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Nottinghamshire Area Prescribing Committee
Joint Formulary
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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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08.01  Expand sub section  Cytotoxic drugs
08.01  Expand sub section  Side-effects of cytotoxic drugs
08.01  Expand sub section  Drugs for cytotoxic-induced side-effects
Dexrazoxane (Cardioxane)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
NHS England
BlueTeq

Infusion

Available through NUH only:

  • Approved for preventing cardiotoxicity in children and young people (under 25 years) receiving high-dose anthracyclines or related drugs for the treatment of cancer as per NHS England commissioning policy 200204P
 
   
Dexrazoxane (Savene)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine

Infusion- NUH only

 
Link  Link to reviews
   
Folinic acid
View adult BNF View SPC online View childrens BNF
Formulary
Red
Available as:
- Tablet 15mg (5 each)
- Injection, 15mg in 2mL, 15mg in 5mL, 300mg in 30mL.
  • Also known as calcium folinate and calcium leucovorin.
  • For Methotrexate rescue or toxicity. 
  • Link  NUH: Haematology guideline for the use of high dose methotrexate and folinic acid rescue
    Link  NUH: Oncology guideline for the use of high dose methotrexate
       
    Mesna
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Tablet, Injection
  • Tablets and injection available. Injection can be diluted in a flavoured drink for oral administration- see BNF
  • At SFH, for dosage instructions in non-cancer indications refer to specific guidelines: cyclophosphamide (rheumatology) or cyclophosphamide (respiratory) 
  •    
    08.01.01  Expand sub section  Alkylating drugs
    08.01.02  Expand sub section  Anthracyclines and other cytotoxic antibiotics to top
    08.01.03  Expand sub section  Antimetabolites
    08.01.04  Expand sub section  Vinca alkaloids and etoposide
    08.01.05  Expand sub section  Other antineoplastic drugs
    08.01.05  Expand sub section  Amsacrine
    08.01.05  Expand sub section  Arsenic trioxide to top
    08.01.05  Expand sub section  Bevacizumab
    08.01.05  Expand sub section  Bexarotene
    08.01.05  Expand sub section  Bortezomib
    08.01.05  Expand sub section  Brentuximab vedotin
    08.01.05  Expand sub section  Cetuximab to top
    08.01.05  Expand sub section  Crisantaspase
    08.01.05  Expand sub section  Dacarbazine and Temozolomide
    08.01.05  Expand sub section  Erlotinib
    08.01.05  Expand sub section  Hydroxycarbamide
    08.01.05  Expand sub section  Imatinab to top
    08.01.05  Expand sub section  Ipilimumab
    08.01.05  Expand sub section  Mitotane
    08.01.05  Expand sub section  Panitumumab
    08.01.05  Expand sub section  Pentostatin
    08.01.05  Expand sub section  Platinum compounds to top
    08.01.05  Expand sub section  Porfimer sodium and temoporfin
    08.01.05  Expand sub section  Procarbazine
    08.01.05  Expand sub section  Protein kinase inhibitors
    08.01.05  Expand sub section  Taxanes
    08.01.05  Expand sub section  Topoisomerase I inhibitors to top
    08.01.05  Expand sub section  Trabectedin
    08.01.05  Expand sub section  Trastuzumab
    08.01.05  Expand sub section  Tretinoin
    08.01.05  Expand sub section  Vismodegib
     ....
     Non Formulary Items
    Calcium Leofolinate  (Isovorin®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Disodium Folinate  (Sodiofolin®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Disodium Levofolinate
    (Lvofolinic acid )

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
     
    Palifermin  (Kepivance)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Grey
    Classified grey for oral mucositosis in patients with haematological malignancies
    Link  Link to reviews
     
      
    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
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    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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