Capsules 10mg, 30mg

Prescribed by or under supervision of a consultant dermatologist.

Contra-indicated in patients with hypersensitivity to peanuts or soya (capsule filling contains soya-bean oil).

Neuropsychiatric reactions have been reported in patients taking oral retinoids. The MHRA advises patients and carers to seek medical attention if changes in mood or behaviour occur.

Patients should avoid excessive exposure to UV light (including sunlight, solariums)—sunscreen with a high protection factor should be applied.

Moderate-to-severe chronic hand eczema (under expert supervision)

 Bandage 7.5cm x 6m (Ichthopaste®)
 Ointment zinc oxide 15% and ichthammol 1% in yellow soft paraffin (Special ointment No1) 

Bandage 7.5cm x 6m (Viscopaste®)

Tablets 30mg, 120mg

The MHRA recommends that patients and their carers should be counselled on the risk of progressive multifocal leukoencephalopathy and advised to seek immediate medical attention if symptoms develop.

Injection pre-filled pen 80mg/1ml
Injection pre-filled syringe 80mg/1ml

Under expert supervision.

Solution for infusion 450mg/7.5ml

Under expert supervision.

Ointment 4micrograms/g

Ointment 50micrograms/g

Gel calcipotriol 0.005%, betamethasone dipropionate 0.05%
Cutaneous foam calcipotriol 0.005%, betamethasone dipropionate 0.05% (Enstilar®)

Potent corticosteroid.

 Lotion - Coal tar 5% (Exorex®)
 Scalp Ointment - Coal tar 1%, salicylic acid 2%, precipitated sulfur 4% (Sebco®)
  Ointment BP - Coal tar 2%, salicylic acid 2%   - For scalp use only
 Ointment - Coal tar, emulsifying ointment  

Not all coal tar products are routinely stocked by pharmacy departments. If the product has to be obtained from a specials manufacturing unit there may be a delay of up to 4 weeks.

Paste zinc oxide 24%, salicylic acid 2%, starch 24%, white soft paraffin 50%

Ointment 2%, 5%, 10%

10%
(0.1%, 0.25%, 0.5%, 1%, 2%, 4%, 6%, 8% dilutions available from pharmacy)
Not all dithranol products are routinely stocked by the pharmacy departments. If the product has to be obtained from a specials manufacturing unit there may be a delay for up to 4 weeks.

Capsules 10mg, 25mg

Prescribed by or under supervision of a consultant dermatologist.

Neuropsychiatric reactions have been reported in patients taking oral retinoids. The MHRA advises patients and carers to seek medical attention if changes in mood or behaviour occur.

Tablets 50mg, 100mg, 200mg

S/C injection 40mg pre-filled syringe, pre-filled pen

Tertiary centre only for hidradenitis suppurativa.

Commissioned in accordance with LSCMMG biologics pathways.
NHSE commissioned for some indications.
Consult chapter links for more details.

Tablets 10mg, 20mg, 30mg

Tablets 25mg, 50mg

Some indications are unlicensed . Please consult product literature for licensing information.

Consultant dermatologist or specialist initiation only.

Film-coated tablets 2mg, 4mg

 Treatment of atopic dermatitis

 Treatment of alopecia areata

Solution for injection pre-filled pen 160mg/1ml, 320mg/2ml
Solution for injection pre-filled syringe 160mg/1ml, 320mg/2ml

Solution for injection pre-filled syringes 210mg/1.5ml 

Solution for injection pre-filled pens 200mg/1ml
Solution for injection pre-filled syringes 200mg/1ml
Solution for injection in a dose-dispenser cartridge 200mg/1ml

Commissioned in accordance with LSCMMG biologics pathways.
Consult chapter links for more details.

Capsules 10mg, 25mg, 50mg, 100mg
Oral solution 100mg/ml

Consultant dermatologist or specilaist initiation only.

Patients should be stabilised on a particular brand of oral ciclosporin because switching between formulations without close monitoring may lead to clinically important changes in blood-ciclosporin concentration.

Film coated tablets 6mg

It is not known whether deucravacitinib, an inhibitor of tyrosine kinase 2 (TYK2), is associated with the adverse reactions of Janus kinase (JAK) inhibition. Risks that have been identified as a class effect of JAK inhibitors include major cardiovascular events, malignancy, venous thromboembolism, serious infections and increased mortality.  

Solution for injection pre-filled pens 300mg/2ml, 200mg/1.14ml
Solution for injection pre-filled syringes 300mg/2ml, 200mg/1.14ml

 NICE TA955: Dupilumab for treating moderate to severe prurigo nodularis

S/C injection 50mg pre-filled syringe, pre-filled pen

Solution for injection in pre-filled pen 100mg/1ml

Solution for injection pre-filled pen 120 mg/1ml 

Adequate resuscitation facilities must be available when infliximab is used.

Solution for injection pre-filled pens 250mg/2ml
Solution for injection pre-filled syringes 250mg/2ml

The MHRA has reviewed the risk of dry eye and serious ocular side-effects associated with dupilumab, an inhibitor of interleukin-4 and interleukin-13 signalling. Lebrikizumab, which similarly inhibits interleukin-13, is also associated with ocular side-effects.

Tablets 2.5mg
Prefilled syringes and pens (various strengths)

Methotrexate should be prescribed once weekly as a single dose on the same day each week.
If oral methotrexate is prescribed only use the 2.5 mg strength.
See hospital policy for prescribing and supply of oral methotrexate.

Methotrexate subcutaneous injection may be supplied through a homecare arrangement.

30 mg powder and solvent for solution for injection in pre-filled pen

Solution for injection pre-filled pens 75mg/0.5ml, 150mg/1ml, 300mg/2ml
Solution for injection pre-filled syringes 75mg/0.5ml, 150mg/1ml, 300mg/2ml

 Unlicensed use of omalizumab for severe chronic inducible urticarias.

Cream 1% 

Consultant dermatologist or specilaist initiation only.

Solution for injection pre-filled syringes 150mg/mL
Solution for injection pre-filled pen 150mg/mL
Solution for injection cartridges 180mg/1.2ml, 360mg/2.4ml

Capsules 50mg

Solution for injection pre-filled pens 150mg/1ml, 300mg/2ml
Solution for injection pre-filled syringes 75mg/0.5ml, 150mg/1ml

 NHSE commissioned for some indications.

Approved by LSCMMG for palmoplantar psoriasis 

Ointment 0.03%, 0.1%

Psoriasis.

Consultant dermatologist or specilaist initiation only.

Solution for injection pre-filled syringes 100mg/1ml

Solution for injection pre-filled syringes 150mg/1ml
Solution for injection pre-filled pens 300mg/2ml

The MHRA has reviewed the risk of dry eye and serious ocular side-effects associated with dupilumab, an inhibitor of interleukin-4 and interleukin-13 signalling. Tralokinumab, which similarly inhibits interleukin-13, is also associated with ocular side-effects.

Prolonged release tablets 15mg, 30mg, 45mg

Solution for injection pre-filled syringes 45mg/0.5ml, 90mg/1ml

Consultant dermatologist or specialist initiation only.