Oncology & Haematology Specialist Formulary List – NON-CHEMOTHERAPY DRUGS

**Other indications for particular drugs may be included on completion of further specialist lists**

For information on use of unlicensed medicines or medicines used 'off-label' - click here

The following medicines are approved for prescribing by or on the recommendation of a prescribing oncology or haematology specialist (including non-medical prescribers where appropriate):

TAF SECTION MEDICINE SUMMARY OF RESTRICTED INDICATION CATEGORY PROTOCOL
4.6 Aprepitant capsules Adjunct to dexamethasone and a 5HT3-receptor antagonist in preventing nausea and vomiting associated with cisplatin containing chemotherapy regimes.

NOSCAN (North of Scotland Cancer Network) Antiemetic Protocol pending.

Prophylaxis of Chemotherapy Induced Nausea and Vomiting follow MASCC guidelines
www.mascc.org
Granisetron tablets, injection Chemotherapy-induced nausea and vomiting (2nd line). Usually given pre-chemotherapy.
Levomepromazine tablets,   injection

Chemotherapy-induced nausea and vomiting (3rd line).
6mg tablets available. Tablets may be halved. Usual dose 3mg or 6mg twice daily.

Lorazepam tablets, injection

 Anticipatory nausea and vomiting. 0.5mg to 1mg the night before and morning of chemotherapy.
Palonosetron Injection Chemotherapy-induced nausea and vomiting. Given as a single dose IV pre-chemotherapy
Granisetron transdermal patch Prevention of nausea and vomiting associated with moderately or highly emetogenic chemotherapy (in adults), for a planned duration of 3 to 5 consecutive days, where oral anti-emetic administration is complicated by factors making swallowing difficult.
6.6 Disodium pamidronate (concentrate for intravenous infusion)

Hypercalaemia of malignancy.
Osteolytic lesions and bone pain associated with bone metastases in patients with breast cancer or multiple myeloma (with calcium and vitamin D supplementation)

  
Ibandronic acid 50mg tablets Reduction of bone damage in bone metastases in breast cancer.
Sodium clodronate 400mg capsules

Osteolytic lesions, hypercalcaemia and bone pain associated with bone metastases in patients with breast cancer or multiple myeloma.
Maintenance of acceptable serum calcium levels in hypercalcaemia of malignancy initially treated with intravenous bisphosphonate.

Zoledronic acid intravenous infusion (Zometa®)

Hypercalcaemia of malignancy.
Reduction of bone damage in advanced malignancies involving bone (with calcium and vitamin D supplementation).
8.3.2 Medroxyprogesterone acetate tablets

Endometrial cancer.
Breast cancer.
Renal cell cancer.

 Clinical Management Guidelines for specific diseases.
Megestrol acetate tablets Breast cancer.

8.3.4.1

 Anastrazole tablets Oestrogen-receptor-positive breast cancer in postmenopausal women

Breast cancer Clinical Management Guideline
Exemestane tablets Oestrogen-receptor-positive breast cancer in postmenopausal women (following 2-3 years of initial adjuvant tamoxifen therapy).
Fulvestrant injection Oestrogen-receptor-positive breast cancer in postmenopausal women. Restricted to use in women who experience disease progression on or after treatment with tamoxifen and aromatase inhibitors.

Local treatment Protocol

 
Letrozole tablets

Oestrogen-receptor-positive breast cancer in postmenopausal women.
Ovarian or primary peritoneal cancer (unlicensed: off-label use) after tamoxifen therapy no longer effective.

Breast cancer Clinical Management Guideline
 

Ovary and Primary Peritoneal cancer Clinical Management Guideline
Tamoxifen tablets

Breast cancer.
Ovarian or primary peritoneal cancer (unlicensed: off-label use)

8.3.4.2

 Bicalutamide tablets Prostate cancer

Prostate cancer Clinical Management Guideline

 

Breast cancer Clinical Management Guideline
Cyproterone acetate tablets Prostate cancer
Goserelin 10.8mg implant  (Zoladex® LA) Prostate cancer
Goserelin 3.6mg implant (Zoladex®) Breast cancer (only Zoladex® licensed in this indication)
Triptorelin modified-release injection Prostate cancer
Degarelix (Firmagon®▼) Hormone naïve metastatic prostate cancer patients with PSA>50 who have severe bone pain, spinal cord compression, or other serious complications of metastatic disease and who need rapid reduction of testosterone levels.

Note that short-term treatment with anti-androgen is not required.
 Prostate cancer Clinical Management Guideline
8.3.4.3 Lanreotide injection (Somatuline Autogel ®, Somatuline® LA) Symptoms associated with functional gastroenteropancreatic endocrine tumours or neuroendocrine tumours 

 

Local Treatment Protocol
Octreotide injection, depot injection (Sandostatin LAR®)

Treatment of advanced neuroendocrine tumours of the midgut or of unknown primary origin where non-midgut sites of origin have been excluded.
Symptoms associated with functional gastroenteropancreatic endocrine tumours or neuroendocrine tumours.
9.5 Magnesium glycerophosphate tablets (unlicensed) (made by UCLH, ordered from IDIS) Hypomagnesemia associated with Platinum chemotherapy. Usual dose 1g twice daily or 1g three times daily.
12.3 Caphosol® oral rinse (medical device) Prevent and treat oral mucositis.  

 

NHS Tayside Mouth care guidance for cancer patients.
Gelclair® sachets (medical device) Protect oral mucosa.
2.11 Tranexamic Acid 500mg/5mL oral solution (unlicensed) (made by St Mary’s Pharmaceutical Unit, NHS Wales, ordered from Oxford Pharmacy Store). Treatment of localised oral bleeding (may be used as a mouthwash).

 

May be prescribed by Hospital Specialists only
May be prescribed in General Practice under the direction of a Specialist

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