North East and North Cumbria
ICS Formulary
 
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8 Malignant disease and immunosuppression
08-02-02 Corticosteroids and other immunosuppressants

Belumosudil Rezurock®
Formulary
  • 200mg tablets
  • Approved for chronic graft-versus-host disease in people 12 years and over after 2 or more systemic treatments in line with NICE
Link  NICE TA949: Belumosudil for treating chronic graft-versus-host disease after 2 or more systemic treatments in people 12 years and over

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Ciclosporin
Formulary
  • Approved formulations include:
    • 10mg, 25mg, 50mg, and 100mg capsules;
    • 100mg in 1ml sugar free oral solution (oily).
    • Should be prescribed by brand for transplant indications   
  • For Transplant indications Red unless from a Trust/speciality that hasn't formally repatriated its patients or for patients who require weekly scripts for MDS boxes Amber

 


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Sirolimus
Formulary
  • Approved for renal transplantation in children and adolescents in line with NICE.
  • For Transplant indications Red unless from a Trust/speciality that hasn't formally repatriated its patients or for patients who require weekly scripts for MDS boxes Amber

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Tacrolimus
Formulary

Approved tacrolimus formulations include:

  • 500 microgram, 1mg & 5mg capsules (Prograf® & Adoport®).
  • 1mg in 1ml oral suspension (unlicensedunlicensed) - this replaces 0.5mg/ml oral
    suspension. 
  • 5mg in 1 ml concentrate for preparing IV infusion - approved for renal transplantation in children and adolescents in line with NICE.
  • 500microgram, 1mg, 3mg & 5mg MR capsules (Advagraf®) approved for use for prophylaxis of organ rejection in kidney and liver transplantation. Advagraf® is also approved for use in patients who are currently prescribed Prograf®, and de novo patients should be prescribed Adoport®.
  • 750microgram, 1 mg and 4 mg m/r tablets (Envarsus®)
    • approved for the treatment of renal and liver transplant patients who are suffering from neurotoxicity with other formulations or for patients requiring large doses of tacrolimus. 
  • For Transplant indications Red unless from a Trust/speciality that hasn't formally repatriated its patients or for patients who require weekly scripts for MDS boxes Amber
Link  NICE TA481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
Link  MHRA Drug Safety Alert (November 2017): Oral tacrolimus products: reminder to prescribe and dispense by brand name only RED drug also for non-transplant indications.

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Voclosporin  Lupkynis®
Formulary
  • 7.9mg capsules
  • Approved with mycophenolate mofetil for treating lupus nephritis in adults in line with NICE and NHSe Specialised Commissioning Policy (SSC2540)
  • Only available from:
    • North Cumbria University Hospital NHS Trust
    • South Tyneside and Sunderland NHS Foundation Trust
    • South Tees Hopsitals NHS Foundation Trust
    • The Newcastle upon Tyne Hospitals NHS Foundation Trust
Link  NICE TA882: Voclosporin with mycophenolate mofetil for treating lupus nephritis

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Antithymocyte immunoglobulin (horse)  Thymoglobuline®
Formulary
  • NETAG approved for aplastic anaemia in adults (unlicensedunlicensed).

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Antithymocyte immunoglobulin (rabbit)  Thymoglobuline®
Formulary
  • Used in the management of transplant rejection.

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Basiliximab
Formulary
  • Approved for limited use in adult renal transplant patients with high risk of acute organ rejection.
  • Approved for severe graft versus host disease post haematopoietic stem cell transplantation.
  • Approved for induction therapy in renal transplantation in children and adolescents in with combinations that include ciclosporin in line with NICE.
Link  NICE TA481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people

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Ciclosporin Sandimmun®
Formulary

Cytotoxic Drug  Red View adult BNF  View SPC online  View childrens BNF
Ciclosporin Deximune®
Non Formulary

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Sirolimus Hyftor®
Non Formulary
  • Sirolimus for treating facial angiofibroma caused by tuberous sclerosis complex in people 6 years and over (terminated appraisal)

Cytotoxic Drug  Black View adult BNF  View SPC online  View childrens BNF