviewed within 4 weeks of initiation of somatostatin analogues. Continuation of treatment should only be recommended if clinicians judge that patients have derived a meaningful response from somatostatin treatment (reduced stoma output, stool volume and progression towards closure of fistulas).

Unlicensed use in Secretory Gastrointestinal Disorders (e.g. enterocutaneous fistula, high output stoma and refractory diarrhoea)

Treatment should only be continued if an adequate response is achieved (e.g. a 50% reduction in the need for transfusion or parenteral iron).

 For orthostatic intolerance disorders - IFR needed.

Injection 50 microgram/1mL, 1mg/5mL (multidose vial)

For use in Bowel obstruction in palliative care, please see chapter 21.

Depot injection 10mg, 20mg, 30mg

Consultant specialist initiation only.

Unlicensed use in non-acute treatment of recurrent gastrointestinal bleeding disorders (including angiodysplasia, small bowel dysplasia, gastric antral vascular ectasia, haemorrhagic telangiectasia)

Patients should be reviewed within 4 weeks of initiation of somatostatin analogues. Continuation of treatment should only be recommended if clinicians judge that patients have derived a meaningful response from somatostatin treatment (reduced stoma output, stool volume and progression towards closure of fistulas).

Unlicensed use in Secretory Gastrointestinal Disorders (e.g. enterocutaneous fistula, high output stoma and refractory diarrhoea)

Treatment should only be continued if an adequate response is achieved (e.g. a 50% reduction in the need for transfusion or parenteral iron).

 For orthostatic intolerance disorders - IFR needed.