Pan Mersey
Area Prescribing Committee
 
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8 Malignant disease and immunosuppression

Coronavirus guidance

Guidance to support primary care prescribers and pharmacists is available from the MLCSU Coronavirus guidance resource page. Links are provided to national resources and regional documents produced by MLCSU, RDTC, and SPS for use by Pan Mersey APC, LSCMMG, and GMMMG.

The list of resources will be updated as new material becomes available so please check back regularly for updates.

The Pan Mersey APC supports the use of COVID-specific guidance issued by NICE, and NHS England and NHS Improvement. During the COVID pandemic this will supersede any APC advice.

Malignant disease and immunosuppression

Review date: January 2022

Non-formulary drugs: Any drug or formulation not listed in the formulary is deemed to be non-formulary.

Off-label use: Drugs are included in the formulary for their licensed indications – where inclusion of off-label use is considered to be included in the formulary this is specifically stated in the formulary entry for the drug N.B. also see Paediatrics note below.

Paediatrics: Drugs are included in the formulary for paediatric use for their BNF for Children recommended indications (indicated by symbol View childrens BNF) which may be off-label, unless otherwise stated. All drugs are deemed to have the same RAG status as they have for adults unless stated otherwise.

NHS England Specialised Commissioning
Drugs carrying the NHS England logo are commissioned by them. Links to key documents, national programmes of care, and clinical reference groups are found below.

NHSE NHS England Specialised Commissioning: Key documents

NHSE NHS England Specialised Commissioning: National programmes of care and clinical reference groups

Medications which are indicated for medically assisted reproduction, including ovulation induction (e.g. clomifene, letrozole and tamoxifen) and assisted reproduction, such as In Vitro Fertilisation or Ex Vitro Fertilisation (e.g. gonadotrophins) are restricted to use by specialist secondary care physicians, and are categorised as RED drugs for these purposes.

08-03-04-02 Gonadorelin analogues

Triptorelin is preferred gonadorelin analogue for prostate cancer.


Triptorelin
First Choice

Decapeptyl® SR Injection, (powder for suspension), m/r, triptorelin (as acetate), 3mg vial (with diluent); Decapeptyl® SR Injection, (powder for suspension), m/r, triptorelin (as acetate/pamoate), 11.25mg vial (with diluent); Decapeptyl® SR Injection, (powder for suspension), m/r, triptorelin (as pamoate), 22.5mg vial (with diluent).

Use in accordance with its licensed indications.

 

For Halton CCG and Warrington CCG patients attending Warrington and Halton Hospitals, GPs currently initiate treatment on the advice of the Trust

Amber Patient Retained Decapeptyl® SR 3mg for early breast cancer

 REDSt Helen's CCG for endometriosis and uterine fibroids

Link   TRIPTORELIN (Decapeptyl® SR), Pan Mersey Area Prescribing Committee Policy Statement
 

Amber Retained View adult BNF  View SPC online
Buserelin
Formulary

Injection 1mg/mL; nasal spray 100 micrograms

For Halton CCG and Warrington CCG patients attending Warrington and Halton Hospitals, GPs currently initiate treatment on the advice of the Trust


Amber Retained View adult BNF  View SPC online
Goserelin
Formulary

Implant 3.6mg, 10.8mg For prostate cancer and breast cancer indications.

For Halton CCG and Warrington CCG patients attending Warrington and Halton Hospitals, GPs currently initiate treatment on the advice of the Trust

RED St Helen's CCG for endometriosis, endometrial thinning and uterine fibroids.


Amber Retained View adult BNF  View SPC online
Leuprorelin acetate
Formulary

Injection 3.75mg, 11.25mg

For Halton CCG and Warrington CCG patients attending Warrington and Halton Hospitals, GPs currently initiate treatment on the advice of the Trust

RED St Helen's CCG for endometriosis and uterine fibroids.


Amber Retained View adult BNF  View SPC online
Triptorelin Gonapeptyl
Formulary

Injection: 3.75mg depot

For Halton CCG and Warrington CCG patients attending Warrington and Halton Hospitals, GPs currently initiate treatment on the advice of the Trust

Link   TRIPTORELIN (Decapeptyl® SR) Pan Mersey Area Prescribing Committee Policy Statement
 

Amber Retained View adult BNF  View SPC online