netFormulary Coventry and Warwickshire Area Prescribing Committee NHS
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 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
08.01.03  Expand sub section  Antimetabolites
Cytotoxic Drug Mercaptopurine
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Red SO
Treatment of leukemia
 
   
Cytotoxic Drug Azacitidine
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Red SO

Treatment of myelodysplastic syndromes, chronic myelomonocytic leukaemia and acute myeloid leukaemia in adults

 
Link  NICE TA218: Azacitidine for myelodysplastic syndromes
   
Cytotoxic Drug Capecitabine
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Red SO
Treatment for all licensed indications 
Link  NICE TA100: Colon cancer (adjuvant) - capecitabine and oxaliplatin
Link  NICE TA191: Gastric cancer (advanced) - capecitabine
Link  NICE TA61: Colorectal cancer - capecitabine and tegafur uracil
   
Cytotoxic Drug Cladribine
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Red SO
Treatment of hairy cell leukaemia and B-cell chronic lymphocytic leukaemia
 
   
Cytotoxic Drug Clofarabine
(Unlicensed indication)
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Red SO
Treatment of acute lymphoblastic leukemia
- unlicensed treatment of acute myeloblastic leukemia CDF

 
   
Cytotoxic Drug Cytarabine
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Red SO
Treatment of lymphomatous meningitis
 
   
Cytotoxic Drug Cytarabine
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Red SO
Treatment of leukaemias
 
   
Cytotoxic Drug Decitabine
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Red SO
Treatment of acute myeloid leukaemia
 
Link  NICE TA270: Leukaemia (acute myeloid ) - decitabine (terminated appraisal) (TA270)
   
Cytotoxic Drug Fludarabine Phosphate
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Red SO
Treatment of B-cell chronic lymphocytic leukaemia
 
Link  NICE TA119: Leukaemia (lymphocytic) - fludarabine
Link  NICE TA29: Leukaemia (lymphocytic) - fludarabine
   
Cytotoxic Drug Fluorouracil iv/oral
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Red SO
Treatment of some solid tumours including gastro-intestinal tract cancers, breast cancer and colorectal cancer
 
   
Cytotoxic Drug Gemcitabine
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Red SO
Treatment of bladder, breast, ovarian, pancreatic and non-small-cell lung cancers
 
Link  NICE TA116: Breast cancer - gemcitabine
Link  NICE TA25: Pancreatic cancer - gemcitabine
Link  NICE TA440: Pegylated liposomal irinotecan for treating pancreatic cancer after gemcitabine
   
Cytotoxic Drug Methotrexate oral, IV, Intrathecal
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Red SO
Treatment of acute lymphoblastic leukaemia, Choriocarcinoma, Non-Hodgkin's lymphoma, Solid tumours, meningeal cancer and lymphoma
 
   
Nelarabine
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Red SO
Treatment of lymphoblastic leukaemia and lymphoblastic lymphoma
 
   
Cytotoxic Drug Pemetrexed (Alimta®)
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Red SO
Treatment of lung cancer and mesothelioma
 
Link  NICE TA124: Lung cancer (non-small-cell) - pemetrexed
Link  NICE TA135: Mesothelioma - pemetrexed disodium
Link  NICE TA181: Lung cancer (non-small cell, first line treatment) - pemetrexed
Link  NICE TA190: Lung cancer (non-small-cell) - pemetrexed (maintenance)
Link  NICE TA309: Lung cancer (non small cell, non squamous) - pemetrexed
   
Cytotoxic Drug Raltitrexed
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Red SO
Palliation of colorectal cancer
 
   
Cytotoxic Drug Tegafur/gimeracil/oteracil
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Red SO
Treatment of gastric cancer
 
   
Cytotoxic Drug Tioguanine
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Red SO
Treatment of leukemias
 
   
Trifluridine/tipiracil
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Red SO
Treatment of 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
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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
Homecare
Homecare

Traffic Light Status Information

Status Description

Preferred

Clinicians are free to prescribe these drugs. They are regarded as cost effective choices which have evidence to support their use.  

Second Line

These drugs should only be prescribed in the scenarios described in the formulary after preferred drug(s) have been ruled out.  

Non Formulary

Non-formulary choice - the vast majority of a patient’s needs should be met by use of formulary preferred choices and second line options when appropriate. Therefore the Clinician should only use a non-formularly drug if this can be justified and it is recommended that all such instances are recorded in the patient record.  

Green SA

Specialist Advised – Specialists may simply advise a patient’s GP to initiate these drugs themselves after they have made an initial assessment. Note: SA drugs can be initiated by the specialist according to patient need and also depending on local commissioning arrangements which may mandate, through the contract between provider and commissioner, that all SA drugs are treated as SI.  

Green SI

Specialist Initiation - These drugs must be initiated, i.e. the first dose prescribed, by the specialist and then may be continued when appropriate by the patient’s GP following communication from the specialist.  

Amber SC

Shared Care - Responsibility for prescribing may be transferred from secondary to primary care with the agreement of an individual GP and when agreed shared care arrangements have been established. The specialist MUST stabilize the patient before asking for care to be transferred. Only specialists should initiate these drugs. Prescribing should be transferred to GPs according to an Shared Care Agreement [SCA]   

Red SO

Specialist Only - These drugs are deemed to be not appropriate for prescribing by GPs. Specialists should not ask GPs to prescribe these drugs.   

Black BL

Black Listed Medicines - These drugs are considered inappropriate for prescribing in Coventry & Warwickshire as they are either not cost-effective or of proven benefit or both.   

Not Recommended

Not Recommended - These are specialist drugs that are not recommended for use.  

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