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Nottinghamshire Area Prescribing Committee
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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
Notes:
For patient information about chemotherapy and chemotherapy regimens, please see the Macmillan cancer support website: 
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08.03.04.03  Expand sub section  Somatostatin analogues
Lanreotide (Somatuline Autogel)
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Restricted Drug Restricted
Red
High Cost Medicine
Homecare

Injection - Prefilled syringe.

  • Restricted for use in Neuroendocrine Tumours and Acromegaly- Consultant endocrinologist and oncologist request only.
  • At SFH: Patient access scheme exists - first dose is replaced for free. For new patients complete this form and contact Pharmacy High Cost Drugs Team (4660) for further information.

 

Available through homecare for NUH patients. Please contact pharmacy medicines homecare team for further information

 
Link  Lanreotide FOC request form
   
Lutetium (177Lu) oxodotreotide (Lutathera)
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Restricted Drug Restricted
Red
High Cost Medicine

Infusion - radiopharmaceutical

NUH: Approved in accordance with NICE TA539 for treating unresectable or metastatic neuroendocrine tumours.  Patients will be referred to Birmingham to receive treatment.

 
   
Octreotide (Sandostatin Lar)
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Formulary
Red
High Cost Medicine
Depot injection-NUH only
  • Restricted for use in Neuroendocrine Tumours and Acromegaly- Consultant endocrinologist and oncologist request only
     
  • Link  Link to reviews
       
    Octreotide (Sandostatin)
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    Formulary
    Amber 2
    High Cost Medicine

    Injection

    • Gastric secretions and nausea and vomiting in oncology and palliative care
    • NUH: For use as prophylaxis against carcinoid syndrome in selected patients with Neuroendocrine Tumours. 
     
    Link  Link to reviews
    Link  NUH: Octreotide Infusion Guideline for Adult Patients at Risk of Carcinoid Crisis
       
     ....
     Non Formulary Items
    Lanreotide  (Somatuline LA)

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    Non Formulary
    Grey
     
      
    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
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    Link to adult BNF
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    Link to children's BNF
    click to search medicines.org.uk
    Link to SPCs
    SMC
    Scottish Medicines Consortium
    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

    Grey

    Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.
    Grey / Non-Formulary (undergoing assessment): Work is ongoing and will be reviewed at a future APC meeting.
    Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market.
      

    Red

    Medicines which should normally be prescribed by specialists only. eg hospital only.
    For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.
      

    Amber 1

    Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised.
    Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the Nottinghamshire APC.
      

    Amber 2

    Medicines suitable to be prescribed in primary care / general practice after specialist* recommendation or initiation.
    A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC.
    *Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice
      

    Amber 3

    Primary care/ non specialist may initiate as per APC guideline.
    The supporting prescribing guideline must have been agreed by the relevant secondary care trust D&TC(s) and approved by the Nottinghamshire APC.
      

    Green

    Medicines suitable for routine use within primary care.
    Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.   

    OTC

      

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