NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Formulary Update

Formulary News (October 2012)

Please note some of the indications have been summarised for brevity but complete details can be found by following the links to the SMC advice.

Additions to Adult Formulary

Greater Glasgow and Clyde Area Drug and Therapeutics Committee (ADTC) met on October 8th and added the following medicines/indications/ formulations to the GGC Formulary.  Additions are to the Total Formulary unless specified otherwise.

Abiraterone acetate (Zytiga®) for the treatment of metastatic castration resistant prostate cancer (mCRPC) is included in the Total Formulary. It is restricted to specialist use in patients who have received only one prior chemotherapy regimen and is to be used in accordance with regional protocol.

For the relevant SMC advice click here

Colecalciferol 800 unit capsules (Fultium-D3®) are included in the Total Formulary for the prevention and treatment of vitamin D deficiency in adults, the elderly and adolescents and as an adjunct to specific therapy for osteoporosis in patients with vitamin D deficiency or at risk of vitamin D insufficiency. 

Fultium D3® contains 800 units of colecalciferol. It should be noted that this preparation is double the daily recommended dose of Vitamin D for adults who are considered to be at risk of vitamin D deficiency as outlined in guidance issued from the Chief Medical Officer for Scotland in February 2012. Healthy Start vitamins contain 400 units of vitamin D and are available for eligible patient groups in NHSGGC and vitamin supplement preparations containing 400 units of vitamin D are readily available for purchase over the counter from pharmacies and health food shops. 

Guidance on when to measure vitamin D levels and the subsequent management are currently in development by the GG&C Osteoporosis Group and Biochemistry Department.

For the relevant SMC advice click here

Collagenase clostridium histolyticum (Xiapex®) for the treatment of Dupuytren’s contracture in adult patients with a palpable cord is included in the Total Formulary.  Use is restricted to specialists in accordance with local protocol.

For the relevant SMC advice click here

Everolimus (Afinitor®) for the treatment of unresectable or metastatic, well or moderately-differentiated neuroendocrine tumours of pancreatic origin (pNET) in adults with progressive disease is included in the Total Formulary.  It is restricted to specialist use in accordance with regional protocol.

For the relevant SMC advice click here

Fingolimod (Gilenya®) is included in the Total Formulary for use in adults with highly active relapsing remitting multiple sclerosis (RRMS). It is restricted to specialist use in highly active RRMS only in adult patients with high disease activity despite treatment with a beta-interferon with an unchanged or increased relapse rate or ongoing severe relapses, as compared to the previous year.

For the relevant SMC advice click here

Fluticasone and formoterol inhaler (Flutiform®) for the treatment of asthma is included in the Preferred List restricted to use in patients on step 3 or above of the BTS/SIGN asthma guidelines.

For the relevant SMC advice click here

Ivabradine (Procoralan®) is included in the Total Formulary for use in chronic heart failure New York Heart Association (NYHA) II to IV class with systolic dysfunction, in patients in sinus rhythm and whose heart rate is ≥75 beats per minute (bpm), in combination with standard therapy including beta-blocker therapy or when beta-blocker therapy is contra-indicated or not tolerated.  It is restricted to use in patients whose resting heart rate remains ≥75 beats per minute despite optimal standard therapy and should only be initiated by prescribers working within specialist heart failure teams.

For the relevant SMC advice click here

Tocilizumab (RoActemra®) is included in the Total Formulary for use as monotherapy in patients who are intolerant to methotrexate or where continued treatment with methotrexate is inappropriate, for the treatment of moderate to severe active rheumatoid arthritis (RA) in adult patients who have either responded inadequately to, or who were intolerant to, previous therapy with one or more disease-modifying anti-rheumatic drugs (DMARDs) or tumour necrosis factor (TNF) antagonists.  It is restricted to specialist use in accordance with the British Society for Rheumatology (BSR) guidelines (2005).

For the relevant SMC advice click here

Velaglucerase (Vpriv®) for long-term enzyme replacement therapy in patients with type 1 Gaucher disease is included in the Total Formulary.  It is restricted to specialist use under the supervision of a physician experienced in the management of patients with Gaucher disease.

For the relevant SMC advice click here

New medicines, indications and formulations not included in the Adult Formulary

The following are not included in the GGC Adult Formulary following the latest ADTC meeting. Where the reason is other than not recommended advice from SMC it is noted.  NB: these medicines may be included in the Formulary for other indications or for other formulations.  Please refer to Formulary.

Bevacizumab (Avastin®) is not included in the Adult Formulary for use in combination with carboplatin and paclitaxel for the front-line treatment of advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer.

For the relevant SMC advice click here

Caffeine citrate (Peyona®) is not included in the Paediatric Formulary for the treatment of primary apnoea of premature newborns.

For the relevant SMC advice click here

Pasireotide (Sifnifor®) is not included in the Adult Formulary for the treatment of adult patients with Cushing’s disease for whom surgery is not an option or for whom surgery has failed.

For the relevant SMC advice click here

Strontium ranelate (Protelos®) is not included in the Adult Formulary for the treatment of osteoporosis in men at increased risk of fracture

For the relevant SMC advice click here

Tocofersolan (Vedrop®) is not included in the Adult or Paediatric Formulary for vitamin E deficiency due to digestive malabsorption in paediatric patients (up to 16-18 years of age) suffering from congenital chronic cholestasis or hereditary chronic cholestasis.

For the relevant SMC advice click here

Vemurafenib (Zelboraf®) is not included in the Adult Formulary as monotherapy for the treatment of adults patients with BRAF V600 mutation-positive unresectable or metastatic melanoma.

For the relevant SMC advice click here

Zonisamide (Zonegran®) is not included in the Adult Formulary for monotherapy treatment of partial seizures (with or without secondary generalisation) in adults with newly diagnosed epilepsy

For the relevant SMC advice click here


New medicines, indications and formulations not included in the Adult Formulary pending protocol / consultation

The following new medicines, indications or formulations require the development of a protocol or further consultation before Formulary status can be concluded.  Until this process is complete, these medicines, indications or formulations are not included in the Formulary.

Tegafur/gimeracil/oteracil (Teysuno®) for the treatment of advanced gastric cancer in adults when given in combination with cisplatin (Regional Cancer Advisory Group)

For the relevant SMC advice click here

Other Formulary information

The following advice has been noted by ADTC.

Imiglucerase (Cerezyme®)  for long-term enzyme replacement therapy in patients with Gaucher disease is included in the Total Formulary.  It is restricted to specialist use under the supervision of a physician experienced in the management of patients with Gaucher disease.

Miglustat (Zavesca® for long-term enzyme replacement therapy in patients with moderate type 1 Gaucher disease is included in the Total Formulary.  It is restricted to specialist use under the supervision of a physician experienced in the management of patients with Gaucher disease. The use in the treatment of Niemann-Pick type C disease is not recommended by SMC and remains non-Formulary

For the relevant SMC advice click here