Leicestershire Health Community
Medicines Formulary
8 Malignant disease and immunosuppression
Further information on specific drugs available locally and the pathways used is available from the East Midlands Cancer Network.  This includes drugs reviewed as part of NICE technology appraisals

The East Midlands has adopted the Palliative Adult Network Guidelines(PANG) as the single guideline across the region to conform with the requirement for a single guideline within a cancer network.  These are freely available to healthcare professionals.
08-02-02 Corticosteroids and other immunosuppressants
Section in development
Currently includes high cost drugs excluded to tariff only plus drugs considered by TAS since 2000
Specialist prescribing only in Renal Transplant in line with NICE TA 481 and TA 482
High cost drug excluded to tariff, NHSE commissioned
Link  NICE TA 481: Immunosuppressive therapy for kidney transplant in adults
Link  NICE TA 482: Immunosuppressive therapy for kidney transplantation in children and young people

Restricted Drug Red View adult BNF  View SPC online  HCD
Immunosupression for the prevention of organ rejection after kidney transplant. In line with NICE TA 481 and 482

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Mycophenolic acid Myfortic®
Specialist renal use in renal transplant only
Link  MHRA Advice: Mycophenolate mofetil, mycophenolic acid: new pregnancy-prevention advice for women and men

Restricted Drug View adult BNF  View SPC online
Tacrolimus Adoport®, Prograf® or Modigraf®
Immunosuppression post renal transplant - prescribe by brand name only as different brands are not interchangeable. Specialist renal initiation only
Shared care request is mandatory
Link  SCA: Tacrolimus, maintenance of immunosuppression following Renal transplantation

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Tacrolimus SR Envarsus®
Once daily preparation. Prophylaxis of transplant rejection in adult kidney transplants. Must be prescribed by brand and not interchangeable with other brands. Total required daily dose is different to other brands of tacrolimus so must not be substituted with other brands

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Antithymocyte immunoglobulin (rabbit)
Specialist use only
High cost drug excluded to tariff, commissioned by NHSE in line with BCSH Guidelines only
Link  BCSH Guidelines

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Tacrolimus SR  Advagraf®
Non Formulary
Oral tacrolimus products should be prescribed and dispensed by brand name only
Link  Leicestershire Evaluation: Advagraf® in Rejection

Black View adult BNF  View SPC online