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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
08.02.03  Expand sub section  Anti-lymphocyte monoclonal antibodies
Cytotoxic Drug Rituximab (MabThera«)
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First Choice
Red
Concentrate for intravenous infusion

Restricted ItemáSpecialist use only 
Alemtuzumab (MabCampath«)
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Formulary
Red
Concentrate for intravenous infusion

Restricted ItemáSpecialist use only

Patient access scheme may be available. Patient access and monitoring form available from pharmacy. 
Link  NICE TA312: Alemtuzumab for treating relapsing-remitting multiple sclerosis
   
Obinutuzumab (Gazyvaro«)
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Formulary
Red
Concentrate for intravenous infusion
Restricted Item Specialist use only; for previously untreated chronic lymphocytic leukaemia (CLL) in patients with comorbidities making them unsuitable for full-dose fludarabine-based therapy 
   
Ofatumumab (Arzerra«)
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Formulary
Red
Cancer Drugs Fund
Concentrate for intravenous infusion

Restricted Item Specialist use only; CDF criteria must be met & funding approval received. 
Link  MHRA Drug Safety Update, August 2014: Ofatumumab: reminder of risk of serious and fatal infusion reactions
Link  MHRA Drug Safety Update, January 2014: Ofatumumab: Screen for hepatitis B virus before treatment
   
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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
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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

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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