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Wye Valley NHS Trust
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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
08.02  Expand sub section  Drugs affecting the immune response
08.02  Expand sub section  Immunosuppressant therapy
08.02.01  Expand sub section  Antiproliferative immunosuppressants
Cytotoxic Drug Azathioprine
(Chemotherapy/ post- transplant)
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Restricted Drug Restricted
Red Amber

 Hospital Only for NEW renal transplant patients

 
   
Azathioprine (Imuran®)
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Restricted Drug Restricted
Amber
 
   
Mycophenolate Mofetil
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Restricted Drug Restricted
Red Amber
High Cost Medicine

Shared care in gastroenterology & rheumatology.

Hospital only for NEW renal transplant patients

Mycophenolate may be used for the licensed indication and for unlicensed use in rheumatology, nephrology, neurology, gastroenterology, haematology and respiratory medicine only

 
   
08.02.02  Expand sub section  Corticosteroids and other immunosuppressants
AdoPORT ® (Tacrolimus)
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Restricted Drug Restricted
Red

Do not prescribe for new renal transplant patients

 
   
Advagraf ®
(Tacrolimus)
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Restricted Drug Restricted
Red

Do not prescribe for new renal transplant patients

 

 
   
Ciclosporin
(transplants)
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Restricted Drug Restricted
Red Amber
High Cost Medicine

Hospital only for NEW renal transplant patients

 
   
Ciclosporin (Capsorin®)
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Restricted Drug Restricted
Red Amber

Hospital only for NEW renal transplant patients

See specialist information for other indications.

Prescribe by brand to ensure consistency of supply

 
   
Ciclosporin (Deximune®)
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Restricted Drug Restricted
Red Amber

Hospital only for NEW renal transplant patients 

See specialist information for other indications.

Prescribe by brand to ensure consistency of supply

 
   
Ciclosporin (Sandimmun®)
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Restricted Drug Restricted
Red Amber

Hospital only for NEW renal transplant patients

See specialist information for other indications.

Prescribe by brand to ensure consistency of supply

 

 
   
Envarsus®
(Tacrolimus)
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Restricted Drug Restricted
Red

Do not prescribe for new renal transplant patients

 

 
   
Modigraf ®
(Tacrolimus)
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Restricted Drug Restricted
Red

Do not prescribe for new renal transplant patients

 
   
Prograf ®
(Tacrolimus)
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Restricted Drug Restricted
Red

Do not prescribe for new renal transplant patients

 

 
   
Cytotoxic Drug Sirolimus (Rapamune®)
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Restricted Drug Restricted
Red
High Cost Medicine

Do not prescribe for new renal transplant patients

 

 
   
Tacrolimus
(Vivadex)
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Restricted Drug Restricted
Red

Do not prescribe for new renal transplant patients

 
   
08.02.03  Expand sub section  Anti-lymphocyte monoclonal antibodies to top
Rituximab (MabThera®)
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Restricted Drug Restricted
Red
High Cost Medicine
 
   
Rituximab (MabThera®)
(Subcutaneous injection)
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Restricted Drug Restricted
Red
High Cost Medicine
 
   
Rituximab (Truxima®)
(Biosimilar)
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Restricted Drug Restricted
Red
High Cost Medicine
 
   
08.02.04  Expand sub section  Other immunomodulating drugs
Dimethyl fumarate (Tecfidera®)
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Restricted Drug Restricted
Red
High Cost Medicine

Not suitable for primary care prescribing

 

 
Link  NICE TA320: Dimethyl fumarate for multiple sclerosis
Link  NICE TA475: Dimethyl fumarate for treating moderate to severe plaque psoriasis
   
Fampridine
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Restricted Drug Restricted
Red
High Cost Medicine

Not suitable for primary care prescribing

 

 
   
Lenalidomide
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Restricted Drug Restricted
Red
High Cost Medicine
Cancer Drugs Fund
NHS England

 ▼in line with NICE TAG 171 for the treatment of multiple myeloma in combination with dexamethasone in patients who have received two or more prior therapies. 

 
   
Thalidomide (Celgene®)
(haematology)
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Restricted Drug Restricted
Red
High Cost Medicine

Named patient basis & restricted to Consultant Haematologists and

Consultant Dermatologist in specific indications

 
   
08.02.04  Expand sub section  Interferon Alfa
Interferon Alfa
(IntronA)
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Restricted Drug Restricted
Red
High Cost Medicine
NHS England

Injectable preparation (NHSE commissioned)

 

 
Link  NICE TA75: Interferon Alfa - Chronic Hepatitis C
   
Interferon Alfa (Roferon-A®)
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Restricted Drug Restricted
Red
High Cost Medicine
NHS England

Injectable preparation (NHSE commissioned)

 
   
Interferon Alfa (Viraferon®)
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Restricted Drug Restricted
Red
High Cost Medicine
NHS England

Injectable preparation (NHSE commissioned)

 
   
Peginterferon Alfa (Pegasys®)
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Restricted Drug Restricted
Red
High Cost Medicine
NHS England

Injectable preparation (NHSE commissioned)

 

 
Link  NICE TA106: Hepatitis C - peginterferon alfa & ribavirin
Link  NICE TA200: Hepatitis C - peginterferon alfa & ribavirin
Link  NICE TA300: Hepatitis C - peginterferon alfa
Link  NICE TA75: Hepatitis C - pegylated interferons, ribavirin & alfa interferon
Link  NICE TA96: Hepatitis B - peginterferon alfa
   
Peginterferon Alfa (PegIntron®)
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Restricted Drug Restricted
Red
High Cost Medicine
NHS England

Injectable preparation (NHSE commissioned)

 
   
Peginterferon Alfa (ViraferonPeg®)
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Restricted Drug Restricted
Red
High Cost Medicine
NHS England

Injectable preparation (NHSE commissioned)

 
   
08.02.04  Expand sub section  Interferon beta
Peginterferon Beta-1a (Plegridy®)
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Restricted Drug Restricted
Red
High Cost Medicine

Injectable preparation (NHSE commissioned)

 

 
   
08.02.04  Expand sub section  Interferon gamma
08.02.04  Expand sub section  Aldesleukin to top
BCG bladder instillation (ImmuCyst®)
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Restricted Drug Restricted
Red

Specialist use only

 
   
BCG bladder instillation (OncoTICE®)
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Restricted Drug Restricted
Red

Specialist use only

 
   
08.02.04  Expand sub section  BCG bladder instillation
08.02.04  Expand sub section  Canakinumab
08.02.04  Expand sub section  Dimethyl fumarate
08.02.04  Expand sub section  Fingolimod
08.02.04  Expand sub section  Glatiramer acetate to top
Glatiramer Acetate (Copaxone®)
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Restricted Drug Restricted
Red
High Cost Medicine
NHS England

Injectable preparation (NHSE commissioned)

 

 
Link  NICE CG32: Glatiramer for the treatment of MS
   
08.02.04  Expand sub section  Histamine
08.02.04  Expand sub section  Lenalidomide, pomalidomide, and thalidomide
08.02.04  Expand sub section  Mifamurtide
08.02.04  Expand sub section  Natalizumab
08.02.04  Expand sub section  Teriflunomide to top
 ....
 Non Formulary Items
Aldesleukin  (Proleukin®)

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Non Formulary
High Cost Medicine
 
Alemtuzumab  (Lemtrada®)

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Non Formulary
Link  NICE TA312: Alemtuzumab for relapsing‑remitting multiple sclerosis
 
Alemtuzumab  (MabCampath®)

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Non Formulary
High Cost Medicine
 
Antithymocyte immunoglobulin (rabbit)  (Thymoglobuline®)

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Non Formulary
High Cost Medicine
 
Basiliximab  (Simulect®)

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Non Formulary
High Cost Medicine
Link  NICE TA481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
 
Belatacept  (Nulojix®)

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Non Formulary
High Cost Medicine
 
Blinatumomab  (Blincyto®)

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Non Formulary
Link  NICE TA450 : Blinatumomab for previously treated Philadelphia-chromosome-negative acute lymphoblastic leukaemia
 
Canakinumab  (Ilaris®)

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Non Formulary
High Cost Medicine
 
Cediranib  (Recentin®)

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Non Formulary
 
Cobimetinib  (Cotellic®)

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Non Formulary
Link  NICE TA414: Cobimetinib in combination with vemurafenib for treating unresectable or metastatic BRAF V600 mutation-positive melanoma
 
Daclizumab  (Zenapax®)

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Non Formulary
Link  NICE TA441 : Daclizumab for treating relapsing–remitting multiple sclerosis
 
Daclizumab  (Zinbryta®)

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Non Formulary
High Cost Medicine
 
Delete

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Dinutuximab  (Unituxin®)

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Non Formulary
 
Cytotoxic Drug  Everolimus  (Certican®)
(Transplant)

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Non Formulary
High Cost Medicine
 
Fingolimod

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Non Formulary
High Cost Medicine
Link  NICE TA254: Fingolimod for highly active relapsing remitting multiple sclerosis
 
Interferon Beta  (Avonex®)

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Non Formulary
High Cost Medicine
 
Interferon Beta  (Betaferon®)

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Non Formulary
High Cost Medicine
 
Interferon beta  (Extavia®)

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Non Formulary
High Cost Medicine
 
Interferon Beta  (Proleukin®)

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Non Formulary
High Cost Medicine
 
Interferon Beta  (Rebif®)

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Non Formulary
High Cost Medicine
Link  NICE TA32: Interferon Beta for MS
Link  NICE TA527: Beta interferons and glatiramer acetate for treating multiple sclerosis
 
Mifamurtide  (Mepact®)

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Non Formulary
Link  NICE TA235: Osteosarcoma - mifamurtide: guidance
 
Mycophenolate Sodium  (Myfortic®)

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Non Formulary
 
Natalizumab  (Tysabri®)

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Non Formulary
High Cost Medicine
Link  NICE TA127: Multiple sclerosis - natalizumab
 
Niraparib  (Zejula®)

Non Formulary
High Cost Medicine
Link  NICE TA528: Niraparib for maintenance treatment of relapsed, platinum-sensitive ovarian, fallopian tube and peritoneal cancer
 
Nivolumab  (Opdivo®)

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Non Formulary
High Cost Medicine
Cancer Drugs Fund
Link  NICE TA384: Nivolumab for treating advanced (unresectable or metastatic) melanoma
Link  NICE TA400: Nivolumab in combination with ipilimumab for treating advanced melanoma
Link  NICE TA417: Nivolumab for previously treated advanced renal cell carcinoma
Link  NICE TA462 : Nivolumab for treating relapsed or refractory classical Hodgkin lymphoma
Link  NICE TA483: Nivolumab for previously treated squamous non-small-cell lung cancer
Link  NICE TA484: Nivolumab for previously treated non-squamous non-small-cell lung cancer
Link  NICE TA490: Nivolumab for treating squamous cell carcinoma of the head and neck after platinum-based chemotherapy
Link  NICE TA530: Nivolumab for treating locally advanced unresectable or metastatic urothelial cancer after platinum-containing chemotherapy
 
Obinutuzumab  (Gazyvaro ®)

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Non Formulary
High Cost Medicine
Link  NICE TA343: Obinutuzumab with chlorambucil for CLL
Link  NICE TA472: Obinutuzumab with bendamustine for treating follicular lymphoma refractory to rituximab
Link  NICE TA513:Obinutuzumab for untreated advanced follicular lymphoma
 
Ofatumumab  (Arzerra®)

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Non Formulary
High Cost Medicine
Link  NICE TA344: Ofatumumab with chlorambucil or bendamustine for CLL
 
Olaparib  (Lynparza®)

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Non Formulary
High Cost Medicine
Link  NICE TA381: Olaparib guidance
 
Osimertinib  (Tagrisso)

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Non Formulary
Link  NICE TA416: Osimertinib for treating locally advanced or metastatic EGFR T790M mutation-positive non-small-cell lung cancer
 
Pemrolizumab  (Keytruda®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Pomalidomide  (Imnovid®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
Cancer Drugs Fund
Link  NICE TA388: Pomalidomide for myeloma
Link  NICE TA427: Pomalidomide for multiple myeloma previously treated with lenalidomide and bortezomib
 
Prednisolone
(Post- transplant)

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Non Formulary
 
Prednisolone
(Immunosuppressant)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Talimogene laherparepvac  (Imlygic®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Teriflunomide  (Aubagio®)

View adult BNF View SPC online View childrens BNF
Non Formulary
High Cost Medicine
Link  NICE TA303: Teriflunomide for relapsing remitting MS
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
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

Green

Suitable for use in primary care  

Amber

Specialist initiation. Shared care in place  

Red

Red do not use..  

Advice

Some formulations restricted  

Black

NICE "Do not do"  

Green 1

1st line option  

Green 2

2nd line option  

Green 3

3rd line option only  

Not Recomended / Black

Low Value Medicine not recommended for use - see NHSE guidelines  

OTC

This preparation should be bought over the counter for self-care  

Red Amber

Check product description for traffic light status  

Red Black

Low Value Medicine  

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