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
 
 Search
 Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
Notes:

Please also refer to the Cancer Drugs Fund list

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.

 Details...
08.01.03  Expand sub section  Antimetabolites
 note  Use in accordance with local guidelines
Cytotoxic Drug Azacitidine injection
View adult BNF View SPC online
Restricted Drug Restricted
Red
High Cost Medicine
CONSULTANT SPECIALISTS ONLY 
Link  NICE TA218: Azacitidine for the treatment of myelodysplastic syndromes, chronic myelomonocytic leukaemia and acute myeloid leukaemia
   
Cytotoxic Drug Capecitabine tabs
View adult BNF View SPC online
Formulary
Red
  • First-line for metastatic colorectal cancer
  • Third- or fourth-line for locally advanced or metastatic breast cancer (where previous therapy with anthracyclines and taxanes had failed) 
  • Link  NICE CG81: Advanced breast cancer: diagnosis and treatment
    Link  NICE TA100: Capecitabine and oxaliplatin in the adjuvant treatment of stage III (Dukes’ C) colon cancer
    Link  NICE TA191: Capecitabine for the treatment of advanced gastric cancer
    Link  NICE TA61: Guidance on the use of capecitabine and tegafur with uracil for metastatic colorectal cancer
       
    Cytotoxic Drug Cladribine injection (haematology oncology )
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine

    For haematology oncology indications

     
       
    Cytotoxic Drug Cytarabine injection
    View adult BNF View SPC online
    Formulary
    Red
     
       
    Cytotoxic Drug Fludarabine tabs, injection
    View adult BNF View SPC online
    Formulary
    Red
     
    Link  NICE TA29: Guidance on the use of fludarabine for B-cell chronic lymphocytic leukaemia
       
    Cytotoxic Drug Fluorouracil injection (keloid scarring - off-label)
    View adult BNF View SPC online
    Formulary
    Red

    Approved off-label indication:

    Intralesional injection for the treatment of keloid and hypertrophic scarring.

    Use in accordance with locally approved protocol

    Dose: 50 mg per cm2 of lesion

     
       
    Cytotoxic Drug Fluorouracil injection (oncology indications)
    View adult BNF View SPC online
    Formulary
    Red

     
       
    Cytotoxic Drug Gemcitabine injection
    View adult BNF View SPC online
    Formulary
    Red
     
    Link  NICE CG121: Lung cancer: diagnosis and management
    Link  NICE TA116: Gemcitabine for the treatment of metastatic breast cancer
    Link  NICE TA25:Guidance on the use of gemcitabine for the treatment of pancreatic cancer
       
    Cytotoxic Drug Mercaptopurine tabs
    View adult BNF View SPC online
    Formulary
    Red
     
       
    Cytotoxic Drug Methotrexate tabs (neurology - off-label)
    View adult BNF View SPC online
    Formulary

    Approved off-label indication:

    Disease modifying and steroid sparing treatment for neurological conditions

     
       
    Cytotoxic Drug Methotrexate tabs injection (oncology)
    View adult BNF View SPC online
    Formulary
    Red

    For oncology indications

    Refer to BNF for highlighted cautions for blood count, and gastro-intestinal, liver and pulmonary toxicities

     
       
    Cytotoxic Drug Pemetrexed injection
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

     
    Link  NICE TA135: Pemetrexed for the treatment of malignant pleural mesothelioma
    Link  NICE TA181: Pemetrexed for the first-line treatment of non-small-cell lung cancer
    Link  NICE TA190: Pemetrexed for the maintenance treatment of non-small-cell lung cancer
    Link  NICE TA402: Pemetrexed maintenance treatment for non-squamous non-small-cell lung cancer after pemetrexed and cisplatin
       
    Cytotoxic Drug Tioguanine tabs
    View adult BNF View SPC online
    Formulary
    Red
     
       
    Trifluridine–tipiracil tablets
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    BlueTeq

     
    Link  NICE TA405: Trifluridine–tipiracil for previously treated metastatic colorectal cancer
       
     ....
    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  

    netFormulary