Formulary Chapter 8: Malignant disease and immunosuppression - Full Chapter
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08.03.04.01 |
Breast cancer |
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Letrozole tabs
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Formulary
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Approved off-label indication:
Fertility preservation in patients undergoing ovarian stimulation prior to chemotherapy in oestrogen receptor postive breast cancer
Consultant specialists in oncology and fertility only
Dose = 5 mg daily for 10-15 days during the course of ovarian stimulation
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Fulvestrant injection

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Non Formulary
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Not approved for use in SE London as monotherapy as per NICE Technology appraisal guidance (see links below).
See section above for approved formulary uses |
Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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Cancer Drugs Fund
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
Status |
Description |

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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.
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Treatment can be initiated in primary care after a recommendation from an appropriate specialist |

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Specialist initiation followed by maintenance prescribing in primary care |

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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 |

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Specialist and non-specialist initiation |

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Not recommended for prescribing |
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