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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
Notes:

For the most up to date list of agents funded by the Cancer Drugs Fund, please see Cancer Drug Fund list

 Details...
08.01.03  Expand sub section  Antimetabolites
Cytotoxic Drug Azacitidine (Vidaza®)
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Red
 
Link  NICE TA218: azacitidine for myelodysplastic syndromes
   
Cytotoxic Drug Capecitabine (Tablets)
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Formulary
Red
 
Link  NICE TA100: Colon cancer (adjuvant) - capecitabine and oxaliplatin
Link  NICE TA191: Gastric cancer (advanced) - capecitabine
Link  NICE TA61: Colorectal cancer - capecitabine and tegafur uracil
   
Cytarabine–daunorubicin liposomal (Vyxeos®)
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Red
NHS England

In line with NICE

 
Link  NICE TA552: Liposomal cytarabine–daunorubicin for untreated acute myeloid leukaemia
   
Cytotoxic Drug Fludarabine Phosphate
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Red
 
Link  NICE TA119: Leukaemia (lymphocytic) - fludarabine
Link  NICE TA29: Leukaemia (lymphocytic) - fludarabine
Link  NICE TA640: Treosulfan with fludarabine for malignant disease before allogeneic stem cell transplant
   
Cytotoxic Drug Gemcitabine (Gemzar®)
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Red
 
Link  NICE NG85: Pancreatic cancer in adults: diagnosis and management
Link  NICE TA116: Breast cancer - gemcitabine
   
Cytotoxic Drug Mercaptopurine (Tablets)
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Red

Red for cancer indications

See section 01.05.03 for use in IBD

 
   
Cytotoxic Drug Methotrexate 2.5mg (Tablets)
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Red

Red for cancer indications 

See section 13.05.03 for psoriasis, 01.05.03 for Crohn's disease, 03.12 for interstitial lung disease and 10.01.03 for rheumatology indications.

 
Link  UKMI Q&A: Should patients drink alcohol whilst taking long-term low-dose methotrexate?
Link  UKMI Q&A: What is the clinical significance of the interaction between methotrexate and penicillins? (Oct13)
   
Cytotoxic Drug Pemetrexed (Alimta®)
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Red
Cancer Drugs Fund
 
Link  NICE TA124: Lung cancer (non-small-cell) - pemetrexed - prior chemotherapy
Link  NICE TA135: Mesothelioma - pemetrexed disodium
Link  NICE TA181: Lung cancer (non-small cell, first line treatment) - pemetrexed
Link  NICE TA190: Lung cancer (non-small-cell) - pemetrexed (maintenance)
Link  NICE TA402: Lung cancer (non-squamous non-small-cell) after pemetrexed and cisplatin: Pemetrexed (maintenance)
   
Raltitrexed (Tomudex®)
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Red
 
Link  NICE CG131:Colorectal cancer: diagnosis and management
   
Cytotoxic Drug Tioguanine (Tablets)
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Red
 
   
Cytotoxic Drug Trifluridine-tipiracil  (Lonsurf ®)
(Tablets)
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Formulary
Red
High Cost Medicine
  • In line with NICE
  • Hospital only- NHSE commissioned 
  • Link  NICE TA405: Trifluridine–tipiracil for previously treated metastatic colorectal cancer
       
     ....
    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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