| Formulary Chapter 1: Gastro-intestinal system - Full Chapter
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| 01.05.03 |
Drugs affecting the immune response |
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Azathioprine
(25mg, 50mg Tablets)
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Formulary
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Walsall
 Amber Initiation Walsall only
Wolverhampton
 Amber Shared Care Wolverhampton only
ESCA Azathioprine (Wolverhampton only)
Sandwell
Amber Shared Care Sandwell only
For use in Inflammatory Bowel Disease (IBD) as per effective shared care agreement
ESCA Azathioprine (Sandwell only)
Dudley
Amber Shared Care Dudley only
ESCA Azathioprine (Dudley only)
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Ciclosporin
(10mg, 25mg, 50mg, 100mg Capsules. 50mg/ml IV infusion)
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 Restricted
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Treatment of ulcerative colitis - for specialist use only
MHRA specify the ciclosporin must be prescribed and dispensed by brand as bioavailabilty differences exist between brands
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Mercaptopurine
(50mg Tablets)
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Formulary
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Maintenance of remission of acute ulcerative colitis and Crohn’s disease in adults – unlicensed but in line with national guidelines
For use in Inflammatory Bowel Disease (IBD)
Walsall
Amber Initiation- Walsall only
Wolverhampton
Amber Shared Care- Wolverhampton only
ESCA Mercaptopurine-Wolverhampton only
Sandwell
Amber Shared Care- Sandwell only
ESCA Mecaptopurine (Sandwell only)
Dudley
Amber Shared Care Dudley only
ESCA Mecaptopurine (Dudley only)
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Methotrexate
(Tablets, Injection)
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Formulary
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Tablets 2.5mg (2.5mg tablets preferred as per NPSA alert)
Cytotoxic - do not crush and disperse in water
For use in active Crohn's disease
For specialist initiation only
Wolverhampton
Amber Shared Care Wolverhampton only
ESCA :Methotrexate (Wolverhampton only):
Walsall
Amber Initiation Walsall only
Sandwell
Amber Shared Care Sandwell only
ESCA:Methotrexate in active Crohn's disease (Sandwell only)
Dudley
Amber Shared Care Dudley only
ESCA:Methotrexate (Dudley only)
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 UKMI Q&A: Can patients drink alcohol whilst taking long-term low-dose methotrexate?
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Tofacitinib (Xeljanz®)
(Tablet)
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Formulary
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In line with NICE
Tofacitinib for moderately to severe active ulcerative colitis - providers are NHS hospital trusts
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NICE TA547: Tofacitinib for moderately to severely active ulcerative colitis
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| 01.05.03 |
Cytokine inhibitors |
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Adalimumab (Humira®)
(Injection)
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Restricted
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For specialist use only in line with NICE guidance
£££££
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NICE TA187: Crohns disease - infliximab (review) and adalimumab (review of TA40)
NICE TA329:Infliximab,adalimumab,and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy
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Infliximab (Remicade®)
(Infusion)
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Restricted
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For specialist use only in line with NICE guidance
Commissioned in paediatrics by NHSE
£££££
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NICE TA163: Ulcerative colitis (acute manifestations) Infliximab
NICE TA187: Crohns disease - infliximab (review) and adalimumab (review of TA40)
NICE TA329: Infiximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy
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| 01.05.03 |
Vedolizumab |
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Vedolizumab (Entyvio®)
(Infusion)
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Restricted
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Specialist use only in line with NICE guidance below
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NICE TA342: Vedolizumab for treating moderately to severely active ulcerative colitis
NICE TA352: Vedolizumab for treating moderately to severely active Crohn’s disease after prior therapy
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Key |
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Restricted Drug |
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Unlicensed |
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
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Cytotoxic Drug |
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Controlled Drug |
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High Cost Medicine |
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Cancer Drugs Fund |
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NHS England |
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Homecare |
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ICB |
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Low carbon footprint |
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Medium carbon footprint |
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High carbon footprint |
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| Status |
Description |
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Medicines which are suitable for initiation and maintenance prescribing by primary and secondary care clinicians. These medicines should be initiated and prescribed within their licensed indications |
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Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry. |
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Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry. |
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Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a specialist. |
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Medicines for initiation and maintenance prescribing by Specialists (hospital or GPs with Special Interest) only |
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Positive NICE TA and /or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information. |
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Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use. |
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Check Notes as varies across the area |
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