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 Formulary Chapter 9: Nutrition and blood - 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.

 Details...
09.01.04  Expand sub section  Drugs used in autoimmune thrombocytopenic purpura
Anagrelide capsules
View adult BNF View SPC online
Formulary
Red

USE UNDER SPECIALIST SUPERVISION ONLY

 
   
Avatrombopag tabs
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
CCG

Approved for use as per NICE Technology Appraisal guidance (see link below)

 
Link  NICE TA626: Avatrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure
   
Azathioprine tablets (immune thrombocytopenia - off-label )
View adult BNF View SPC online
Formulary
Red

Approved off-label indication:

Treatment of symptomatic acute Immune Thrombocytopenia (ITP)

Dose = 1–2 mg/kg daily, adjusted according to response (maximum 150mg/day)

Refer to SE London APC guidance for management of ITP in adult patients (link below)

 
   
Caplacizumab injection
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England

Approved for use as per NICE Technology Appraisal guidance (see link below)

 
Link  NICE TA667: Caplacizumab with plasma exchange and immunosuppression for treating acute acquired thrombotic thrombocytopenic purpura
   
Ciclosporin capsules (immune thrombocytopenia - off-label )
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Formulary
Red

Approved off-label indication:

Last line treatment for symptomatic acute Immune Thrombocytopenia (ITP)

Dose = 5mg/kg/day for 6 days then 2.5-3mg/kg/day

Refer to SE London APC guidance for management of ITP in adult patients (link below)

 
   
Cycloposphamide tablets  (immune thrombocytopenia - off-label )
View adult BNF View SPC online
Formulary
Red

Approved off-label indication:

Last line treatment for symptomatic acute Immune Thrombocytopenia (ITP)

Dose = 1-2mg/kg orally daily for a minimum of 16 weeks

Refer to SE London APC guidance for management of ITP in adult patients (link below)

 
   
Danazol capsules (immune thrombocytopenia - off-label )
View adult BNF View SPC online
Formulary
Red

Approved off-label indication:

Last line treatment for symptomatic acute Immune Thrombocytopenia (ITP)

Dose = 200mg 2-4 times daily

Refer to SE London APC guidance for management of ITP in adult patients (link below)

 
   
Dapsone tablets (immune thrombocytopenia - off-label )
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Formulary
Red

Approved off-label indication:

Last line treatment for symptomatic acute Immune Thrombocytopenia (ITP)

Dose = 75-100mg daily

Refer to SE London APC guidance for management of ITP in adult patients (link below)

 
   
Eltrombopag tablets
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Restricted Drug Restricted
Red
High Cost Medicine
CCG

Consultant Haematologists specialising in the treatment of ITP only

 
Link  MHRA Jul 2018: Eltrombopag (Revolade): reports of interference with bilirubin and creatinine test results
Link  NICE TA293: Eltrombopag for treating chronic immune (idiopathic) thrombocytopenic purpura (review of technology appraisal 205)
   
Lusutrombopag tabs
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Formulary
Red
High Cost Medicine
CCG

Approved for use as per NICE Technology Appraisal guidance (see link below)

 
Link  NICE TA617: Lusutrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure
   
Mycophenolate mofetil tabs, caps (immune thrombocytopenia - off-label )
View adult BNF View SPC online
Formulary
Red

Approved off-label indication:

Treatment of symptomatic acute Immune Thrombocytopenia (ITP)

Dose = Start at 500 mg twice daily, increasing to 1g twice daily if tolerated

Refer to SE London APC guidance for management of ITP in adult patients (link below)

 
   
Rituximab injection  (immune thrombocytopenia - off-label )
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
CCG

Approved off-label indication:

Treatment of symptomatic acute Immune Thrombocytopenia (ITP)

Dose = 100mg weekly for 4 weeks

Biosimilar products available, to be prescribed by brand name.

Contact pharmacy department for advice on brand for routine prescribing if unsure

Refer to SE London APC guidance for management of ITP in adult patients (link below)

 
   
Romiplostim injection
View adult BNF View SPC online
Restricted Drug Restricted
Red
High Cost Medicine
CCG

Consultant Haematologists specialising in the treatment of ITP only

 
Link  NICE TA221: Thrombocytopenic purpura - romiplostim
   
Vinblastine injection  (immune thrombocytopenia - off-label )
View adult BNF View SPC online
Formulary
Red

Approved off-label indication:

Last line treatment for symptomatic acute Immune Thrombocytopenia (ITP)

Refer to SE London APC guidance for management of ITP in adult patients (link below)

 
   
Vincristine injection  (immune thrombocytopenia - off-label )
View adult BNF View SPC online
Formulary
Red

Approved off-label indication:

Last line treatment for symptomatic acute Immune Thrombocytopenia (ITP)

Refer to SE London APC guidance for management of ITP in adult patients (link below)

 
   
Eltrombopag tablets
View adult BNF View SPC online
Restricted Drug Restricted
Red
High Cost Medicine
CCG

Consultant Specialists only

Refractory aplastic anaemia in patients who are platelet transfusion dependent and also contraindicated/failed bone marrow transplant.

 
   
 ....
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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