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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
08.03.04  Expand sub section  Hormone antagonists
08.03.04.01  Expand sub section  Breast cancer
Anastrozole
(Breast cancer)
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Restricted Drug Restricted
Amber
 
   
Letrozole
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Restricted Drug Restricted
Amber
 
   
Palbociclib (Ibrance)
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Restricted Drug Restricted
Red
High Cost Medicine
Cancer Drugs Fund

Oral cancer drug (NHSE commissioned)

 

 
Link  NICE TA495: Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
   
Ribociclib (Kisqali)
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Restricted Drug Restricted
Red
High Cost Medicine
Cancer Drugs Fund

Oral cancer drug (NHSE commissioned)

 

 
Link  NICE TA496: Ribociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer
   
Tamoxifen
(Breast cancer/ mastocytosis)
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Restricted Drug Restricted
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08.03.04.02  Expand sub section  Prostate cancer and gonadorelin analogues
08.03.04.02  Expand sub section  Gonadorelin analogues
Degarelix (Firmagon)
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Restricted Drug Restricted
Amber

▼ Consultant initiation only in advanced hormone dependant Prostate cancer - see shared care

 

 
Link  NICE TA404: Degarelix for treating advanced hormone-dependent prostate cancer
   
08.03.04.02  Expand sub section  Anti-androgens to top
Bicalutamide
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Prescribe generically. Use 50mg OD for four weeks to inhibit tumour flare when starting treatment with an LHRH analogue

 
   
Buserelin
(Prostate)
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Red

Not suitable for primary care, cancer or gynaecology indications

 
   
Cyproterone
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Restricted Drug Restricted
Amber

(Acetate) 50-100mg TDS for hot flushes only (not to be used to reduce tumour flare)

 
   
Enzalutamide (Xtandi)
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Restricted Drug Restricted
Red
High Cost Medicine
NHS England

Oral cancer drug (NHSE commissioned)

 

 
Link  NICE TA316: Enzalutamide for prostate cancer
Link  NICE TA377: Enzalutamide for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated
   
Flutamide
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Restricted Drug Restricted
Red
NHS England

Oral cancer drug (NHSE commissioned

 

 
   
Goserelin (Zoladex)
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Amber
 
   
Goserelin (Zoladex LA)
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Restricted Drug Restricted
Amber
 
   
Leuprorelin Acetate (Prostap 3)
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Formulary
Amber
 
   
Leuprorelin Acetate (Prostap SR)
(Monthly preparation)
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Formulary
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Triptorelin (Decapeptyl)
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Formulary
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Decapeptyl SR® first line for new patients

The 3mg (one month) preparation to be stocked in hospital. Three (11.25mg) and six (22.5mg) month preparations prescribed on advice of urology team via primary care

 
   
08.03.04.03  Expand sub section  Somatostatin analogues
Lanreotide (Somatuline Autogel)
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Red
High Cost Medicine

 Injectable preparation not suitable for use in Primary Care

 
   
Lanreotide (Somatuline LA)
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Restricted Drug Restricted
Red

Injectable preparation not suitable for use in Primary Care

May be used "off label" to reduce output in patients with pancreatic fistula 

 
   
Octreotide (Sandostatin Lar)
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Amber
High Cost Medicine
 
   
Octreotide (Sandostatin)
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Restricted Drug Restricted
Amber
High Cost Medicine
 
   
 ....
 Non Formulary Items
Abiraterone  (Zytiga)

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Non Formulary
Red
High Cost Medicine
NHS England

Oral cancer drug (NHSE commissioned)

Link  NICE TA259: Abiraterone for castration resistant prostate cancer
Link  NICE TA387:Abiraterone for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated
 
Exemestane

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Non Formulary
 
Fulvestrant  (Faslodex)

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Non Formulary

NICE "do-not-do" recommendation

 

Link  NICE TA239: Fulvestrant for the treatment of locally advanced or metastatic breast cancer
Link  NICE YA503: Fulvestrant for untreated locally advanced or metastatic oestrogen-receptor positive breast cancer
 
Goserelin  (Zoladex)
(Breast cancer)

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Non Formulary
 
Histrelin  (Vantas®)

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Non Formulary
 
Neratinib

Non Formulary
 
Radium-223 dichloride
(Xofigo)

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Non Formulary
High Cost Medicine
Cancer Drugs Fund
Link  NICE TA376: Radium-223 dichloride for treating hormone-relapsed prostate cancer with bone metastases
Link  NICE TA412: Radium-223 dichloride for treating hormone-relapsed prostate cancer with bone metastases
 
Tamoxifen  (Nolvadex-D®)

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Non Formulary
 
Toremifene  (Fareston)

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Non Formulary
 
Triptorelin  (Gonapeptyl Depot)

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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
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Link to children's BNF
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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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