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

Formulary Update (August 2014)

Additions to the GGC Adult Formulary

Greater Glasgow and Clyde Area Drug and Therapeutics Committee (ADTC) met on 11th August 2014 and added the following medicines/indications/ formulations to the GGC Formulary.  Additions are to the Total Formulary unless specified otherwise.

Alemtuzumab intravenous infusion (Lemtrade®) for adult patients with relapsing-remitting multiple sclerosis (RRMS) with active disease defined by clinical or imaging features is included in the GGC Adult Formulary. It is restricted to specialist use only. 

For relevant SMC advice click here

Beclomethasone & formoterol aerosol inhalation (Fostair®) for the symptomatic treatment of patients with severe COPD (FEV1 <50% predicted normal) and a history of repeated exacerbations, who have significant symptoms despite regular therapy with long-acting bronchodilators is included in the GGC Adult Formulary (Preferred List). It is restricted to use in accordance with current NHSGGC COPD guidelines.

For relevant SMC advice click here

Botulinum toxin type A (Botox®) for the management of bladder dysfunctions in adult patients who are not adequately managed with anticholinergics (overactive bladder with symptoms of urinary incontinence, urgency and frequency) is included in the GGC Adult Formulary for the indication in question. It is restricted to specialist use only and to use in patients who have failed appropriate oral treatment options.

For relevant SMC advice click here

Certolizumab pegol injection (Cimzia®) in combination with methotrexate, for the treatment of active psoriatric arthritis in adults when the response to previous disease-modifying drug (DMARD) therapy has been inadequate is included in the GGC Adult Formulary. It is restricted to specialist use in patients whose disease has not responded to adequate trials of at least two standard DMARDs either individually or in combination.

Prescribing note: Certolizumab pegol can be given as monotherapy in case of intolerance to methotrexate or when continued treatment with methotrexate is inaproproriate.

For relevant SMC advice click here

Dapagliflozin tablets (Forxiga®) for adults aged 18 years and older with type 2 diabetes mellitus to improve glycaemic control as add-on combination therapy in combination with other glucose-lowering medicinal products including insulin, when these, together with diet and exercise, do not provide adequate glycaemic control is included in the GGC Adult Formulary. Its use is restricted to clinicians experienced in the management of diabetes for triple therapy in combination with metformin and sulphonylurea, as an alternative to dipeptidyl peptidase-4 (DPP-4) inhibitor.

For relevant SMC advice click here

Dapagliflozin with metformin tablets (Xigduo®) in adults aged 18 years and older with type 2 diabetes mellitus as an adjunct to diet and exercise to improve glycaemic control in:

  • patients inadequately controlled on their maximally tolerated dose of metformin alone
  • combination with other glucose-lowering medicinal products, including insulin, in patients inadequately controlled with metformin and these medicinal products
  • patients already being treatedwith the combination of dapagliflozin and metformin as separate tablets 

is included in the GGC Adult Formulary.  Its use is restricted to clinicians experienced in the management of diabetes in patients for whom a combination of dapagliflozin and metformin is an appropriate choice of therapy i.e.

  • when metformin alone does not provide adequate glycaemic control and a sulphonylurea is inappropropriate.
  • in combination with insulin, when insulin and metformin does not provide adeqaute control.
  • in combination with a sulphonylurea, when a sulphonylurea and metformin does not provide adequate control. 

In addition, this preparation is restricted to those patients who have demonstrated compliance issues with the separate constituents.

For relevant SMC advice click here

Ocriplasmin intravitreal injection (Jetrea®) for use in adults for the treatment of vitreomacular traction, including when associated with macular hole of diameter less or equal to 400 microns is included in the GGC Adult formulary. It is restricted to specialist use only by Vitreo-Retinal Surgeons in patients who are unfit for surgery who have either vitreomacular traction plus macular hole, regardless of whether they have epiretinal membrane formation, or vitreomacular traction alone (no epiretinal membrane and no macular hole).

For relevant SMC advice click here

Rituximab subcutaneous injection (MabThera®) for non-Hodgkin's lymphoma (NHL) in adults:

  • previously untreated patients with stage III-IV follicular lymphoma in combination with chemotherapy;
  • maintenance therapy is indicated for the treatment of follicular lymphoma patients responding to induction therapy;
  • treatment of patients with CD20 positive diffuse large B cell-non-Hodgkin's lymphoma in comabination with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) chemotherapy 

is included in the GGC Adult formulary.  It is restricted to specialist use in accordance with regional protocols.

Prescribing note: the subcutaneous preparation is not licensed for all the indications that the IV infusion is licensed for.

For relevant SMC advice click here

Tocilicumab subcutaneous injection (RoActemra®) in combination with methotrexate (MTX) 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 diease-modifying anti-rheumatic drugs (DMARDs) or tumour necrosis factor (TNF) antagonists is included in the GGC Adult Formulary.  In these patients, tocilizumab can be given as monotherapy in case of intolerance to MTX or where continued treatment with MTX is inappropriate. It is restricted to specialist use only and in accordance with current eligibility and continuation rules for biologic therapies in rheumatopid arthritis.

For relevant SMC advice click here

New medicines, indications and formulations not included in the GGC Adult Formulary or GGC Paediatric 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.

Botulium tocin type A injection (Botox®) for the treatment of focal lower limb spasticity, including the treatment of ankle disability due to lower limb spasticity associated with stroke in adults is not included in the GGC Adult Formulary.

For relevant SMC advice click here

Dapoxetine  tablets (Priligy®) for the treatment of premature ejaculation (PE) in adult men aged 18 to 64 years is not included in the GGC Adult Formulary.

For relevant SMC advice click here

Lubiprostone capsules (Amitiza®) for the treatment of chronic idiopathic constipation and associated symptoms in adults, when response to diet and other non-pharmacological measures (e.g. educational measures, physical activity) are inappropriate is not included in the GGC Adult Formulary for the indication in question.

For relevant SMC advice click here

Olodaterol solution for inhalation (Striverdi Respimat®) for maintenance bronchodilator treatment in patients with chronic obstructive pulmonary disease is not included in the GGC Adult Formulary for the indication.

For relevant SMC advice click here

Pomalidomide capsules (Imnovid®) in combination with dexamethasone for the treatment of adult patients with relapsed and refractory multiple myeloma who have received at least two prior treatment regimes, including lenalitomide and bortezomib, and have demonstrated disease progression on the last therapy is not included in the GGC Adult Formulary.

For relevant SMC advice click here

Racecadotril granules (Hidrasec Infants®, Hidrasec Children®) for the complementary symptomatic treatment of acute diarrhoea in infants older than three months and in children, together with oral rehydration and the usual support measures, when these measures alone are insufficient to control the clinical condition and when causal treatment is not possible is not included in the GGC Paediatric Formulary. 

For relevant SMC advice click here

Umeclidinium/ vilanterol  dry powder for inhalation (Anoro®) as a maintenance bronchodilator treatment to relieve symptoms in adult patients with chronic obstructive pulmonary disease is not included in the GGC Adult Formulary.

For relevant SMC advice click here

Other Formulary Decisions

Zerodouble® gel  an emollient preparation for dry skin conditions is now included in the GGC Adult Formulary (Total Formulary).