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North Staffordshire Joint Formulary
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Stoke-on-Trent Clinical Commissioning Group
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 Formulary Chapter 1: Gastro-intestinal system - Full Chapter
01.05  Expand sub section  Chronic bowel disorders
01.05.01  Expand sub section  Aminosalicylates
 note 

There is no evidence to show that any one oral preparation of mesalazine is more effective than another; however, the delivery characteristics of oral mesalazine preparations may vary. If it's necessary to switch a patient to a different brand of mesalazine, the patient should be advised to report any changes in symptoms

Balsalazide (Colazide®)
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Formulary
Green

Balsalazide 750mg capsules

Restriction: For acute relapses of ulcerative colitis

 
   
Mesalazine 
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Formulary
Green

Octasa MR gastro-resistant 400mg and 800mg tabs
Pentasa MR 500mg tabs
Mesalazine Foam Enema 1g/Dose 14g (Asacol®)

Prescribe by recommended BRAND.

 

Other brands – Pentasa, Asacol, Asacol MR, Salofalk (granules/enema), Mezavant XL.

 
   
Sulfasalazine 
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Formulary
Green

Sulfasalazine 500mg tablets (plain tablets)
Sufasalzine enteric coated tablets
Sulfasalazine 500mg Suppositories 
Sulfasalazine 250mg/5ml Suspension SF (ONLY for patients with swallowing difficulties)


Please note the plain tablets are more cost effective than enteric coated ones- (Applicable in Primary care only)

 
   
01.05.02  Expand sub section  Corticosteroids
Prednisolone 
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Green

Prednisolone 1mg tablets

Prednisolone 5mg tablets

Where possible, please refrain from prescribing E/C tablets

 
   
Colifoam®

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Green

Hydrocortisone foam 10% aerosol

1st line rectal preparation

 
   
Hydrocortisone 
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Green

Standard release

Hydrocortisone 10mg tablets

Hydrocortisone 20mg tablets

 
   
Prednisolone foam enema

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Green

Restriction: For patients that cannot tolerate Colifoam®

Please note that is significantly more expensive than Colifoam® enema.
HCD 

 

 
   
01.05.03  Expand sub section  Drugs affecting the immune response
Cytotoxic Drug Azathioprine 
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Formulary
Amber E

Tablets 25mg and 50mg

For the treatment of Inflammatory Bowel Disease [unlicensed indication]

Link to ESCA

 
   
Cytotoxic Drug Mercaptopurine 
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Amber E

Mercaptopurine 50mg Tablets
Xaluprine® 20mg/1ml Oral Suspension

For the treatment of Inflammatory Bowel Disease [unlicensed indication]

BNF States : Mercaptopurine tablets and Xaluprine® oral suspension are not bioequivalent, haematological monitoring is advised when switching formulations.

Link to ESCA

 
   
Cytotoxic Drug Methotrexate 
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Formulary
Amber E

Methotrexate 2.5mg Tablets

For the treatment of Inflammatory Bowel Disease [unlicensed indication]

Prescribe WEEKLY on the same day each week, as 2.5mg strength tabs.

Link to ESCA

 
Link  NPSA Alert- Improving compliance with oral Methotrexate guidelines
   
01.05.03  Expand sub section  Cytokine inhibitors : Treatment of ulcerative colitis and Crohn’s diseaseTwo biosimilar versions of to top
Adalimumab (Hyrimoz®, Amgevita®, Imraldi®, Hulio®, Humira®)
(Prescribe by brand)
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Red
High Cost Medicine
BlueTeq

Restriction: In line with NICE Guidance only

Clinicians must ensure the biosimilar brand for their region is prescribed first-line.
(Hyrimoz is the first line biosimilar in West Midlands region; Amgevita is used in patients intolerant to citrate content i.e injection site reactions)

 
Link  NICE TA187: Crohn’s disease - infliximab and adalimumab
Link  NICE TA329: Infliximab, adalimumab and golimumab for moderately to severely active ulcerative colitis
   
Golimumab 
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Formulary
Red
High Cost Medicine
BlueTeq

Restriction: In line with NICE Guidance only

 
Link  NICE TA329: Infliximab, adalimumab and golimumab for moderately to severely active ulcerative colitis
   
Infliximab (Flixabi®, Inflectra®, Remicade®, Remsima®)
(Prescribe by brand)
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Formulary
Red
High Cost Medicine
BlueTeq

Restriction: In line with NICE Guidance only

 
Link  NICE TA163: Ulcerative colitis (acute manifestations) Infliximab
Link  NICE TA187: Crohns disease - infliximab & adalimumab
Link  NICE TA329: Infliximab, adalimumab and golimumab for moderately to severely active ulcerative colitis
   
Tofacitinib 
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Formulary
Red
High Cost Medicine
BlueTeq

Restriction: In line with NICE Guidance only

 
Link  NICE TA547: Tofacitinib for moderately to severely active ulcerative colitis
   
Ustekinumab 
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Formulary
Red
High Cost Medicine
BlueTeq

Restriction: In line with NICE Guidance only

 
Link  NICE TA456: Ustekinumab for treating severly active Crohns Disease after previous treatment
   
Vedolizumab Black Triangle
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Formulary
Red
High Cost Medicine
BlueTeq

Restriction: In line with NICE Guidance only

 
Link  NICE TA352: Vedolizumab for treating moderately to severely active Crohn’s disease after prior therapy
Link  NICE TA342: Vedolizumab for treating moderately to severely active ulcerative colitis
   
01.05.04  Expand sub section  Food allergy
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG
Blueteq
High Cost Drug Approval System

Traffic Light Status Information

Status Description

Red

Medicines that can only be prescribed within Secondary Care. Examples of medicines which fall into this category are: Certain new medicines and new indications for older medicines where there is at present no experience of use in Primary Care. Medicines or dressings not available or prescribable in Primary Care. Where a medicine has been classified as Amber E, but an approved shared-care guideline is not yet available   

Amber

Medicines which can be prescribed within Secondary Care, but are only suitable for prescribing in Primary Care after specialist referral. There is no need for approved shared care guidelines for medicines in this category. This replaces Amber 2 on the North Staffs Formulary.   

Amber E

Medicines which can be prescribed within Secondary Care, but are only considered suitable for prescribing in Primary Care under an approved shared-care agreement (ESCA) or Rationale for Initiation, Continuation and Discontinuation (RICaD). This replaces Amber 1 on the North Staffs Formulary  

Green

Medicines which can be prescribed in either Primary or Secondary Care.  

Grey

These medicines have been reviewed by the New Medicines Committee and the Area Prescribing Committee and found not to be suitable for inclusion in the Joint Formulary. Inadequate or weak evidence for efficacy No clearly defined local need Lack of long term safety data No perceived benefit over established formulary alternatives Prescribers can consider these medicines where formulary alternatives are unsuitable, ineffective or not tolerated.  

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