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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
08.02.02  Expand sub section  Other immunosuppressants
Ciclosporin
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Formulary
Amber
Capsules
Oral solution

note Prescribe by brand. Do not switch between brands.
Brands:
  • Capimune®
  • Capsorin®
  • Deximune®
  • Neoral®


    Red Traffic Light  Red if no shared care protocol (licensed indications only)

     
  • Link  GMMMG Shared Care Protocols
       
    Tacrolimus
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    Formulary
    Amber
    Capsules
    Granules
    Modified-release capsules
    Concentrate for intravenous infusion

    note Prescribe by brand. Do not switch between brands.

    There are 3 different oral formulations of tacrolimus:
  • Adoport®, Prograf®, Capexion®, Tacni®, and Vivadex® are immediate-release capsules that are taken twice daily, once in the morning and once in the evening;
  • Modigraf® granules are used to prepare an immediate-release oral suspension which is taken twice daily, once in the morning and once in the evening;
  • Advagraf® is a prolonged-release capsule that is taken once daily, in the morning.  
  • Link  MHRA Drug Safety Update, June 2012. Oral tacrolimus products - prescribe by brand
       
     ....
     Non Formulary Items
    Basiliximab  (Simulect®)

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    Non Formulary
    Red
     
    Belatacept  (Nulojix®)

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    Non Formulary
    Red
     
    Daclizumab  (Zenapax®)

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    Non Formulary
     
    Sirolimus  (Rapamune®)

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    Non Formulary
    Amber
    MAY BE USED FOR ESTABLISHED PATIENTS ONLY

    note The 500 microgram tablets are not bioequivalent with the 1mg and 2mg tablets and multiples must not be used as a substitute for the other tablet strengths.

     
      
    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
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    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

    Amber

    Drugs designated amber are suitable for shared care arrangements under a shared care protocol. Prescribing may be transferred from secondary to primary care once the patient is stabilised and agreed shared care arrangements have been established. Alternatively primary care may initiate under the supervision of secondary care if this option is given in the shared care document. It is recommended that shared care arrangements should be drawn up following local discussion and agreement by prescribing parties.   

    Black

    These products have been reviewed by the GM Joint Formulary Group and have been deemed not suitable for prescribing for adults in primary or secondary care within Greater Manchester. These decisions have been made on the basis of safety, efficacy and cost-effectiveness of the products.  

    Green

    Not used   

    Green 1

    Drugs designated green1 are suitable for initiation and ongoing prescribing within primary care.   

    Green 2

    Drugs designated green2 can be initiated by primary care following written or verbal advice from a specialist and then be subsequently safely prescribed in primary care with little or no monitoring required.  

    Green 3

    Drugs designated green3 are suitable for on-going prescribing within primary care after specialist initiation and an initial review (unless specified) in secondary care. Little or no monitoring is required.  

    Grey

    Not suitable for routine prescribing but may be suitable for a defined patient population. Whilst prescribers should think very carefully before prescribing or recommending any of the products on the grey list, there may be exceptional instances when the use of one of these products is necessary for a particular patient.   

    Red

    Drugs designated red are considered to be specialist medicines and prescribing responsibility for these medicines should normally remain with the consultant or specialist clinician. These drugs should not be initiated or prescribed in primary care. It is recommended that the supply of these specialist medicines should be organised via the hospital pharmacy, this may include arranging for supply via a home care company.   

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