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 Formulary Chapter 13: Skin - Full Chapter
Notes:

Please note: Silk garments are non-formulary.

 Details...
13.05.03  Expand sub section  Drugs affecting the immune response
Adalimumab
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Formulary
Red
High Cost Medicine
 
Link  NICE TA146: Adalimumab for the treatment of adults with psoriasis
   
Apremilast
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Formulary
Red
High Cost Medicine
  • In line with NICE
  • Use in adults is commissioned by CCGs 
  • Link  NICE TA433: Apremilast for treating active psoriatic arthritis
    Link  NICE TA419: Apremilast for treating moderate to severe plaque psoriasis
       
    Cytotoxic Drug Azathioprine (dermatology)
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    Formulary
    Amber SC
    • supported by ESCA, see link below
     
    Link  ESCA Azathioprine (dermatology)
    Link  UKMI Q&A: Can mothers breastfeed while taking azathioprine?
       
    Ciclosporin
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    Formulary
    Amber SC
    • supported by ESCA, see link below
     
    Link  ESCA Ciclosporin (dermatology)
       
    Dimethyl fumarate (Skilarence®)
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    Formulary
    Red
    High Cost Medicine
  • For use in moderate to severe plaque psoriasis- CCG commissioned
  • In line with NICE 
  • Link  NICE TA475: Dimethyl fumarate for treating moderate to severe plaque psoriasis
       
    Etanercept
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    Formulary
    Red
    High Cost Medicine
  • use in line with NICE TA 103 
  • Link  NICE TA103: Etanercept and efalizumab for the treatment of adults with psoriasis
       
    Guselkumab (Tremfya ® )
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    Formulary
    Red
    CCG

    Use in line with NICE

     
    Link  NICE TA521: Guselkumab for treating moderate to severe plaque psoriasis
       
    Hydroxycarbamide
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    Formulary
    Red
     
       
    Hydroxychloroquine
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    Formulary
    Amber Recommended
     
       
    Infliximab
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    Formulary
    Red
    High Cost Medicine
  • For treatment of adults with psoriasis- use in line with NICE TA134 
  • Link  NICE TA134: Infliximab for psoriasis
       
    Ixekizumab (Taltz®)
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    Formulary
    Red
    CCG
    • In line with NICE
     
    Link  NICE TA 537: Ixekizumab for treating active psoriatic arthritis after inadequate response to DMARDs
    Link  NICE TA442: Ixekizumab for treating moderate to severe plaque psoriasis
       
    Cytotoxic Drug Methotrexate
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    Formulary
    • supported by ESCA, see link below
     
    Link  ESCA Methotrexate (dermatology)
    Link  UKMI Q&A: What is the clinical significance of the interaction between methotrexate and penicillins? (Oct13)
       
    Mycophenolate
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    Formulary
    Amber
  • supported by ESCA (to be developed) 
  •    
    Omalizumab
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    Formulary
    Red
  • In line with NICE  
  • Link  NICE TA 339: Omalizumab for previously treated chronic spontaneous urticaria
       
    Pimecrolimus  (Elidel®)
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    Formulary
    Amber Recommended
    • in line with NICE
     
    Link  NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
       
    Secukinumab
    ( View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine
  • Use in line with NICE  
  • Link  TA445: Certolizumab pegol and secukinumab for treating active psoriatic arthritis after inadequate response to DMARDs
    Link  TA350: Secukinumab for treating moderate to severe plaque psoriasis
    Link  TA407: Secukinumab for active ankylosing spondylitis after treatment with non-steroidal anti-inflammatory drugs or TNF-alpha inhibitors
       
    Tacrolimus  (Protopic®)
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    Formulary
    Amber Recommended
    • in line with NICE
    • 0.03% & 0.1% ointment
     
    Link  NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
       
    Thalidomide
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    Formulary
    Red
  • NHS England commissioned drug 
  •    
    Tildrakizumab
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    Formulary
    Red
    CCG
    • In line with NICE
     
    Link  NICE TA575: Tildrakizumab for treating moderate to severe plaque psoriasis
       
    Ustekinumab
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    Formulary
    Red
    High Cost Medicine
  • For treating moderate to severe psoriasis- use in line with NICE TA180

     
  • Link  NICE TA180: Ustekinumab for the treatment of adults with moderate to severe psoriasis
    Link  For use in psoriatic arthritis, click here for Chapter 10
       
     ....
     Non Formulary Items
    Efalizumab  (Raptiva®)

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    Non Formulary
     
      
    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
    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

    Prescribing in children

    The APC notes that the informed use of unlicensed medicines or of licensed medicines for unlicensed applications (‘off-label’ use) is often necessary in paediatric practice.

    The APC advises GPs to consider specialist prescribing recommendations for Green and Amber medicines that are not subject to ESCAs or RICaDs in combination with the information provided in the BNFC which goes beyond that of marketing authorisations. The BNFC has been designed for rapid reference and the information presented has been carefully selected to aid decisions on prescribing.
      

    Green

    Medicines suitable for routine use within primary care. Initiation and maintenance of prescribing by Specialists, GPs and other qualified clinicians.   

    Amber Initiation

    Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry.  

    Amber Recommended

    Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.  

    Amber SC

    Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry.  

    Red

    Medicines for initiation and maintenance prescribing by Specialists only.  

    Black

    Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use.  

    Grey

    Positive NICE TA and/or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information.  

    The term 'Specialist' refers to Consultants, General Practitioners and Independant Prescribers with a Specialist Interest.  

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