| Formulary Chapter 6: Endocrine system - Full Chapter
|
| Chapter Links... |
 NTAG Endocrine System Recommendations |
| Details... |
| 06.05.01 |
Hypothalamic and anterior pituitary hormones and anti-oestrogens |
|
|
Follitropin delta (Rekovelle®)
|
Formulary
|
- Approved for patients at risk of ovarian hyper stimulation syndrome (OHSS).
|
|
|
| 06.05.01 |
Anti-oestrogens |
|
|
Clomifene Citrate
|
Formulary
|
|
|
|
| 06.05.01 |
Anterior pituitary hormones |
|
|
Tetracosactide (Synacthen®)
(Corticotrophin)
|
Formulary
|
- Approved formulations include:
- 250microgram in 1ml injection;
- 1mg in 1ml depot injection.
|
|
|
Choriogonadotropin Alfa (Ovitrelle®)
(Gonadotrophin)
|
Formulary
|
- Fertility treatment
- Hypogonadism
|
|
|
Lutropin Alfa
|
Formulary
|
|
|
|
Menotrophin (75 units FSH & 75 units LH activity) injection
(Gonadotrophin)
|
Formulary
|
|
|
|
Pegvisomant (Somavert®)
|
Formulary
|
|
|
|
Somatrogon (Ngenla®)
|
Formulary
|
24mg and 60mg solution for injection in pre-filled pen
|
NICE TA863: Somatrogon for treating growth disturbance in children and young people aged 3 years and over
|
Somatropin (children)
(Growth hormone - children)
|
Formulary
|
- First line
- Omnitrope® 5-mg (15-unit) vial (powder with diluent) for use with Omnitrope Pen L® device, 3.3 mg (10 units)/ml, 1.5 ml (5-mg, 15-unit) cartridge & 6.7 mg (20 units)/ml, 1.5 ml (10-mg, 30-unit) cartridge - for use with Omnitrope Pen 5® & Omnitrope Pen 10® devices respectively.
- Note: Omnitrope is the least expensive formulation of somatropin and should be used in all de novo paediatric patients where possible.
- Second line
- Norditropin SimpleXx® 1.5ml cartridges for use in Nordipen® devices - 5mg (15 units), 10mg (30 units) and 15mg (45 units). Note: norditropin is the second least expensive alternative formulation for patients who cannot tolerate omnitrope.
- Saizen® 8mg vials (powder with diluent), Saizen® 5.83 mg/ml solution for injection (6mg cartridges), 8 mg/ml solution for injection (12mg and 20mg cartridges) - for use in EasyPod® device (to be used in patients with compliance issues).
- Third line
- Genotropin Miniquick® syringes - 0.2mg (0.6 units) 0.8mg (2.4 units) 1.4mg (4.2 units), 0.4mg (1.2 units) 1mg (3 units) 1.6mg (4.8 units) 0.6mg (1.8 units), 1.2mg (3.6 units) 2mg (6 units). To be used for patients when travelling.
- Zomacton® (needle free presentation) 12 unit (4mg) injection; 1st line: 75% to 85% of total mg usage; 2nd line: 15% to 25% of total mg usage; 3rd line: up to 5% of total mg usage.
|
NICE TA188: Human growth hormone (somatropin) for the treatment of growth failure in children
|
Somatropin - adults
(Growth hormone - adults)
|
Formulary
|
- Genotropin® cartridges for use in Genotropin pens - 16 unit (5.3mg) & 36 unit (12mg) in 1ml.
- Genotropin Miniquick® syringes - 0.2mg (0.6 units), 0.8mg (2.4 units), 1.4mg (4.2 units) 0.4mg (1.2 units) 1mg (3 units) 1.6mg (4.8 units) 0.6mg (1.8 units) 1.2mg (3.6 units) 2mg (6 units) - to be used for patients when travelling.
|
NICE TA64: Human growth hormone (somatropin) in adults with growth hormone deficiency
|
Follitropin Alfa
(Recombinant human follicle stimulating hormone)
|
Formulary
|
|
|
|
| 06.05.01 |
Hypothalmic hormones |
|
|
Gonadorelin 100microgram in 1ml
|
Formulary
|
|
|
|
Protirelin (TRH)
|
 Unlicensed
|
|
|
|
| .... |
Key |
|
|
|
|
Cytotoxic Drug
|
|
|
Controlled Drug
|
|
High Cost Medicine
|
|
NHS England |
|
Homecare |
|
CCG |
|
Traffic Light Status Information
| Status |
Description |
|
Drugs for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician and the drug should be supplied through the hospital throughout the duration of treatment.
In some very exceptional circumstances (e.g. due to distance from the hospital, storage, supply or mobility/transport problems) it may be appropriate for the GP to be asked to prescribe a Red drug. This should be negotiated on an individual patient basis and should only be done with the GP’s prior informed agreement where the roles of the GP and hospital services are clearly defined and agreed. The GP should not feel under pressure to prescribe in these circumstances.
For all RED drugs automatically added to the formulary in response to a positive NICE TA: Prescribers need to ensure that local Trust new drug governance procedures and pharmacy processes are followed before any prescribing. |
|
Drugs initiated by hospital specialist, but where continuing treatment by GPs may be appropriate under a shared care arrangement.
The specialist should send the GP a copy of the shared care agreement to sign. The GP should sign the shared care agreement, or indicate they do not want to be part of such an agreement, and return a copy back to the specialist. Shared care guidelines are available or are being developed for most of the drugs listed as Amber.
If no shared care guideline is available, the hospital specialist should provide the patient’s GP with sufficient information and support to allow treatment to be continued and managed safely in primary care. |
|
Drugs normally recommended or initiated by a specialist (hospital or GP with an extended role https://www.rcgp.org.uk/gpwer), but can be safely maintained in primary care with very little or no monitoring required. In some cases there may be a further restriction for use outlined - these will be defined in each case. Provision of additional information, or an information leaflet, may be appropriate in some cases to facilitate continuing treatment by GPs. |
|
Drugs where prescribing by GPs is appropriate. Can be initiated and prescribed in all care settings, and if appropriate, discontinued without recourse to secondary care. |
|
NOT APPROVED: Drugs that have been considered by NTAG or the NENC ICB Medicines Subcommittee (or other approved body) and are not approved for prescribing within the North East and North Cumbria. |
|
UNDER REVIEW: drugs whose current formulary status or RAG status is currently under review. |
|
NOT REVIEWED: Drugs that haven not been reviewed yet. This usually means that an application is in progress. These drugs are not normally considered appropriate for prescribing in the North East and North Cumbria until such time that a decision is taken on their formulary status. |
|
|
|
