Formulary Group Decisions June 2006
Approved for use in NHS Grampian
Dorzolamide 2% preservative-free unit-dose eye drops (Trusopt®)
Treatment of glaucoma BNF 11.6
Dorzolamide 2% preservative-free unit-dose eye drops (Trusopt®) was approved for inclusion in the GJF. This preparation is substantially more expensive than the equivalent multi-dose eye drop preparation and should be restricted to use in patients for whom dorzolamide is appropriate and who have proven sensitivity to the preservative benzalkonium chloride. Available for restricted use, treatment may be initiated in the community on the recommendation of a consultant/specialist.
Somatropin injection (Norditropin SimpleXx®)
Hypothalamic and anterior pituitary hormones and anti-oestrogens BNF 6.5.1
Somatropin injection (Norditropin SimpleXx®) was approved for inclusion in the GJF for the treatment of growth disturbance in short children born small for gestational age as per SMC advice 260/06. Treatment should be initiated and monitored by a paediatrician with expertise in managing childhood growth disorders and growth hormone therapy. Somatropin for this indication is available for restricted use under specialist supervision, 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.
Not approved for use in NHS Grampian
Bevacizumab solution for IV infusion (Avastin®)
Other antineoplastic drugs BNF 8.1.5
Bevacizumab (Avastin®)
is not recommended in combination with intravenous fluorouracil/folinic acid or intravenous fluorouracil/folinic acid/irinotecan for first-line treatment of patients with metastatic carcinoma of the colon or rectum [Re-submission SMC No 221/05].
Not recommended by SMC for use within NHS Scotland - will not be included in Grampian Joint Formulary for this indication.
Esomeprazole tablets (Nexium®)
Proton pump inhibitors BNF 1.3.5
Esomeprazole (Nexium®) is not recommended for the prevention of gastric and duodenal ulcers associated with non-steroidal anti-inflammatory drug (NSAID) therapy SMC No 257/06, or for the healing of gastric ulcers associated with non-steroidal anti-inflammatory drug (NSAID) therapy SMC No 274/06.
Not recommended by SMC for use within NHS Scotland - will not be included in Grampian Joint Formulary for this indication.
Oxybutinin XL tablets (Lyrinel® XL)
Drugs for urinary frequency, enuresis, and incontinence BNF 7.4.2
Oxybutinin XL tablets (Lyrinel® XL) is not recommended for second-line use in patients intolerant of immediate release oxybutinin. The side-effect incidence and profile in the papers presented did not differ substantially between immediate release and modified release formulations. Not recommended for use in NHS Grampian, cost-effective alternatives available (see 7.4).
Not approved for use within NHS Grampian - will not be added to Grampian Joint Formulary for this indication.
Pegvisomant (Somavert®)
Hypothalamic and anterior pituitary hormones and anti-oestrogens BNF 6.5.1
Pegvisomant (Somavert®)
is not recommended for the treatment of patients with acromegaly who have had an inadequate response to surgery and/or radiation therapy and in whom an appropriate medical treatment with somatostatin analogues did not normalise insulin-like growth factor 1 (IGF-1) concentrations or was not tolerated [Resubmission - SMC No 158/05].
Not recommended by SMC for use within NHS Scotland - will not be included in Grampian Joint Formulary for this indication.
Allergen Immunotherapy BNF 3.4.2
[Not recommended on resubmission SMC No 259/06 February 2007].
Not recommended by SMC for use within NHS Scotland - will not be included in Grampian Joint Formulary for this indication.
Sildenafil citrate (Revatio®)
Vasodilator antihypertensive drugs BNF 2.5.1
Sildenafil citrate 20mg tablets (Revatio®) for the treatment of patients with pulmonary arterial hypertension (high blood pressure on the pulmonary artery) classified as WHO functional class III, to improve exercise capacity. This is an orphan indication for sildenafil with limited clinical evidence from short-term clinical trials [SMC 235/06].
Not approved for use within NHS Grampian - It is restricted to initiation by specialists working in the Scottish Pulmonary Vascular Unit and by physicians experienced in the management of pulmonary vascular disease - will not be added to Grampian Joint Formulary for this indication.
Rituximab and aletuzemab BNF 8.2.3
Rituximab is not recommended as a treatment for severe systemic autoimmune diseases when conventional therapies have failed [off-label use]. Reclassification of advice; due to its very limited use and unlicensed indication rituximab as a treatment for severe systemic autoimmune diseases was not considered appropriate for addition to the GJF.
Not approved for use within NHS Grampian - will not be added to Grampian Joint Formulary for this indication.