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
Notes:

Where a formulary entry does not detail a medicine’s indications for use, the medicine can be assumed to be approved for all licensed indications.

Formulary approved "off-label" use is detailed separately.

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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 (licensed use)
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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
  • Prevention of osteoporosis associated with long-term high dose systemic glucocorticoid therapy, where oral bisphosphonates are not possible (off-label)
 
Link  MHRA Jul 2015: Denosumab (Xgeva▼, Prolia); intravenous bisphosphonates: osteonecrosis of the jaw—further measures to minimise risk
   
Zoledronic acid injection 4mg (Improved outcomes in early stage post-menopausal breast cancer - off-label)
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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
 ....
 Non Formulary Items
Ibandronic acid tabs

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Non Formulary
Grey

Not approved for use in SE London (all indications)

 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red

Specialist or hospital prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist or hospital. 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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