netFormulary South East London Joint Medicines Formulary NHS
Guy's and St Thomas' NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Lewisham and Greenwich NHS Trust
 
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 Formulary Chapter 6: Endocrine system - Full Chapter
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06.06.02  Expand sub section  Bisphosphonates and other drugs affecting bone metabolism
 note  For pain relief in men with hormone-refractory prostate cancer, refer to NICE clinical guideline 175
06.06.02  Expand sub section  Bisphosphonates
Alendronic acid tabs

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First Choice FIRST-LINE ORAL BISPHOSPHONATE
Disodium etidronate tabs

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Formulary
   
Disodium pamidronate injection

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Formulary
Red
Approved for licensed use, and the following off-label indication:
Non-malignant hypercalcaemia - follow local guidelines

Link  MHRA Jul 2015: Denosumab (Xgeva▼, Prolia); intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk    
Ibandronic acid injection

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Restricted Drug Restricted
Red
CONSULTANT SPECIALISTS ONLY
Treatment of osteoporosis in postmenopausal women at increased risk of fracture, who do not tolerate oral bisphosphonates

Link  MHRA Jul 2015: Denosumab (Xgeva▼, Prolia); intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk    
Risedronate tabs

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Formulary
   
Risedronate, calcium carbonate and colecalciferol tabs

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Formulary
   
Sodium clodronate caps, tabs

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Formulary
Red
   
Zoledronic acid injection 4mg

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Restricted Drug Restricted
Red
RESTICTED USE – ONCOLOGY, HAEMATOLOGY & UROLOGY ONLY

Link  MHRA Jul 2015: Denosumab (Xgeva▼, Prolia); intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk    
Zoledronic acid injection 5mg

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Restricted Drug Restricted
Red
CONSULTANT SPECIALISTS ONLY
  • Paget’s disease of the bone
  • Osteoporosis in post-menopausal women and men at increased risk of fracture
  • Treatment of osteoporosis associated with long-term systemic glucocorticoid therapy in post-menopausal women and in men at increased risk of fracture

  • Link  MHRA Jul 2015: Denosumab (Xgeva▼, Prolia); intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk    
    Zoledronic acid injection 4mg

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    Restricted Drug Restricted
    Red
    Approved off-label indication:
    Improved outcomes in early stage post-menopausal breast cancer
    Dose = 4mg infusion every 6 months after completion of adjuvant chemotherapy - maximum 5 years treatment
    Consultant oncologists only

    Link  MHRA Jul 2015: Denosumab (Xgeva▼, Prolia); intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk    
    06.06.02  Expand sub section  Denosumab
    06.06.02  Expand sub section  Strontium renelate
     ....
    Key
    note Notes First Choice Item First Choice item
    Section Title Section Title (top level) Non Formulary Item Non Formulary section
    Section Title Section Title (sub level)
    Cytotoxic Drug
    Cytotoxic Drug
    Restricted Drug
    Restricted Drug
    CD
    Controlled Drug
    Unlicensed Drug
    Unlicensed
    High Cost Medicine
    High Cost Medicine
    click to search medicines.org.uk
    Link to SPCs
    click to search medicines.org.uk
    Link to adult BNF
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Cancer Drugs Fund
    Cancer Drugs Fund
       

     

    Traffic Light Status Information

    Status Description
      Red   Specialist Prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist. In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.   
      Amber 1   Treatment can be initiated in primary care after a recommendation from an appropriate specialist  
      Amber 2   Specialist initiation followed by maintenance prescribing in primary care  
      Amber 3   Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation  
      Green   Specialist and non-specialist initiation  
      Grey   Not recommended for prescribing  

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