RED Dupilumab solution for injection (Dupixent®▼)
The Pan Mersey Area Prescribing Committee recommends the prescribing of Dupilumab solution for injection (Dupixent®▼), by specialists only, for the treatment of moderate to severe atopic dermatitis in adults in accordance with NICE TA534.
RED Ixekizumab subcutaneous injection (Taltz®▼)
The Pan Mersey Area Prescribing Committee recommends the prescribing of IXEKIZUMAB subcutaneous injection (Taltz®▼), by specialists only, for active psoriatic arthritis in adults after inadequate response to DMARDs in accordance with NICE TA537.
AMBER RETAINED Degarelix subcutaneous injection (Firmagon®)
The Pan Mersey Area Prescribing Committee recommends the prescribing of DEGARELIX SC injection (Firmagon®) following specialist initiation for treating advanced hormone-dependent prostate cancer in people with spinal metastases in accordance with NICE TA404.
AMBER INITIATED Brivaracetam tablets and oral solution (Briviact®▼)
The Pan Mersey Area Prescribing Committee recommends the prescribing of BRIVARACETAM tablets/oral solution (Briviact®▼) for adjunctive treatment of focal seizures following initiation by a consultant neurologist.
GREY Tofacitinib film-coated tablets (Xeljanz®▼) tablets
The Pan Mersey Area Prescribing Committee does not currently recommend the prescribing of TOFACITINIB film-coated tablets (Xeljanz®▼) for the treatment of Ulcerative Colitis.
GREY Certolizumab pegol solution for injection (Cimzia®)
The Pan Mersey Area Prescribing Committee does not currently recommend the prescribing of CERTOLIZUMAB PEGOL solution for injection (Cimzia®) for the treatment of Plaque Psoriasis.
GREY Denosumab solution for injection (Prolia®)
The Pan Mersey Area Prescribing Committee does not currently recommend the prescribing of DENOSUMAB solution for injection (Prolia®) for the treatment of bone loss associated with long-term systemic glucocorticoid therapy.
GREY Cariprazine hard capsules (Reagila®▼)
The Pan Mersey Area Prescribing Committee does not currently recommend the prescribing of Cariprazine capsules (Reagila®▼), for the treatment of schizophrenia in adult patients.
GREY Erenumab solution for injection (Aimovig®▼)
The Pan Mersey Area Prescribing Committee does not currently recommend the prescribing of ERENUMAB pre-filled syringes (Aimovig®▼) for prophylaxis of migraine.
Formulary and guidelines
BLACK Lidocaine plaster (Ralvo®, Versatis®)
The Pan Mersey Area Prescribing Committee does not recommend the prescribing of lidocaine plaster 5% (Ralvo®,
Versatis®), except in limited circumstances outlined below.
Addition to formulary in line with BSR gout guideline – alternative to sulfinpyrazone or benzbromarone where allopurinol or febuxostat are unsuitable. No additional drug cost for primary care.
RED Sequential use of biological agents in the management of psoriasis in adults
The Pan Mersey Area Prescribing Committee recommends the sequential use of biological agents, adalimumab (Humira®), brodalumab (Kyntheum®▼), etanercept (Benepali®▼, Enbrel®), guselkumab (Tremfya®▼), infliximab (Inflectra®▼, Remicade®, Remsima®▼), ixekizumab (Taltz®▼), secukinumab (Cosentyx®▼) and ustekinumab (Stelara®), in the management of psoriasis according to the attached flowchart.
AMBER INITIATED Quetiapine I/R tablets
The Pan Mersey Area Prescribing Committee recommends that IMMEDIATE RELEASE QUETIAPINE is the preferred formulation of quetiapine for prescribing across the Pan Mersey Area.
AMBER INITIATED Insulin lispro (Humalog Junior®)
Additional formulation suitable for administering 0.5-unit increments. No cost implication.
Change of designation to 2nd line therapy after simple analgesics, NSAIDs and mild opiates in view of greater cost. Possible small cost reduction.
Routine review of chapter. Some costs savings anticipated from removal of bath emollient and shower preparations from formulary.
AMBER RETAINED Gonadorelin analogues Prescribing Support Information
Addition of supporting information for the prescribing of add-back tibolone (see below) plus the addition of precocious puberty in children to the list of indications.
AMBER RECOMMENDED Tibolone 2.5mg tablets
Addition to the formulary. To be prescribed for the duration of treatment with a gonadorelin analogue. The first month to be prescribed by the specialist.
PURPLE Lithium Shared Care Framework
Routine review of the existing shared care framework.
Safe Prescribing and Dispensing of Methotrexate
Exceptional specialist co-prescription of trimethoprim with methotrexate amended to accurately reflect APC discussion. Three- day treatment of UTI removed.
Genital tract infections
Revision of antimicrobial formulary section.
Ciprofloxacin ear drops (Cetraxal®): licensed product replaces Otomize® as preferred second line option, and offlabel use of eye drops in tympanic perforation. Perichondritis: ciprofloxacin replaces flucloxacillin.