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  • Joint Wound Care Formulary
  • . . . Introduction
  • 1. Gastro-Intestinal System
  • 2. Cardiovascular System
  • 3. Respiratory System
  • 4. Central Nervous System
  • 5. Infections
  • 6. Endocrine System
    • 6.1 Drugs used in diabetes
    • 6.2 Thyroid and antithyroid drugs
    • 6.3 Corticosteroids
    • 6.4 Sex hormones
    • 6.5 Hypothalamic and pituitary hormones and anti-oestrogens
    • 6.6 Drugs affecting bone metabolism
    • 6.7 Other endocrine drugs
  • 7. Obstetrics, Gynaecology and Urinary Tract Disorders
  • 8. Malignant Disease and Immunosuppresion
  • 9. Nutrition and Blood
  • 10. Musculoskeletal and Joint Disease
  • 11. Eye
  • 12. Ear, Nose and Oropharynx
  • 13. Skin
  • 14. Immunological products and vaccines
  • 15. Anaesthesia
  • Appendix 1. Drugs for emergency use in General Practice
  • Appendix 2. Palliative Care
  • Appendix 3. Oral Nutritional Supplements (ONS)
  • Appendix 4. Gluten-free and cow's milk protein-free products
  • Medicines No Longer included in the GJF
  • Medicines not recommended for use in NHS Grampian
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6.5 Hypothalamic and pituitary hormones and anti-oestrogens

These preparations are specialist use only and if required should only be used on the recommendation of a consultant, following prior detailed investigation of the patient.

Anti-oestrogens

Clomifene citrate (50mg tablets) is an anti-oestrogen which is indicated in anovulatory infertility. Note CSM warning: should not normally be used for longer than 6 cycles.

Tamoxifen is used in the treatment of anovulatory infertility, for use in breast cancer see 8.3.4.1.

Anterioir pituitary hormones

Tetracosactide (250micrograms/mL injection) is used for testing adrenocortical function.

Chorionic gonadotrophin (human chorionic gonadotrophin; HGC), choriogonadotropin alfa, follitropin alpha and follitropin beta (recombinant human follicle stimulating hormone) and human menopausal gonadotrophins are mainly used in infertility treatment.

Somatropin is synthetic human growth hormone and is indicated for use in children for the treatment of short stature in HGH deficiency states, Turner syndrome [see NICE guidance No 42] and for the treatment of growth disturbance in short children born small for gestational age as per SMC No 240/06 (Genotropin®) and SMC No 260/06 (Norditropin SimpleXx®). Treatment should be initiated and monitored by a paediatrician with expertise in managing childhood growth disorders and growth hormone therapy. Treatment may be initiated in the community on the recommendation of a specialist, and subject to an individual care plan being agreed between the consultant and the GP.

Thyrotropin alpha injection (900micrograms/vial) is a recombinant form of thyrotropin (TSH) and is used prior to radioiodine imaging to detect thyroid remnants or thyroid cancer in post-thyroidectomy patients.

Hypothalmic hormones

Gonadorelin injection (gonadotrophin-releasing hormone) is used for the assessment of pituitary function.

POSTERIOR PITUITARY HORMONES

Desmopressin (tablets, sublingual tablets, injection, nasal spray) is used in the diagnosis and treatment of diabetes insipidus and for nocturnal enuresis.

Desmopressin oral lyophilisate s/l tablets (DDAVP Melt®) is used for the treatment of vasopressin-sensitive cranial diabetes insipidus and in the treatment of post-hypophysectomy polyuria/polydipsia.  In patients for whom desmopressin is an appropriate choice of therapy, it offers a sublingual formulation at an equivalent cost to a clinically equivalent dose in a solid oral dose formulation. 

Terlipressin (injection) is indicated for the treatment of bleeding oesophageal varices.

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