netFormulary NHS
North East and North Cumbria
ICS Formulary
 Introduction
Welcome to the Shared Formulary for the North East / North Cumbria Integrated Care System

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 Please click below to download application form for addition or
amendments to North East and North Cumbria (NENC) ICS Formulary

Application Form

Local Guidelines and Information Leaflets

County Durham  and Darlington North Cumbria North of Tyne, Gateshead and North Cumbria South Tyneside and Sunderland Tees

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Drug Safety Update - November 2024
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Formulary Amendments
Last updated: 20th November 2024
Chapter Change Traffic light
status
Reason for change
04.03.01 Trimipramine now not to be initiated for new patients and deprescribed in existing patients where possible. NENC Medicines Committee (October 2024)
18.08.03 Silk garments not approved for use NENC Medicines Committee (October 2024)
10.03.02 Rubefacients not approved for use NENC Medicines Committee (October 2024)
02.05.05.01 Perindopril Arginine not approved for use NENC Medicines Committee (October 2024)
02.12 Omega-3 Fatty acid compounds (except Vazkepa) not approved for use NENC Medicines Committee (October 2024)
09 Lutein and Antioxidants preparations not approved for use NENC Medicines Committee (October 2024)
09 Glucosamine and Chondroitin not approved for use. NENC Medicines Committee (October 2024) 
02.05.04 Doxazosin MR not approved for use. NENC Medicines Committee (October 2024) 
 04.03.01 Dosulepin now not to be initiated for new patients and deprescribed in existing patients where possible. NENC Medicines Committee (October 2024) 
04.07.01 Co-proxamol now classed as a medicines of low clinical value NENC Medicines Committee (October 2024) 
13.02.01 Bath and shower preparations for dry and pruritic skin conditions classed as medicines of low clinical value NENC Medicines Committee (October 2024) 
02.05.05.03 Aliskiren now classed as a medicine of low clinical value NENC Medicines Committee (October 2024) 
05.02.01 Off label indication for treatment of non-invasive fungal infections using the voriconazole 100mg tablets ONLY   NENC Medicines Committee (October 2024) 
02.08.02 Following statement added to all DOAC listings: "In the absence of a specific clinical reason to select a particular DOAC, choose the most effective DOAC first. Rivaroxaban 'cost effective once daily for non-valvular AF' and Apixaban 'cost effective twice daily choice for non-valvular AF' "   NENC Medicines Committee (October 2024)
13.04.01 Removal of calcipotriol scalp solution as now discontinued   NENC Medicines Committee (October 2024)
06.04.02 Removal of tradename (Nebido) from testosterone undecanoate 1g/4ml as generics now available   NENC Medicines Committee (October 2024)
01.06.07 Prucalopride RAG status changed from GREEN to GREEN+   NENC Medicines Committee (October 2024)
07.02.01 Removal of trademark from estriol 1mg/g (0.1%) cream and clarification of dosage statement   NENC Medicines Committee (October 2024)
01 Atropine 500microgram in 5ml mixture removed from formulary   NENC Medicines Committee (October 2024)
11.06 Latanoprost 0.005% with Timolol 0.5% eye drops preservative free (Fixapost) added as a PF option   NENC Medicines Committee (October 2024) 
04.06 Additional off-license indication (use in children under 12yrs / longer term use, when required, for the prevention of nausea and vomiting in paediatric patients undergoing haematopoietic stem cell transplantation (HSCT)) added to aprepitant 80mg and 125mg capsules  NENC Medicines Committee (October 2024)
04.10.02 Smoking Cessation Therapy entry to replace individual NRT products NENC Medicines Committee (October 2024)
04.12 Tafamidis for treating transthyretin amyloidosis with cardiomyopathy NICE TA984
08.01.05 Pembrolizumab with trastuzumab and chemotherapy for untreated locally advanced unresectable or metastatic HER2-positive gastric or gastro-oesophageal junction adenocarcinoma (not recommended) NICE TA983
10.01.03 Baricitinib for treating juvenile idiopathic arthritis in people 2 years and over (terminated appraisal) NICE TA982
08.01.05 Ivosidenib with azacitidine for untreated acute myeloid leukaemia with an IDH1 R132 mutation NICE TA979
11.08.02 Faricimab for treating visual impairment caused by macular oedema after retinal vein occlusion NICE TA1004
07.04.02 North of Tyne, Gateshead & North Cumbria: Urinary Continence Enablement Products and Devices Formulary 2024   NENC Guidelines Group (October 2024)
04.07 NENC Clinical Pain Network: Position Statement on Chronic Pain Guidelines   NENC Guidelines Group (October 2024)
06.04.01.01 NENC ICB-wide Menopause guidance - update   NENC Guidelines Group (October 2024)
09.05.01.03 NENC ICB-wide Management of Hypomagnesaemia in adults   NENC Guidelines Group (October 2024)
09.04 NENC ICB-wide Guidelines for the appropriate prescribing of Oral Nutritional Supplementation in the management of adults at risk of undernutrition in primary care   NENC Guidelines Group (October 2024) 
13.02.01 NENC ICB-wide Emollient Prescribing Guideline and Formulary added   NENC Guidelines Group (October 2024) 
08.01.05 Trastuzumab deruxtecan for treating HER2-low metastatic or unresectable breast cancer after chemotherapy (not recommended) NICE TA992
02.11 Etranacogene dezaparvovec for treating moderately severe or severe haemophilia B NICE TA989
08.01.05 Lisocabtagene maraleucel for treating relapsed or refractory aggressive B-cell non-Hodgkin lymphoma (terminated appraisal) NICE TA987
13.05.03 Lebrikizumab for treating moderate to severe atopic dermatitis NICE TA986
19 QuiremSpheres for treating unresectable advanced hepatocellular carcinoma NICE TA985
01.05.03 Risankizumab for treating moderately to severely active ulcerative colitis NICE TA998
02.05.01 Sildenafil - amendment of secondary Raynaud's to Raynaud's NENC Medicines Committee (August 2024)
02.10.02 Tenecteplase for treating acute ischaemic stroke NICE TA990
03.09.01 Gefapixant for treating refractory or unexplained chronic cough (terminated appraisal) NICE TA969
04.01.01 Daridorexant - addition of NHCFT to list of providers  NENC Medicines Committee (August 2024)
04.03.03 Fluoxetine 10mg capsules - addition of formulation NENC Medicines Committee (August 2024)
04.06 Doxylamine & pyrodoxine for use in nausea and vomiting in pregnancy  NENC Medicines Committee (August 2024)
04.07.02 Morphine sulfate oro-dispersible tablets (Actimorph) added and Sevredol removed NENC Medicines Committee (August 2024)
04.07.04.02 Atogepant for preventing migraine  NICE TA973
05 Addition of link for cellulitis diagnosis and management   NENC Medicines Committee (August 2024)
05.03.01 Addition of bictegravir, emtricitabine, tenofovir alafenamide (Biktarvy®) Correction of missing entry
06.03.02 Hydrocortisone oral solution & merged entries NENC Medicines Committee (August 2024)
06.04.01.02 Progesterone - Addition of Utrogestran vaginal capsules and clarification of use in relation to NICE NG25  NENC Medicines Committee (August 2024)
06.07 Setmelanotide for treating obesity and hyperphagia in Bardet-Biedl syndrome NICE HST31
07.04.02 Vibegron for treating symptoms of overactive bladder syndrome  NICE TA999
08.01.05 Cabozantinib with nivolumab for untreated advanced renal cell carcinoma NICE TA964
08.01.05 Dabrafenib with trametinib for treating BRAF V600E mutation-positive glioma in children and young people aged 1 year and over NICE TA977
08.01.05 Dostarlimab with platinum-based chemotherapy for treating advanced or recurrent endometrial cancer with high microsatellite instability or mismatch repair deficiency  NICE TA963
08.01.05 Melphalan flufenamide with dexamethasone for treating relapsed or refractory multiple myeloma (terminated appraisal) NICE TA968
08.01.05 Pembrolizumab for treating relapsed or refractory classical Hodgkin lymphoma in people 3 years and over NICE TA967
08.01.05 Pembrolizumab with gemcitabine and cisplatin for untreated advanced biliary tract cancer (terminated appraisal) NICE TA966
08.01.05 Selinexor with bortezomib and dexamethasone for previously treated multiple myeloma NICE TA974
08.01.05 Trastuzumab deruxtecan for treating HER2-mutated advanced non-small-cell lung cancer after platinum-based chemotherapy (terminated appraisal) NICE TA976
08.01.05 Zanubrutinib with obinutuzumab for treating relapsed or refractory B-cell follicular lymphoma after 2 or more treatments (terminated appraisal) NICE TA978
08.02.02 Sirolimus for treating facial angiofibroma caused by tuberous sclerosis complex in people 6 years and over (terminated appraisal) NICE TA972
09.01.01.01 Addition of position statement for oral iron supplementation for iron deficiency anaemia   NENC Medicines Committee (August 2024)
10.02.02 Quinine Sulfate - addition of 200mg tablets NENC Medicines Committee (August 2024)
11.04.01 Hydroortisone Sodium Phosphate eye drops for patients who require a preservative-free low potency ocular corticosteroid  NENC Medicines Committee (August 2024)
13.05.03 Pimecrolimus cream - additional wording to clarify initiation  NENC Medicines Committee (August 2024)
13.05.03 Tacrolimus ointment - additional wording to clarify initiation  NENC Medicines Committee (August 2024)
15.01.01 Ketamine in palliative care - changed from Amber to Red NENC Medicines Committee (August 2024)

A formulary is only as good as the guidelines which underpin it. It is essential that this formulary is used in conjunction with the current guidelines. Throughout this formulary links to NICE and local guidelines are provided. This guidance should be read before selecting a drug from this formulary.

It is recognised that we cannot expect 100% compliance. This formulary will only cover 80-90% of what may be needed for individual patients. This formulary is expected to cover the majority of occasions but in exceptional circumstances both parties may agree to work outside of this guidance. Where necessary, secondary and primary care prescribers should discuss the appropriate management of individual patients personally.

 The contents of the formulary are supported by:

  • NENC North East and North Cumbria ICB
  • County Durham and Darlington NHS Foundation Trust
  • Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust
  • Gateshead Health NHS Foundation Trust
  • Newcastle Upon Tyne Hospitals NHS Foundation Trust
  • North Cumbria University Hospital NHS Trust
  • North Tees and Hartlepool NHS Foundation Trust
  • Northumbria Healthcare NHS Foundation Trust
  • South Tees Hospitals NHS Foundation Trust
  • South Tyneside and Sunderland NHS Foundation Trust
  • Tees, Esk and Wear Valley NHS Foundation Trust

 The formulary is intended to:

  • encourage safe, effective and economical prescribing
  • enable safe and effective transfer of prescribing from secondary to primary care
  • facilitate continuity of treatment and minimise supply problems.

 It is not intended to be a comprehensive prescribing guide or to replace the BNF or BNF for children.

 Medicines are listed in chapters and subsections that generally correspond with those in the legacy BNF .

 Where appropriate the formulary gives information as to which drugs are regarded as being the first choice and alternatives. Where no ranking of drugs is stated, products are listed alphabetically.

 For hospital prescribers please note that not all formulary approved medicines will be available for prescribing and use in all organisations due to differences in commissioned services and stock holding or preferences in each organisation. Please consultant Pharmacy within your organisation.

Does the ICS single formulary cover every medication?

The formulary is comprehensive but will not cover every medicine in every situation.  Some patients may already be stabilised on non-formulary medications and it is not intended for these patients to be changed to formulary choices unless appropriate to do so. Whilst the formulary aims to standardise practice it is recognised that individual patients may require medicines which lie outside this guidance.

What if I feel the entry in the ICS single formulary is not correct?

Historically across the NENC ICS area there were three formularies and now there is a single ICS-wide formulary. There has been wide consultation on the new ICS Single formulary which was put together by team of stakeholders from across the NENC and based on an harmonisation exercise undertaken over the past 12 months comparing the three previous formularies in the NENC and reaching a consensus where there was a difference.

With merger of three formularies, the ICS has tried to ensure links and vital clinical information is not lost from entries in the formulary.  However, if you feel that an entry is not correct please email the Regional Drug and therapeutics Centre nuth.nyrdtc.rxsupp@nhs.net  The RDTC is being used as a central point to collate any feedback to pass on to the relevant group within the ICB for action and is not responsible for the formulary.

Process for formulary applications for ICS for NENC ICS

  • All formulary applications or amendments from partner organisations in the NENC ICS should be submitted via nuth.nyrdtc.rxsupp@nhs.net for consideration at the Formulary Working Group.

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