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 Formulary Chapter 13: Skin - Full Chapter
13.05.03  Expand sub section  Drugs affecting the immune response
Pimecrolimus (Elidel®)
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Formulary
Green

Elidel®1% cream 30g, 60g, 100g

Restriction: Initiation only by physicians with a special interest and experience in dermatology

 

 
Link  NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
   
Tacrolimus (Protopic®)
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Formulary
Green

Protopic®0.03% ointment 30g,60g
Protopic®0.1% ointment 30g,60g

Restriction: Initiation only by physicians with a special interest and experience in dermatology

 

 
Link  NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
   
Cytotoxic Drug Azathioprine 
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Formulary
Amber E

For the treatment of Inflammatory Skin Disease [unlicensed indication]

Azathioprine 25mg tablets
Azathioprine 50mg tablets

Link to ESCA

 
   
Cytotoxic Drug Methotrexate 
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Formulary
Amber E

For the treatment of Inflammatory Skin Disease

Methotrexate 2.5mg tablets

Prescribe WEEKLY (on the same day each week); orally as multiples of 2.5mg strength tablets.

Link to ESCA

 
   
Apremilast (Otezla®)
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Formulary
Red
High Cost Medicine
CCG
BlueTeq

Restriction: In line with NICE Guidance only

 
Link  NICE TA419: Apremilast for treating moderate to severe plaque psoriasis
   
Ciclosporin 
(Prescribe by brand)
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Formulary
Red

Restriction: Initiation on specialist dermatological advice

Brand must be stated

MHRA/CHM advice: ciclosporin must be prescribed and dispensed by brand name (December 2009)

 
   
Dimethyl Fumarate  (Skilarence®)
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Formulary
Red
High Cost Medicine
CCG
BlueTeq

Skilarence® 30mg G/R tablets
Skilarence® 120mg G/R tablets

Restriction: In line with NICE Guidance only

 
Link  NICE TA475: Dimethyl fumarate for treating moderate to severe plaque psoriasis
   
Cytotoxic Drug Methotrexate injection

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Formulary
Red

Methotrexate injection (as pre-filled syringes/ pens/ injectors)- brands include Nordimet®, Zlatal®, Methofill® and Metoject PEN®

Prescribe WEEKLY (on the same day each week)

Restriction: Initiation on specialist dermatological advice

 

 
   
Tildrakizumab (Ilumetri®)Black Triangle
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Formulary
Red
High Cost Medicine
CCG
BlueTeq

Restriction: In line with NICE Guidance only

 
Link  NICE TA575: Tildrakizumab for treating moderate to severe plaque psoriasis
   
Adalimumab (Hyrimoz®, Amgevita®, Imraldi®, Hulio®, Humira®)
(Prescribe by brand)
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Formulary
Red
High Cost Medicine
NHS England
CCG
BlueTeq

Restriction: In line with NICE Guidance only

Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people is commissioned by NHS England for patients treated in specialised dermatology centres and CCGs for treatments in non-specialist centres where commissioned.

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 TA146: Adalimumab for the treatment of adults with psoriasis
Link  NICE TA455: Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
   
Brodalumab (Kyntheum®)Black Triangle
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Formulary
Red
High Cost Medicine
CCG
BlueTeq

Restriction: In line with NICE Guidance only

 
Link  NICE TA511: Brodalumab for treating moderate to severe plaque psoriasis
   
Dupilumab (Dupixent®)Black Triangle
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Formulary
Red
High Cost Medicine
CCG
BlueTeq

Restriction: In line with NICE Guidance only

 
Link  NICE TA534: Dupilumab for treating moderate to severe atopic dermatitis
   
Etanercept (Enbrel®, Benepali®, Erelzi®)Black Triangle
(Prescribe by brand)
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Formulary
Red
High Cost Medicine
CCG
BlueTeq

Restriction: In line with NICE Guidance only

 

 
Link  NICE TA103: Etanercept and efalizumab for the treatment of adults with psoriasis
Link  NICE TA455: Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
   
Guselkumab (Tremfya®)Black Triangle
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Formulary
Red
High Cost Medicine
CCG
BlueTeq

Restriction: In line with NICE Guidance only

 
Link  NICE TA521 : Guselkumab for treating moderate to severe plaque psoriasis
   
Infliximab (Flixabi®, Inflectra®, Remicade®, Remsima®)
(Prescribe by brand)
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Formulary
Red
High Cost Medicine
CCG
BlueTeq

Restriction: In line with NICE Guidance only

 
Link  NICE TA134: Infliximab for the treatment of adults with psoriasis
   
Ixekizumab (Taltz® )Black Triangle
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Formulary
Red
High Cost Medicine
CCG
BlueTeq

Restriction: In line with NICE Guidance only

 
Link  NICE TA442: Ixekizumab for treating moderate to severe plaque psoriasis
   
Risankizumab (Skyrizi®)Black Triangle
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Formulary
Red
High Cost Medicine
CCG
BlueTeq

Restriction: In line with NICE guidance only

 
Link  
Link  NICE TA596:Risankizumab for treating moderate to severe plaque psoriasis
   
Secukinumab (Cosentyx®)Black Triangle
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Formulary
Red
High Cost Medicine
CCG
BlueTeq

Restriction: In line with NICE Guidance only

 
Link  NICE TA350: Secukinumab for treating moderate to severe plaque psoriasis
   
Ustekinumab (Stelara®)
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Formulary
Red
High Cost Medicine
CCG
BlueTeq

Restriction: In line with NICE Guidance only

 

 
Link  MHRA Guidance on Ustekinumab (Stelara): risk of exfoliative dermatitis
Link  NICE TA180: Ustekinumab for the treatment of adults with moderate to severe psoriasis
Link  NICE TA340: Ustekinumab for treating active psoriatic arthritis
Link  NICE TA455 : Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young people
   
 ....
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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