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

Formulary Update (Dec 2015)

Additions to the GGC Adult Medicines Formulary

Greater Glasgow and Clyde Area Drug and Therapeutic Committee (ADTC) met on 14th December 2015 and added the following medicines/indications/formulations to the GGC Adult Formulary. Additions are to the Total Formulary unless specified otherwise. For brevity, some indications may be shortened. For the full detail of the indications and SMC restrictions (where applicable) see the relevant SMC advice.

Atazanavir/cobicistat tablets (Evotaz®) for use in combination with other antiretroviral medicinal products for the treatment of HIV-1 infected adults without known mutations associated with resistance to atazanavir is included in the GGC Adult Formulary for the indication in question.  It is restricted to use by HIV specialists.

For the relevant SMC advice click here

Atomoxetine oral solution (Strattera®) for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children of 6 years and older, in adolescents and in adults as part of a comprehensive treatment programme (See SMC advice for full details of indication) is included in the GGC Adult Formulary.  It is restricted to specialist initiation for the treatment of ADHD in patients who are unable to swallow capsules.

For the relevant SMC advice click here

Bevacizumab infusion (Avastin®) for use in combination with carboplatin and paclitaxel, for the front-line treatment of advanced (International Federation of Gynaecology and Obstetrics (FIGO) stages IIIB, IIIC and IV) epithelial ovarian, fallopian tube, or primary peritoneal cancer is included in the GGC Adult Formulary pending protocol for the indication in question.  It is restricted to specialist use in accordance with regional protocol (in development) for patients with FIGO stage IV disease.

For the relevant SMC advice click here

Ceritinib capsules (Zykadia®) for the treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (NSCLC) previously treated with crizotinib is included in the GGC Adult Formulary pending protocol for the indication in question.  It is restricted to specialist use in accordance with regional protocol (in development).

For the relevant SMC advice click here

Edoxaban tosilate tablets (Lixiana) for the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and prevention of recurrent DVT and PE in adults is included in the GGC Adult Formulary for the indication in question.

For the relevant SMC advice click here

Edoxaban tosilate tablets (Lixiana®) for the prevention of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation (NVAF) with one or more risk factors, such as congestive heart failure, hypertension, age 75 years, diabetes mellitus, prior stroke or transient ischaemic attack (TIA) is included in the GGC Adult Formulary for the indication in question.

For the relevant SMC advice click here

Gefitinib tablets (Iressa®) for treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with activating mutations of epidermal growth factor receptor tyrosine kinase (EGFRTK) is included in the GGC Adult Formulary pending protocol for the indication in question.  It is restricted to specialist use in accordance with regional protocol (in development) in patients with previously untreated locally advanced or metastatic NSCLC with activating EGFR-TK mutations i.e. as a first-line therapy.

For the relevant SMC advice click here

Glatiramer acetate injection (Copaxone®) for the treatment of relapsing forms of multiple sclerosis (MS) is included in the GGC Adult Formulary for the indicaiton in question.  It is restricted to specialist use only in line with current Formulary advice relating to glatiramer acetate.

For the relevant SMC advice click here

Insulin Degludec/Liraglutide injection (Xultophy®) for the treatment of type 2 diabetes mellitus is included in the GGC Adult Formulary for the indication in question.  It is restricted to initiation by Consultant Diabetologists for use in patients who are uncontrolled on basal insulin analogues (glycosylated haemoglobin [HbA1c] >7.5% [59mmol/mol]) and for whom a GLP-1 receptor agonist is appropriate as an add-on intensification therapy to basal insulin to obtain glucose control. Note: Single agent insulin degludec is not recommended for use in NHSScotland and is not included in the GGC Formulary.

For the relevant SMC advice click here

Ivermectin cream (Soolantra®) for the topical treatment of inflammatory lesions of rosacea (papulopustular) in adult patients is included in the GGC Adult Formulary for the indication in question.  It is restricted to the treatment of moderate to severe inflammatory lesions of rosacea where other topical treatments are unsuitable or ineffective.

For the relevant SMC advice click here

Lenalidomide capsules (Revlimid®) for the treatment of adult patients with previously untreated multiple myeloma who are not eligible for transplant is included in the GGC Adult Formulary pending protocol for the indication in question.  It is restricted to specialist use in accordance with regional protocol (in development) for use in patients unsuitable for thalidomide-containing regimens.

For the relevant SMC advice click here

Naloxegol tablets (Moventig) for the treatment of opioid-induced constipation in adult patients who have had an inadequate response to laxative(s) is included in the GGC Adult Formulary for the indication in question.  It is restricted to use in patients who have failed to respond to at least two classes of laxative (given at an adequate dose for a sufficient duration).

For the relevant SMC advice click here

Pembrolizumab infusion (Keytruda®) as monotherapy for the treatment of advanced (unresectable or metastatic) melanoma in adults previously untreated with ipilimumab is included in the GGC Adult Formulary pending protocol for the indication in question. It is restricted to specialist use in accordance with regional protocol (in development).

For the relevant SMC advice click here

Tiotropium/olodaterol inhalation solution (Spiolto® Respimat®) as maintenance bronchodilator treatment to relieve symptoms in adult patients with chronic obstructive pulmonary disease (COPD) is included in the GGC Adult Formulary for the indication in question.

For the relevant SMC advice click here

Additions to the GGC Paediatric Medicines Formulary

Atomoxetine oral solution (Strattera®) for the treatment of attention-deficit/hyperactivity disorder (ADHD) in children of 6 years and older, in adolescents and in adults as part of a comprehensive treatment programme (See SMC advice for full details of indication) is included in the GGC Paediatric Formulary.  It is restricted to specialist initiation for the treatment of ADHD in patients who are unable to swallow capsules.

For the relevant SMC advice click here

Efavirenz tablets (Sustiva®) for use as antiviral combination treatment of human immunodeficiency virus-1 (HIV-1) infected children aged 3 months to 3 years and weighing at least 3.5kg is included in the GGC Paediatric Formulary for the indication in question. It is restricted to use by HIV specialists.

For the relevant SMC advice click here

Raltegravir chewable tablets (Isentress®) in combination with other anti-retroviral medicinal products for the treatment of human immunodeficiency virus (HIV-1) infection in children from the age of 4 weeks to <2 years is included in the GGC Paediatric Formulary for the indication in question.  It is restricted to use by HIV specialists in patients who are intolerant or resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs) or protease inhibitors (PIs) or when these options are compromised due to drug-drug interactions

For the relevant SMC advice click here

Raltegravir granules (Isentress®) in combination with other anti-retroviral medicinal products for the treatment of human immunodeficiency virus (HIV-1) infection in children from the age of 4 weeks is included in the GGC Paediatric Formulary for the indication in question.  It is restricted to use by HIV specialists in patients who are intolerant or resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs) or protease inhibitors (PIs) or when these options are compromised due to drug-drug interactions

For the relevant SMC advice click here

Travoprost eye drops (Travatan®) for the decrease of elevated intraocular pressure in paediatric patients aged 2 months up to 18 years with ocular hypertension or paediatric glaucoma is included in the GGC Paediatric Formulary for the indication in question.  It is restricted to specialist initiation.

For the relevant SMC advice click here

Triamcinolone hexacetonide injection for the use in Juvenile Idiopathic Arthritis (JIA) is included in the GGC Paediatric Formulary for the indication in question. 

For the 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 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 as other formulations. Please refer to Formulary.

Anakinra (Kineret®) for the treatment of Cryopyrin-Associated Periodic Syndromes (CAPS) in adults, adolescents, children and infants aged 8 months and older with a body weight of 10 kg or above (See SMC advice for full details of indication) is not included in the GGC Paediatric Formulary for the indication in question.

For the relevant SMC advice click here

Co-careldopa intestinal gel (Duodopa®) for the treatment of advanced levodopa-responsive Parkinson's disease with severe motor fluctuations and hyper-/dyskinesia when available combinations of Parkinson medicinal products have not given satisfactory results is not included in the GGC Adult Formulary for the indication in question.

For the relevant SMC advice click here

Denosumab infusion (Xgeva®) for adults and skeletally mature adolescents with giant cell tumour of bone that is unresectable or where surgical resection is likely to result in severe morbidity is not included in the GGC Adult Formulary for the indication in question.

For the relevant SMC advice click here

Everolimus tablets (Certican®) for prophylaxis of organ rejection in adult patients at low to moderate immunological risk receiving a cardiac transplant or prophylaxis of organ rejection in patients receiving a hepatic transplant is not included in the GGC Adult formulary for the indication in question.

For the relevant SMC advice click here

Pembrolizumab infusion (Keytruda®) as monotherapy for the treatment of advanced (unresectable or metastatic) melanoma in adults previously treated with ipilimumab is not included in the GGC Formulary for the indication in question.

For the relevant SMC advice click here

Regorafenib tablets (Stivarga®) for adult patients with metastatic colorectal cancer (CRC) who have been previously treated with, or are not considered candidates for, available therapies is not included in the GGC Adult Formulary for the indication in question.

For the relevant SMC advice click here

Other Formulary Decisions

Denosumab infusion (Xgeva®) for the prevention of skeletal related events adult patient with cancer is now restricted in the GGC Adult Formulary to use in circumstances where zoledronic acid is not appropriate, for example, due to renal impairment or venous access problems. The change reflects a recent review of the relevant regional guideline.

Zoledronic acid 4mg infusion for the prevention of skeletal related events in adult patient with cancer is now available as an option in patients with solid tumours with symptomatic bone metastases and is no longer restricted to breast and myeloma patients. The change reflects a recent review of the relevant regional guideline.