netFormulary South East London Joint Medicines Formulary NHS
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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
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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
     ....
     Non Formulary Items
    Ibandronic acid tabs

    View adult BNF View SPC online
    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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