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Milton Keynes Formulary
Milton Keynes University Hospital NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes Clinical Commissioning Group
Milton Keynes Community Health Services
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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
Notes:

 

NHS Clinical Commissioning Policy: Haematopoietic Stem Cell Transplantation B04/P/a

Contacting Milton Keynes Hospital

      
For Haematology and Oncology:

  • During hours: Macmillan Unit on 01908 243671; Internal Ext 5111 or 5112
  • Out of hours: Advanced Nurse Practitioner on bleep 1090    

Paediatric patients:

  • During hours: Paediatric Day Community Unit on 01908 242703; Internal Ext 2703      

Pharmacy:

  • Cancer and Aseptic Services Manager on bleep 1721
  • Aseptic Unit 01908 243952
  • On-call pharmacist via switchboard 01908 660033
Chapter Links...
 Details...
08.02.02  Expand sub section  Corticosteroids and other immunosuppressants
Basiliximab (Simulect)
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Formulary
Red
High Cost Medicine

Simulect Injection 10mg, 20mg

 

 

 
Link  NICE TA481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
   
Ciclosporin
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Formulary
Amber SCG
High Cost Medicine
Homecare

Neoral caosules 10mg, 25mg, 50mg, 100mg

Sandimmun concentrate for iv infusion 250mg/5ml (Hospital only)

 

Notes:
Patients should be stabilised on a particular brand of oral ciclosporin because
switching between formulations without close monitoring may lead to clinically
important changes in blood-ciclosporin concentration.


Prescribing and dispensing of ciclosporin should be by brand name to
avoid inadvertent switching.


If it is necessary to switch a patient to a different brand of ciclosporin, the
patient should be monitored closely for changes in blood-ciclosporin
concentration, serum creatinine, blood pressure, and transplant function.

 
   
Sirolimus (Rapamune)
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Formulary
Amber 3
High Cost Medicine
Homecare

Tablets 500mcg, 1mg and 2mg
Oral solution 1mg/mL

Notes:
The 500mcg (i.e. 0.5mg) tablet is not bioequivalent to the 1mg and 2mg
tablets.
Multiples of 0.5mg tablets should not be used as a substitute for other tablet
strengths.

 
   
Tacrolimus
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Formulary
Red

Adoport® capsules 500mcg and 1mg
Modigraf®granules 200mcg and 1mg sachet packs

Notes:

Switching between different oral formulations of Tacrolimus requires careful
therapeutic monitoring. Changes to oral tacrolimus therapy should be made
only under the close supervision of a transplant specialist.


The three different pharmaceutical forms of oral tacrolimus products are shown
below, together with brand names of currently approved products.
1. Immediate release capsule taken twice a day (including the following brands -
Adoport, Aletris, Capexion, Evenil, Miloprosan, Prograf, Tacni, Takon, Taliximun,
Tamitect and Vivadex)
2. Prolonged release capsule taken once daily (Advagraf)
3. Granules for oral solution taken twice daily (Modigraf).

 
Link  Drug Safety Update: Oral tacrolimus products: reminder to prescribe and dispense by brand name only
   
 ....
 Non Formulary Items
AdoPORT  (Tacrolimus)

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Non Formulary
Homecare
 
Advagraf
(Tacrolimus)

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Non Formulary
Homecare
Link  CAS letter: Oral tacrolimus products should be prescribed and dispensed by brand name to avoid the risk of medication errors
 
Antithymocyte immunoglobulin (rabbit)  (Thymoglobuline)

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Non Formulary
High Cost Medicine
 
Belatacept  (Nulojix)

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Non Formulary
High Cost Medicine
 
Ciclosporin  (Capsorin)

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Non Formulary
 
Daclizumab  (Zenapax)

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Non Formulary
 
Envarsus
(Tacrolimus)

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Non Formulary
Homecare
 
Everolimus  (Certican)
(Transplant)

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Non Formulary
High Cost Medicine
 
Modigraf
(Tacrolimus)

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Non Formulary
Homecare
 
Prednisolone
(Immunosuppressant)

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Non Formulary
 
Prednisolone
(Post- transplant)

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Non Formulary
 
Prograf
(Tacrolimus)

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Non Formulary
Homecare
 
  
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

Routine prescribing within licensed indication  

Amber 1

Specialist recommendation followed by GP initiation and continuation  

Amber 2

Specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation   

Amber 3

Specialist initiation and stabilisation followed by GP continuation  

Amber SCG

Specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline  

Red

Hospital or specialist prescribing only  

Red Red

These medicines have been evaluated and rejected by MKPAG and are NOT approved for use within MK. They are not recommended for use because of lack of clinical effectiveness, cost effectiveness or safety.  

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