Area drug & therapeutic committee

Area Drug & Therapeutics Committee

NHS Ayrshire & Arran Formulary Bulletin
August 2012
Area Drug & Therapeutic Committee updates The following medicines were considered by the Formulary Management Group and Area Drug & Therapeutics Committee (ADTC) and recommendations made regarding their use within primary and secondary care. Endorsement of these decisions will be made at the 27th August 2012 ADTC meeting SMC Accepted
Indication
NHS Ayrshire & Arran
Number Medicine
(click on SMC number for more detailed)
Formulary Decision
Treatment of adults with pulmonary arterial hypertension (PAH) classified as World Health Organisation functional class (WHO-FC) II and III, to SMC restriction: To initiation by specialists working
in the Scottish Pulmonary Vascular Unit or Adjunctive therapy in the treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in SMC restriction: restricted to use in patients who
have failed treatment with or are intolerant of other The following products have been not recommended for use in NHS Scotland and are excluded from the NHS Ayrshire & Arran formulary. Click on SMC number for detailed SMC advice Scottish Medicines Consortium advice: not recommended for use within NHS Scotland
Amifampridine 10mg tablet, as phosphate (Firdapse®)
Symptomatic treatment of Lambert-Eaton myasthenic syndrome (LEMS) in adults Rifaximin 200mg film coated tablets (Xifaxanta®)
Treatment of travellers' diarrhoea that is not associated with any of: Eight or more unformed stools in the previous 24 h Occult blood or leucocytes in the stool. ADTC Decision – exclude from the formulary
Implication for all A & A Prescribers - not for prescribing within NHS Ayrshire & Arran
NHS Ayrshire & Arran Formulary Bulletin, Medicines Utilisation Unit Discontinued Preparations

Discontinuations – formulary
Alphosyl HC® cream
Been discontinued by GSK since May 2012 who are unable to advise on any suitable alternative. Will be discontinued from 1st September 2012 Been discontinued but replaced by Nicorette Invisi® Patch 10mg 15mg and 25mg. Nicotinell® Classic Chewing Gum 2mg and 4mg Been discontinued – others flavours remain available Tretinoin (Retin-A®) gel 0.01% and 0.025% Been discontinued. No stock remains of the 0.025% gel and stocks of the 0.01% gel are expected to be exhausted in October 2012. Discontinuations – non-formulary
Pancreatin (Nutrizym 10®) capsules
Discontinuing from end of June 2012 due to low demand for the product. Other pancreatin products remain available, including Nutrizym 22® Area Drug & Therapeutics Committee (ADTC) issues
The following guidelines have been approved by the ADTC and are available on the ADTC intranet section within AthenA (accessed via AthenA front page → Prescribing guidelines)
Medicines under review by Area Drug & Therapeutics Committee (ADTC)
NHS Ayrshire and Arran – Area Drug and Therapeutics Committee
The medicines listed below are still being considered by the ADTC. A final decision will be communicated in
the near future but in the meantime they are excluded from the NHS Ayrshire & Arran formulary
Dalteparin injection (Fragmin®) – extended treatment
Prilocaine hydrochloride (Priloketal®) hyperbaric of venous thromboembolism and prevention of solution – spinal anaesthesia (SMC 665/10) recurrence in pts with a solid tumour (SMC 683/11) Medicines under review by the Formulary Management Group
NHS Ayrshire and Arran – Formulary Management Group (FMG)
The medicines listed below have been considered by the ADTC and their formulary status is currently being
reviewed by the FMG. A final decision will be communicated in the near future but in the meantime they are
excluded from the NHS Ayrshire & Arran formulary.
Atazanavir (Reyataz ) capsules - HIV adults (SMC Iron isomaltoside 1000 (Monofer ) – iron deficiency anaemia (haemodialysis pts excluded) (SMC 697/11) Botulinum toxin injection – focal spasticity after stroke Lamivudine/zidovudine (Combivir ) – HIV-1 in paediatric (Botox® SMC 80/03), (Xeomin® SMC 731/11) Darunavir (Prezista ) tablets – HIV infection in anti- Mercaptopurine oral suspension (Xaluprine®) - treatment retroviral naïve adults.(SMC 566/09), highly pre-treated of acute lymphoblastic leukaemia in adults, adolescents children and adolescents (SMC 604/10), anti-retroviral therapy experienced adult (SMC 707/11) Emtricitabine, tenofovir disoproxil, rilpivirine tablet Nevirapine prolonged release tablets (Viramune®) - HIV-1 infected adults, adolescents, and children three years and above (SMC 760/12) Etravirine (Intelence ) tablets – HIV (SMC 530/09) Raltegravir (Isentress®) tablets– HIV in adults (SMC 613/10) Ferric carboxymaltose (Ferinject®) - iron deficiency Rilpivirine tablet (Edurant®) – HIV (SMC 758/12) anaemia (haemodialysis pts excluded) (SMC 463/08) Fidaxomicin tablets (Dificlir®) - treatment of adults with Tenofovir disoproxil (Viread®) tablet - chronic hepatitis B Clostridium difficile infections (SMC 791/12) Fosamprenavir (Telzir ) suspension and tablets (SMC Tipranavir (Aptivus®) -HIV-1 infection oral solution (SMC NHS Ayrshire & Arran Formulary Bulletin, Medicines Utilisation Unit Medicines under review by the Medicines Resource Group
NHS Ayrshire & Arran: Medicines Resource Group (MRG)
The medicines listed below have been considered by the ADTC and are currently being considered by the
MRG. Recurring funding has not yet been identified for the medicine and a final decision on their formulary
status has not been made by the MRG. However the medicines listed below may be requested on a case
by case basis, according to SMC access criteria. Requests should be sent to the Director of Pharmacy for
consideration. Where it is intended to use the medicines out with SMC access criteria an Individual Patient
Treatment Request application must be completed
Most relevant to Primary Care:
Most relevant to Secondary Care:
Abiraterone acetate tablets (Zytiga®) - with prednisone or prednisolone for the treatment of metastatic castration resistant prostate cancer in adult men whose disease has progressed on or after a docetaxel-based chemotherapy regimen (SMC 746/12 (resubmisison))
SMC approved medicines available on a Case by case basis in NHS Ayrshire & Arran
Full updated lists of all the medicines which are available within NHS Ayrshire & Arran on a case by case basis according to SMC criteria can be located on the Joint Formulary website, located on the NHS Ayrshire & Arran intranet. These can be accessed via “Bulletin downloads and Area Drug & Therapeutics Committee minutes “, then click on “managed entry of new drugs”. For further information please refer to the SMC websit

Scottish Medicines Consortium – Medicines “Not Recommended for Use”
A full updated list of medicines which are not recommended for use within NHS Scotland for specific indications can be located on the Joint Formulary website, located on the NHS Ayrshire & Arran intranet. These can be accessed via “Bulletin downloads and Area Drug & Therapeutics Committee minutes “, then click on “managed entry of new drugs”. For access to these medicines an Individual Patient Treatment Request must be completed. For further information please refer to the SMC websit
NHS Ayrshire & Arran Formulary Bulletin, Medicines Utilisation Unit Medicines launched, not yet reviewed and not for prescribing
The following are medicines that have been launched or have had an extension to their licensed indications
but have not as yet been considered by the ADTC. Since they have yet to be considered by the SMC, they
are therefore NOT recommended for prescribing within NHS Ayrshire & Arran until a decision is
communicated from the ADTC. They are however available on an Individual Patient Treatment Request
application basis.
Alemtuzumab (MabCampath®) inf – first line CLL
Lacosamide (Vimpat®) liquid - partial onset seizures with or without secondary generalization Amphotericin (AmBisome®) inf - first line treatment of Mannitol inhalation powder (Bronchitol®) – cystic severe systemic or deep mycoses Argatroban (Exembol®) inf - anticoagulation of Palonosetron (Aloxi®) caps – nausea and vomiting patients with heparin induced thrombocytopenia prevention (moderately emetogenic chemotherapy) Bevacizumab (Avastin®) - in combination with Phenylephrine + tropicamide (Mydriasert ®) Opthalmic carboplatin and paclitaxel for the first line treatment of insert – diagnostic eye surgery advanced epithelial ovarian, fallopian tube and primary peritoneal cancer Bortezomib (Velcade®) – untreated multiple myeloma Ramipril (Tritace®) – treatment of incipient glomerular with melphalan & prednisolone C1-Esterase inhibitor (Berinert®) – hereditary Recombinant Antithrombin (Atryn®) – prophylaxis of angioedema type I and II (acute episode) C1-Esterase inhibitor (Cinryze®) – hereditary Sitagliptin (Januvia®) tabs – type 2 diabetes mellitus angioedema (prophylaxis and acute episode) Carmellose/ Glycerine (Optive®) eyedrops – dry eyes Somatropin (Humatrope®) inj – growth disturbance in short children. Growth failure associated with SHOX deficiency Colecalciferol (Fultium-D3®) caps - prevention and Strontium ranelate (Protelos®) - osteoporosis in men treatment of vitamin D Dasatinib (Sprycel®) - newly diagnosed Philadelphia Temsirolimus (Torisel®) inf – advanced renal cell leukaemia in the chronic phase
Doripenem (Doribax®) inj –complicated UTIs
Tetrabenazine (Tetmodis®) tabs - hyperkinetic motor disorders with Huntington’s chorea Doxycycline (Efracea®) caps – treatment of rosacea Teysuno® (tegafur/ gimeracil/ oteracil) - combination with cisplatin for advanced gastric cancer Ertapenem (Invanz®) inj – community acquired Topotecan inj - metastatic ovarian carcinoma pneumonia & acute gynaecological infections Eurartesim® tablets (piperaquine tetraphosphate and Travoprost (Travatan®) eye drops - benzalkonium dihydroartemisinin) - uncomplicated Plasmodium falciparum malaria Grass Pollen Extract (Grazax®) tabs – children Ulipristal (Esmya®) tablets - pre-operative treatment of moderate to severe symptoms of uterine fibroids Glatiramer (Copaxone®) inj – treatment of first Urofollitropin (Fostimon®) inj – infertility episode and those at high risk of developing MS Infliximab (Remicade®) - treatment of severely active Vemurafenib (Zelboraf®) caps - unresectable or ulcerative colitis (aged 6-17 years) L-carnitine (Carnitor®) tabs carnitine deficiency Vildagliptin (Galvus®) – type 2 diabetes (monotherapy) NHS Ayrshire & Arran Formulary Bulletin, Medicines Utilisation Unit

Source: http://www.nhsaaa.net/media/129969/fbaug12.pdf