Formulary Group Decisions December 2006
Approved for use in NHS Grampian
Adefovir dipivoxil tablets (Hepsera®)
Viral hepatitis BNF 5.3.3
Adefovir (tablets)
was approved for inclusion in the GJF for the treatment of chronic hepatitis B infection in patients who have developed resistance to lamivudine or in combination with lamivudine where viral flare would be particularly dangerous [NICE TA96, SMC No 54/03]. Use is restricted to use by specialist physicians experienced in the diagnosis and treatment of viral hepatitis. Available for restricted use under specialist supervision, treatment may be initiated in the community on the recommendation of a consultant/specialist and subject to an individual care plan being agreed between the consultant and GP.
Daptomycin 500 mg powder for intravenous infusion (Cubicin®)
Some other antibacterials BNF 5.1.7
ADVICE: following review of an abbreviated submission SMC No 338/06
Daptomycin 500 mg powder for intravenous infusion
, this new strength vial was approved for inclusion in the GJF for restricted use for the treatment of complicated skin and soft-tissue infections in adults as per advice in SMC 338/06. Restricted to use in patients with known or suspected methicillin-resistant Staphylococcus aureus (MRSA) infection and on the advice of local microbiologists or specialists in infectious diseases. The new strength allows patients weighing over 87.5 kg to be treated with a single 500mg vial at a reduced cost compared to two vials of the 350mg strength. Daptomycin is a restricted list antimicrobial available for restricted use under specialist supervision, hospital use only.
Drugs which suppress the rheumatic disease process BNF 10.1.3
Rituximab (MabThera®) was approved for inclusion in the GJF for restricted use in combination with methotrexate for the treatment of adult patients with severe active rheumatoid arthritis who have had an inadequate response or intolerance to other antirheumatic drugs [SMC No 323/06]. Use is restricted to specialist physicians experienced in the diagnosis and treatment of rheumatoid arthritis. Available for restricted use under specialist supervision, hospital use only.
Approved by SMC, not requested by local clinicians - not approved for use in NHS Grampian
Treatment of diabetic nephropathy and neuropathy BNF 6.1.5
Duloxetine (Cymbalta®)
for restricted use for the treatment of diabetic peripheral neuropathic pain in adults.Short-acting insulins BNF 6.1.1.1
Insulin glulisine injection (Apidra®)
for restricted use for the treatment of adult patients with diabetes mellitus in whom treatment with a short-acting insulin is appropriate.Not approved for use in NHS Grampian
Mitotane 500mg tablets (Lysodren®)
Other antineoplastic drugs BNF 8.1.5
Mitotane (Lysodren®)
is not recommended for the symptomatic treatment of advanced (unresectable, metastatic or relapsed) adrenal cortical carcinoma. Mitotane should be used only within the context of clinical trials [SMC No 328/06].
Not recommended by SMC for use within NHS Scotland - will not be included in Grampian Joint Formulary for this indication.
Natalizumab 300mg concentrate for solution for infusion (Tysabri®)
Other immunomodulating drugs BNF 8.2.4
Natalizumab (Tysabri®)
is not recommended for use as single disease-modifying therapy in highly active relapsing remitting multiple sclerosis. The economic case has not been demonstrated [SMC No 329/06].
Not recommended by SMC for use within NHS Scotland - will not be included in Grampian Joint Formulary for this indication.
Rasagiline 1mg tablet (Azilect®)
Dopaminergic drugs used in parkinsonism BNF 4.9.1
Rasagiline (Azilect®)
is not recommended for the treatment of idiopathic Parkinson's disease
- as monotherapy SMC 243/06
- as adjunct therapy SMC No 255/06
Not recommended by SMC for use within NHS Scotland - will not be included in Grampian Joint Formulary for this indication.