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

Formulary Update (Oct 2014)

Additions to the GGC Adult Formulary

Greater Glasgow and Clyde Area Drug and Therapeutics Committee (ADTC) met on 20th October 2014 and added the following medicines/indications/ formulations to the GGC Formulary.  Additions are to the Total Formulary unless specified otherwise.  For brevity, some indications may be shortened.  For the full detail of the indication, see the relevant SMC advice.

Alogliptin tablets (Vipidia®) for adults aged 18 years and older with type 2 diabetes mellitus to improve glycaemic control in combination with other glucose lowering medicinal products including insulin is included in the GGC Formulary. It is restricted to:

  • dual therapy in combination with metformin, when metformin alone, together with diet and exercise does not provide adequate glycaemic control in patients for whom the addition of a sulfonylurea is inappropriate. 
  • Use in combination with a sulfonylurea, when sulfonylurea alone, together with diet and exercise does not provide adequate glycaemic control in patients for whom the addition of metformin is inappropriate due to contra-indications or intolerance.

For relevant SMC advice click here

Alogliptin and Metformin tablets (Vipdomet®) for the treatment of adult patients aged 18 years and older with type 2 diabetes mellitus is included in the GGC Formulary.  It is restricted to use in patients for whom this fixed dose combination of alogliptin and metformin is an appropriate choice of therapy and only when the addition of a sulphonylurea to metformin monotherapy is not appropriate. Combination preparations are further restricted to use only in those patients who have demonstrable compliance issues with the separate constituents.

For relevant SMC advice click here

Azelastine and fluticasone propionate nasal spray (Dymista®) for the relief of symptoms of moderate to severe seasonal and perennial allergic rhinitis if monotherapy with either intranasal antihistamine or glucocorticoid is not considered sufficient is included in the GGC Formulary.  It is restricted to specialist initiation for use in patients who require both a nasal steroid and nasal antihistamine and where compliance is considered to be an issue.

For relevant SMC advice click here

Brentuximab vedotin infusion (Adcetris®) for the treatment of adult patients with relapsed or refractory CD30+ Hodgkin lymphoma (HL) following autologous stem cell transplant (ASCT) or 2) following at least two prior therapies when ASCT or multi-agent chemotherapy is not a treatment option is included in the GGC Formulary pending protocol.  It is restricted to specialist use in accordance with regional protocol (in development) for the treatment of adult patients with relapsed or refractory CD30+ Hodgkin lymphoma following autologous stem cell transplant (ASCT) or following at least two prior therapies when ASCT or multi-agent chemotherapy is not a treatment option. Use in patients with relapsed or refractory systemic anaplastic large cell lymphoma remains non-Formulary.

For relevant SMC advice click here

Capsaicin patch (Qutenza®) for the treatment of peripheral neuropathic pain in non-diabetic adults either alone or in combination with other medicinal products for pain is included in the GGC Formulary.  It is restricted to specialist use in patients who have not achieved adequate pain relief from, or have not tolerated, conventional first and second line treatments.

For relevant SMC advice click here

Dabigatran etexilate capsules (Pradaxa®) 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 Formulary.  It is restricted to use in patients who fail to tolerate other therapeutic options or where other agents are not appropriate where the intended duration of treatment is 3-6 months. Where indefinite duration is indicated, the the treatment of choice should be a low molecular weight heparin followed by warfarin.

For relevant SMC advice click here

Empagliflozin tablets (Jardiance®) for the treatment of type 2 diabetes to improve glycaemic control in adults 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 Formulary. It is restricted to initiation by clinicians experienced in the management of diabetes for the treatment of type 2 diabetes in adult patients as dual therapy in combination with metformin, when a sulphonylurea is inappropriate; triple therapy in combination with metformin plus standard of care or as add-on to insulin therapy in combination with insulin plus standard of care.

For relevant SMC advice click here

Fingolimod capsules (Gilenya®) as a single disease modifying therapy in highly active relapsing remitting multiple sclerosis is included in the GGC Formulary.  It is restricted to specialist use in patients with rapidly evolving severe relapsing remitting multiple sclerosis.  It is already included in the Formulary for RRMS where first-line treatment options are not effective.

For relevant SMC advice click here

Lurasidone tablets (Latuda®) for the treatment of schizophrenia in adults aged 18 years and over is included in the GGC Formulary pending protocol.  It is restricted to specialist initiation in accordance with local protocol (in development) as an alternative treatment option in patients in whom it is important to avoid weight gain and metabolic adverse effects.

For relevant SMC advice click here

Misoprostol vaginal delivery system (Mysodelle®) for the induction of labour in women with an unfavourable cervix, from 36 weeks gestation, in whom induction is clinically indicated is included in the GGC Formulary.  It is restricted to specialist use in accordance with local protocol.

For relevant SMC advice click here

Posaconazole gastro-resistant tablets (Noxafil®) for the treatment and prophylaxis of invasive fungal infections is included in the GGC Formulary.  It is restricted to specialist use in accordance with local protocol in patients in whom there is a specific risk of Aspergillus infection or where fluconazole or itraconazole are not tolerated on the advice of local microbiologists or specialists in infectious diseases.

For relevant SMC advice click here

Simeprevir capsules (Olysio®) in combination with other medicinal products for the treatment of chronic hepatitis C in adult patients is included in the GGC Formulary pending protocol.  It is restricted to specialist use in accordance with local protocols.

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.

Golimumab injection (Simponi®) for the treatment of moderately to severely active ulcerative colitis in adult patients who have had an inadequate response to conventional therapy including corticosteroids and 6-mercaptopurine or azathioprine, or who are intolerant to or have medical contraindications for such therapies is not included in the GGC Formulary.

For relevant SMC advice click here

Tetracaine and lidocaine cream (Pliaglis®) for local dermal anaesthesia on intact skin prior to dermatological procedures in adults. Is not included in the GGC Formulary.

For relevant SMC advice click here

Trastuzumab emtansine infusion (Kadcyla®) as a single agent, for the treatment of adults with human epidermal growth factor type 2 (HER2)-positive, unresectable locally advanced or metastatic breast cancer who previously received trastuzumab and a taxane, separately or in combination is not included in the GGC Formulary.

For relevant SMC advice click here

Other Formulary Decisions

Nortriptyline tablets for the management of neuropathic pain (unlicensed indication) is included in the GGC Adult Formulary. It is restricted to use in the management of neuropathic pain where amitriptyline is not appropriate because of issues with sedation or hypotension.

Renavit® multivitamin tablets for the dietary management of water soluble vitamin deficiency in renal failure patients receiving dialysis is included in the GGC Adult Formulary. It is restricted to specialist initiation for use in patients undergoing peritoneal dialysis.

Eye Chapter Formulary Review: Several changes have been made to chapter 11 of the Adult Formulary following a review.  The section with the most changes was 11.8.1 Tear deficiency, ocular lubricants, and astringents where the first line preparation for dry eyes has changed.  See the formulary for details.