Formulary Group Decisions May 2011
Approved for use in NHS Grampian
Dalteparin sodium injection (Fragmin®)
Parenteral anticoagulants BNF 2.8.1
Dalteparin sodium injection (Fragmin®) was approved for inclusion in the Grampian Joint Formulary for restricted use for extended treatment of symptomatic venous thromboembolism (VTE) and prevention of its recurrence in patients with solid tumours. Use is restricted to initiation by healthcare professionals experienced in the treatment of VTE. Available for general use and treatment may be initiated in the community on the recommendation of a consultant/specialist.
Parenteral anticoagulants BNF 2.8.1
Dalteparin sodium injection (Fragmin®)
was approved for inclusion in the Grampian Joint Formulary for restricted use for extended treatment of symptomatic venous thromboembolism (VTE) and prevention of its recurrence in patients with solid tumours. Use is restricted to initiation by healthcare professionals experienced in the treatment of VTE. Available for general use and treatment may be initiated in the community on the recommendation of a consultant/specialist.Exenatide injection (Byetta®)
Other antidiabetic drugs BNF 6.1.2.3
Exenatide injection (Byetta®) was approved for inclusion in the Grampian Joint Formulary for restricted use for the treatment of type 2 diabetes mellitus in patients who have not achieved adequate glycaemic control on maximally tolerated doses of these oral therapies. Use is restricted to use in combination with metformin and a thiazolidinedione as a third-line pre-insulin treatment option. Available for restricted use under specialist supervision and treatment may be initiated in the community on the recommendation of a consultant/specialist.
Other antidiabetic drugs BNF 6.1.2.3
Exenatide injection (Byetta®)
was approved for inclusion in the Grampian Joint Formulary for restricted use for the treatment of type 2 diabetes mellitus in patients who have not achieved adequate glycaemic control on maximally tolerated doses of these oral therapies. Use is restricted to use in combination with metformin and a thiazolidinedione as a third-line pre-insulin treatment option. Available for restricted use under specialist supervision and treatment may be initiated in the community on the recommendation of a consultant/specialist.Fluticasone furoate nasal spray (Avamys®)
Drugs used in nasal allergy BNF 12.2.1
Fluticasone furoate nasal spray (Avamys®) was approved for inclusion in the Grampian Joint Formulary as a second- or third- line option for the treatment of the symptoms of allergic rhinitis in adults, adolescents (12 years and over) and children (6 to 11 years). Available for general use and treatment may be initiated in either hospital or community.
Prescribers should be aware that the recommended doses of fluticasone furoate are not equivalent, on a microgram per microgram basis, to other fluticasone nasal sprays currently available, and that other intranasal steroids are available at a lower cost.
Drugs used in nasal allergy BNF 12.2.1
Fluticasone furoate nasal spray (Avamys®)
was approved for inclusion in the Grampian Joint Formulary as a second- or third- line option for the treatment of the symptoms of allergic rhinitis in adults, adolescents (12 years and over) and children (6 to 11 years). Available for general use and treatment may be initiated in either hospital or community.
Prescribers should be aware that the recommended doses of fluticasone furoate are not equivalent, on a microgram per microgram basis, to other fluticasone nasal sprays currently available, and that other intranasal steroids are available at a lower cost.
Infliximab intravenous infusion [off-label use]
Skin BNF 13
Infliximab intravenous infusion is available for restricted off-label use for the treatment of severe pyoderma gangrenosum. Restricted to use when other treatments are not tolerated or contraindicated. Licensed product requested for off-label use and licensed for hospital use only.
The Group requested that the service consider a trial off treatment after induction and during treatment to confirm which patients require continued infusions.
Skin BNF 13
Infliximab intravenous infusion is available for restricted off-label use for the treatment of severe pyoderma gangrenosum. Restricted to use when other treatments are not tolerated or contraindicated. Licensed product requested for off-label use and licensed for hospital use only.
The Group requested that the service consider a trial off treatment after induction and during treatment to confirm which patients require continued infusions.
Approved by SMC, not requested by local clinicians - not approved for use in NHS Grampian
Botulinum toxin type A injection (Botox®)
Drugs used in essential tremor, chorea, tics, and related disorders, torsion dystonias and other involuntary movements BNF 4.9.3
Botulinum toxin type A injection (Botox®) is accepted for use within NHS Scotland.
Indication under review: focal spasticity, including the treatment of wrist and hand disability due to upper limb spasticity associated with stroke in adults.
In a placebo-controlled study, botulinum toxin type A was significantly superior to placebo in terms of the disability assessment scale and efficacy was maintained across repeated injections in an open-label extension study with a duration of one year.
Not requested by local clinicians - Not recommended for use in NHS Grampian for this indication.
Not approved for use in NHS Grampian
Alfentanil 5mg/5mL spray [unlicensed product]
Opioid analgesics BNF 4.7.2
Alfentanil 5mg/5mL spray was not recommended for inclusion in the Grampian Joint Formulary for the treatment of incident pain. Unlicensed product, these drugs will not normally be added to the Grampian Joint Formulary.
Opioid analgesics BNF 4.7.2
Alfentanil 5mg/5mL spray was not recommended for inclusion in the Grampian Joint Formulary for the treatment of incident pain. Unlicensed product, these drugs will not normally be added to the Grampian Joint Formulary.
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