• Abstral sublingual tablets 100 micrograms, 200 micrograms, 300 micrograms, 400 micrograms, 600 micrograms, 800 micrograms  Palliative Care Team only


• Effentora buccal tablets 100 micrograms, 200 micrograms, 400 micrograms  Palliative Care Team only


• Actiq buccal lozenges 200 micrograms, 400 micrograms, 600 micrograms, 800 micrograms, 1200 micrograms, 1600 micrograms  Palliative Care Team only


• Instanyl nasal spray 50 micrograms/spray, 100 micrograms/spray, 200 micrograms/spray  Palliative Care Team only


• Patches releasing 12 micrograms/hour, 25 micrograms/hour, 50 micrograms/hour, 75 micrograms/hour, 100 micrograms/hour  Use restricted to patients who have failed on oral opiates or where the oral route is inappropriate - see link to 'Medicine of the Month' bulletin

• Tablets 250mg, capsules MR 250mg, injection 500mg.
• Oral suspension 125mg/5ml (unlicensed)

• Injection 20mg, 40mg
   Consultant gastroenterologist initiation only.


• For Crohn's and ulcerative colitis only, in accordance with NICE guidance.

• Injection 20mg, 40mg
   Consultant Dermatologists only

• Dermatologists only


• 45g

• Emerade^® Injection, 150 micrograms, 300 micrograms, 500 micrograms


• Jext^® Injection, 150 micrograms, 300 micrograms


• Emerade and Jext brands used instead of EpiPen

• Suspension, 500mg in 5ml


• Capsules, 1000iu


• Injection 100mg in 2ml Paediatric Consultants only

 Neurologists and elderly care only.

Dacepton

• Vials, 100mg in 20ml 
• Cartridges, 30mg in 3ml

Apo-go 

• Prefilled syringes, 50mg in 10ml 
• Disposible pen, 30mg in 3ml

• Tablets: - starter pack containing 10mg, 20mg and 30mg; maintenance pack containing 30mg
   Consultant Dermatologists and Rheumatologists only

• Eye drops 1.5%

• Purulent bacterial conjunctivitis in children (aged from birth to 17 years) and adults(second line)

  Trachomatous conjunctivitis caused by Chlamydia trachomatis in children (aged from birth to 17 years) and adults

• Injection 38.5micrograms

• 30mg,90mg,180mg film coated tablets
• Oncology Consultant use only
• Brigatinib is indicated as monotherapy for the treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (NSCLC) previously treated with crizotinib.  
• Brigatinib is indicated as monotherapy for the treatment of adult patients with anaplastic lymphoma kinase (ALK)-positive advanced non-small cell lung cancer (NSCLC) previously not treated with an ALK inhibitor

• Tablets, 10mg, 25mg, 50mg, 100mg


• Oral solution 10mg/ml


• Injection 50mg/5ml vials
  Adults - Indication and approved use - For use as an adjunctive third line treatment option for the management of partial-onset seizures with or without secondary generalisation in adults. Brivaracetam may be considered if there is:
  
  
  
  
  
  • Failure of one or more first line drugs(carbamazepine, lamotrigine or levetiracetam) AND
  
  
  • Failure of one or more 2nd line drugs (topiramate, pregabalin, lacosamide, zonisamide or perampanel)
  
  
  
  
  Stop/review criteria - Treatment with brivaracetam should be reviewed with respect to outcome criteria as recommended by NICE, and careful consideration given to stopping or switching to an alternative anti-epileptic in patients who:
  
  
  
  
  
  • Fail to achieve a significant reduction in seizure frequency (defined as a 50% or more reduction despite optimum doses of the drug)
  
  
  • Fail to achieve a significant reduction in seizure severity despite optimum doses of the drug
  
  
  • Experience a combination of side effects significant enough to warrant discontinuation
  
  
  • Have a combination of the above factors
    If more than one antiepileptic medication is likely to produce the same clinical outcome then prescribing decisions must include consideration of cost-effectiveness
  
  
  
  Paediatrics - Paediatric Consultant use for partial seizures, with or without secondary generalisation, as add on therapy. Only for patients who have failed on monotherapy or have not tolerated levetiracetam.

 Liquid restricted to Paediatrics/Neurology; Injection restricted to Paediatrics

• Intravitreal injection 120mg/ml (19.8mg in 0.165ml Pre-filled syringe)
   Ophthalmology consultants only

• Injection 1 gram
    Microbiologist recommendation only

• 250mcg prefilled syringe/pen

 Neurologists and Care of the Elderly consultants only, where compliance is a problem

• Contains levodopa, carbidopa and entacapone


• Tablets, 50mg/12.5mg/200mg, 75mg/18.75mg/200mg, 100mg/25mg/200mg, 125mg/31.25mg/200mg, 150mg/37.5mg/200mg, 200mg/50mg/200mg,

• Capsules, 100mg, 200mg

• Licenced brand has been discontinued. Unlicensed product approved for single patient with aplastic anaemia. No new patients to start treatment.

Available in MYHT as:

• Film coated tablet:5mg,10mg

• Treatment of symptomatic chronic heart failure with reduced ejection fraction in diabetic or non diabetic patients (Approved by MOG November 2020 for cardiology use-RAG status to be confirmed by APC). Can be used in patients with an eGFR> 30ml/minute.

• 20mg/ml intravenous (100mg/5ml and 400mg/20ml)
• 1800mg/15ml subcutaneous
• Approved for use as per NICE TAs

• Tablets, 30mg, 120mg
   Consultant Dermatologists only

• Propess pessary, 10mg - preferred drug for induction of labour.
• Injection, 10mg/ml
• Injection, 1mg/ml- Treatment of patent ductus arteriosus in neonates (unlicensed)
   Prostin gel, 1mg, 2mg - available for selected indications

• Injection 120mg in 2.4ml, 500mg in 10ml
   Oncology Consultants only

Available in MYHT as:

• Film-coated tablet: 10mg, 25mg

For use in line with NICE TA336 and TA390

First choice SGLT2 inhibitor, particularly in patients with atherosclerotic CVD and/or heart failure

• Prefilled pen or syringe, 50mg
   Consultant Dermatologists only
  


• See monograph for Etanercept (Enbrel) for relevant NICE guidance

• Injection, 10ml

 Haematology only - restricted to 5 patients per year.

 Cardiology only

• Pre-filled syringe, 30 million units, 48 million units

• Capsules, 500mcg
   Initiation by Neurology consultants only.

• Haematology Consultant use only
• 40mg tablets
• Gilteritinib monotherapy is recommended as an option for treating relapsed or refractory FLT3‑mutation-positive acute myeloid leukaemia (AML) in adults 

Also approved for unlicensed indication mastectomy flap necrosis in February 2021.

Red RAG status for this indication.

• Eye drops, preservative free minims
    

• Powder for reconstitution for IV infusion 100mg
   Consultant Dermatologists only

• 1mg vial

•  Consultant Haematologists only

Available in MYHT as:

• 100units/ml: FlexTouch pre-filled pen, vial

 Restricted to initiation by a diabetes specialist or paediatrician

Approved for use in MYHT for type 1 diabetes in adults and children aged 2 years and over who are likely to benefit directly from a more rapid onset of action, including:

• Pregnant patients 

• Patients on insulin pump therapy

• Young adult patients unable to manage with Novorapid due to poor post-prandial glucose control, despite adequate therapeutic trial