Endocrinology

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):

MEDICINE	SUMMARY OF RESTRICTED INDICATION	CATEGORY	PROTOCOL
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 (2^nd line). Usually given pre-chemotherapy.
Levomepromazine tablets, injection	Chemotherapy-induced nausea and vomiting (3^rd 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.
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).
Medroxyprogesterone acetate tablets	Endometrial cancer. Breast cancer. Renal cell cancer.		Clinical Management Guidelines for specific diseases.
Megestrol acetate tablets	Breast cancer.		Clinical Management Guidelines for specific diseases.
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).		Breast cancer Clinical Management Guideline
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)
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
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.		Local Treatment Protocol
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.
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.
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).

Traffic light status information
	To be prescribed by Hospital Specialists Only.
	Can be prescribed in General Practice under the direction of a Specialist.