Lancashire and South Cumbria
Formulary
Formulary
8 Malignant disease and immunosuppression
The majority of systemic anti-cancer therapies are not listed in this formulary as they are included in either the Lancashire and South Cumbria Cancer Alliance SACT protocols or the Cancer Drugs Fund list, produced by NHSE.NHS England commissions some high cost noncancer drugs. A list of high cost drugs commissioned by NHS England can be found here |
08-01-03 Antimetabolites
| Cladribine Mavenclad® |
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Formulary
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For treatment of active relapsing forms of multiple sclerosis. |
 MHRA: Cladribine (Mavenclad): new advice to minimise risk of serious liver injury NICE TA1053: Cladribine for treating active relapsing forms of multiple sclerosis NICE TA616: Cladribine for treating relapsing–remitting multiple sclerosis |
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| Mercaptopurine |
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Formulary
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Tablets 50mg Mercaptopurine has been confused with mercaptamine; care must be taken to ensure the correct drug is prescribed and dispensed. |
 LSCMMG: Azathioprine and Mercaptopurine shared care guideline MHRA: Thiopurines and intrahepatic cholestasis of pregnancy |
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When used for Crohn's and ulcerative colitis, see section 01.05.03.| Methotrexate |
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Formulary
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Tablets 2.5mg |
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LSCMMG: Methotrexate shared care guideline MHRA: Methotrexate once-weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing MHRA: Methotrexate: advise patients to take precautions in the sun to avoid photosensitivity reactions |
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Links
- Biosimilars policy statement
- Healthier LSC - Immune-Related Adverse Event: Diarrhoea/Colitis
- Healthier LSC - Immune-Related Adverse Event: Diarrhoea/Colitis
- LSC Breast Chemotherapy Protocols
- LSCMMG: Azathioprine and Mercaptopurine shared care guideline
- LSCMMG: Methotrexate shared care guideline
- MHRA Drug Safety Update Dec 2017: Cladribine (Litak, Leustat) for leukaemia: reports of progressive multifocal encephalopathy (PML); stop treatment if PML suspected
- MHRA Drug Safety Update Dec 2017:Cladribine (Litak, Leustat) for leukaemia: reports of progressive multifocal encephalopathy (PML); stop treatment if PML suspected
- MHRA Drug Safety Update July 2011: Dexrazoxane (Cardioxane): restriction of use
- MHRA Drug Safety Update July 2020: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
- MHRA Drug Safety Update July 2020: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection
- MHRA Drug Safety Update March 2022: Cladribine (Mavenclad): new advice to minimise risk of serious liver injury
- MHRA Drug Safety Update Oct 2020: 5-fluorouracil (intravenous), capecitabine, tegafur: DPD testing recommended before initiation to identify patients at increased risk of severe and fatal toxicity
- MHRA Drug SAfety Update: Epidermal growth factor receptor (EGFR) inhibitors: serious cases of keratitis and ulcerative keratitis
- MHRA Drug Safety Update: Panitumumab (Vectibix): risk of necrotising fasciitis
- MHRA Drug Safety Update: Panitumumab (Vectibix): serious hypersensitivity reactions
- MHRA DSU Oct 2020: 5-fluorouracil (intravenous), capecitabine, tegafur: DPD testing recommended before initiation to identify patients at increased risk of severe and fatal toxicity
- MHRA: Cladribine (Mavenclad): new advice to minimise risk of serious liver injury
- MHRA: Methotrexate once-weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing
- MHRA: Methotrexate: advise patients to take precautions in the sun to avoid photosensitivity reactions
- MHRA: risk of severe skin reactions—discontinue treatment
- MHRA: Thiopurines and intrahepatic cholestasis of pregnancy
- NHSE: National Cancer Drugs Fund list
- NICE NG101: Early and locally advanced breast cancer: diagnosis and management
- NICE NG12: Suspected cancer: recognition and referral
- NICE NG122 : Lung cancer: diagnosis and management
- NICE NG224: Melanoma: assessment and management
- NICE NG47: Haematological cancers: improving outcomes
- NICE NG52: Non-Hodgkin’s lymphoma: diagnosis and management
- NICE NG99: Brain tumours (primary) and brain metastases in adults
- NICE Patient access schemes
- NICE TA100: Colon cancer (adjuvant) - capecitabine and oxaliplatin
- NICE TA1034: Anhydrous sodium thiosulfate for preventing hearing loss caused by cisplatin chemotherapy in people 1 month to 17 years with localised solid tumours
- NICE TA1053: Cladribine for treating active relapsing forms of multiple sclerosis
- NICE TA116: Breast cancer - gemcitabine
- NICE TA119: Leukaemia (lymphocytic) - fludarabine
- NICE TA124: Lung cancer (non-small-cell) - pemetrexed
- NICE TA135: Mesothelioma - pemetrexed disodium
- NICE TA181: Lung cancer (non-small cell, first line treatment) - pemetrexed
- NICE TA190: Lung cancer (non-small-cell) - pemetrexed (maintenance)
- NICE TA191: Gastric cancer (advanced) - capecitabine
- NICE TA218: azacitidine for myelodysplastic syndromes
- NICE TA29: Leukaemia (lymphocytic) - fludarabine
- NICE TA307: Aflibercept in combination with irinotecan and fluorouracil-based therapy for treating metastatic colorectal cancer that has progressed following prior oxaliplatin-based chemotherapy
- NICE TA389: Topotecan, pegylated liposomal doxorubicin hydrochloride, paclitaxel, trabectedin and gemcitabine for treating recurrent ovarian cancer
- NICE TA399: Azacitidine for treating acute myeloid leukaemia with more than 30% bone marrow blasts
- NICE TA402: Pemetrexed maintenance treatment for non-squamous non-small-cell lung cancer after pemetrexed and cisplatin
- NICE TA408: Pegaspargase for treating acute lymphoblastic leukaemia
- NICE TA439: Cetuximab and panitumumab for previously untreated metastatic colorectal cancer
- NICE TA493: Cladribine tablets for treating relapsing–remitting multiple sclerosis
- NICE TA512: Tivozanib for treating advanced renal cell carcinoma
- NICE TA548: Decitabine for untreated acute myeloid leukaemia (terminated appraisal)
- NICE TA61: Capcitabine and tegafur - Colorectal cancer
- NICE TA61: Colorectal cancer - capecitabine and tegafur uracil
- NICE TA616: Cladribine for treating relapsing–remitting multiple sclerosis
- NICE TA616:Cladribine for treating relapsing–remitting multiple sclerosis
- NICE TA827: Oral azacitidine for maintenance treatment of acute myeloid leukaemia after induction therapy
- NICE TA932: Decitabine–cedazuridine for untreated acute myeloid leukaemia when intensive chemotherapy is unsuitable (terminated appraisal)
- NICE: Leukaemia (acute myeloid ) - decitabine (terminated appraisal) (TA270)
UKMI Q&A: alcohol and methotrexate guidance- UKMI Q&A: What is the clinical significance of the interaction between methotrexate and penicillins? (Oct13)