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Southampton Joint Formulary
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 Formulary Chapter 13: Skin - Full Chapter
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13.05.03  Expand sub section  Drugs affecting the immune response
Adalimumab/ adalimumab biosimilar (Humira®, Imraldi®, Amgevita®) (dermatology)
(injection)
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Formulary
Red
High Cost Medicine

note Specify brand.

Restricted Item Specialist centres only for moderate to severe hidradenitis suppurativa - commissioned by NHS England in accordance with NICE TA392.

Amgevita and Imraldi are black triangle

 
Link  NICE TA146: Adalimumab for adults with psoriasis
Link  NICE TA392: Adalimumab for treating moderate to severe hidradenitis suppurativa
Link  NICE TA455: Adalimumab, etanercept and ustekinumab for plaque psoriasis in children and young people
   
ApremilastBlack Triangle
(tab)
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Formulary
Red
High Cost Medicine
 
Link  NICE TA419: Apremilast for moderate to severe plaque psoriasis
   
Cytotoxic Drug Azathioprine (dermatology)
(tab)
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Formulary
Amber SCG
 
Link  Shared Care Guideline for Azathioprine or Mercaptopurine (GP summary)
   
Brodalumab
(injection)
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Formulary
Red
High Cost Medicine
 
Link  NICE TA511:Brodalumab for treating moderate to severe plaque psoriasis
   
Certolizumab pegol (Cimzia®)
(dermatology) (injection)
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Formulary
Red
High Cost Medicine
 
Link  NICE TA574: Certolizumab pegol for treating moderate to severe plaque psoriasis
   
Ciclosporin (dermatology)
(caps/oral liq)
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Formulary
Amber SCG

Prescribe by brand name

 
Link  Shared Care Guideline for Ciclosporin (GP Summary)
   
Diphenylcyclopropenone in acetone 0.00001-6.0% w/v
Formulary
Red

Restricted Item Dermatology only

note From British Association of Dermatologists (BAD) Specials List 2014

unlicensed Unlicensed

Red Triangle Topical immunotherapy - highly sensitising. To be applied only by trained professionals. Wear gloves when handling.

 
   
DupilumabBlack Triangle (Dupixent®) (dermatology)
(subcutaneous injection)
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Formulary
Red
High Cost Medicine
NHS England
CCG
BlueTeq

Restricted Item Specialist use only for atopic dermatitis in eligible adult patients (see NICE TA534) - commissioned by CCGs.

Commissioned by NHS England for adolescent patients 12 to 18 years if the patient is seen within a specialist treatment centre (e.g. specialised paediatric dermatology and/or paediatric allergy) and meets the criteria set out in NICE TA534. Also available via MHRA EAMS for patients aged 6 to 11 years with severe atopic dermatitis who are candidates for systemic therapy and where existing therapies are not advisable. Note: use in children <12 years is off label. Paediatric patients must be registered via Blueteq.

 

 

Red Triangle Currently non-formulary for severe asthma (awaiting NICE TA guidance - due Jan 2021)

 
Link  NICE TA534: Dupilumab for treating moderate to severe atopic dermatitis
   
Etanercept/etanercept biosimilar (Enbrel®, Benepali®, Erelzi®) (dermatology)
(injection)
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Formulary
Red
High Cost Medicine

note Specify brand.

Benepali and Erelzi are black triangle

 
Link  NICE TA103: Efalizumab and etanercept for adults with psoriasis
Link  NICE TA455: Adalimumab, etanercept and ustekinumab for plaque psoriasis in children and young people
   
Guselkumab
(injection)
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Formulary
Red
High Cost Medicine
 
Link  NICE TA 521: Guselkumab for treating moderate to severe plaque psoriasis
   
Hydroxychloroquine (dermatology)
(tab)
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Formulary
Amber SCG

Restricted Item Supported only for use in indications detailed in Shared Care guidelines.

Not for use in Covid-19 treatment/prevention outside of clinical trials (see links below). Seek further advice from infection control specialist/pharmacy team.

 
Link  Shared Care Guideline for Hydroxychloroquine (GP Summary) May 2017
Link  EMA statement: COVID-19: chloroquine and hydroxychloroquine only to be used in clinical trials or emergency use programmes April 2020
Link  MHRA Advice March 2020: Do not use hydroxychlorquine or chloroquine for Covid-19 treatment except within a clinical trial
Link  NHS England/UK Chief Medical Officers’ joint letter: Novel coronavirus: clinical trials April 2020
Link  NPA Advice for Pharmacists on sales or supply of chloroquine/hydroxychloroquine for Covid-19 treatment/prevention
   
Infliximab/infliximab biosimilar (dermatology)
(injection)
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Formulary
Red
High Cost Medicine

note Specify brand (e.g. Remicade®, Remsima®, Inflectra®, Flixabi®, Zessly®)

 
Link  NICE TA134: Infliximab for adults with psoriasis
   
IxekizumabBlack Triangle (Taltz®)
(injection)
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Formulary
Red
High Cost Medicine
 
Link  NICE TA442 : Ixekizumab for moderate to severe plaque psoriasis
   
Cytotoxic Drug Mercaptopurine (dermatology)
(tablet)
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Formulary
Amber SCG

unlicensed 10mg tablets unlicensed

 
Link  Shared Care Guideline for Azathioprine or Mercaptopurine (GP Summary)
   
Cytotoxic Drug Methotrexate (dermatology)
(tab/injection)
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Formulary
Amber SCG

note Once weekly.

 
Link  National Patient Safety Agency: Improving compliance with oral methotrexate
Link  Shared Care Guideline for Methotrexate (GP summary)
   
Mycophenolate sodium (mycophenolic acid) (dermatology)
(tab)
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Formulary
Red

Restricted Item Dermatology only

unlicensed Off label use

 
   
Pimecrolimus (Elidel®)
(cream)
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Formulary
Amber Recommended
 
Link  NICE TA82: Tacrolimus and pimecrolimus for atopic eczema
   
SecukinumabBlack Triangle (Cosentyx®) (dermatology)
(injection)
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Formulary
Red
High Cost Medicine
 
Link  NICE TA350: Secukinumab for moderate to severe plaque psoriasis
   
Tacrolimus
(ointment)
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Formulary
Amber Recommended

0.03% and 0.1%

 
Link  MHRA Drug Safety Update: Tacrolimus ointment (Protopic): possible risk of malignancies including lymphomas and skin cancers
Link  NICE TA82: Tacrolimus and pimecrolimus for atopic eczema
   
TildrakizumabBlack Triangle (Ilumetri®)
(dermatology) (injection)
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Formulary
Red
High Cost Medicine
 
Link  NICE TA575: Tildrakizumab for treating moderate to severe plaque psoriasis
   
Ustekinumab (Stelara®) (dermatology)
(injection)
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Formulary
Red
High Cost Medicine

note 45mg, 90mg injections (130mg not licensed for dermatology indications).

 
Link  NICE TA180: Ustekinumab for moderate to severe psoriasis
Link  NICE TA455 : Adalimumab, etanercept and ustekinumab for plaque psoriasis in children and young people
   
 ....
 Non Formulary Items
Sirolimus (rapamycin)
(ointment/cream)

Non Formulary

unlicensed Unlicensed

Available in various strengths as a special.

Although 0.1% and 0.5% preparations are included in the current BAD Specials List, this product has not yet been evaluated locally and all formulations are therefore currently non-formulary.

 

 
  
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
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine

Traffic Light Status Information

Status Description

Green

Suitable for prescribing by all in both primary and secondary care.  

Amber Recommended

Specialist recommended but suitable for continuation in primary care.  

Amber Initiation

Specialist initiated but suitable for continuation in primary care.  

Amber SCG

Specialist initiated and for continuation in primary care under a locally approved shared care guideline.  

Red

Suitable for prescribing in specialist settings (secondary care) only.   

Red Specialist Centre

Secondary care medicines to be used under specialised commissioning arrangements only.  

Blue

For primary care, either via FP10 or supplied through specialist services. These products may be stocked by hospital pharmacies only for supply to primary care units/wards or for continuing supplies for patients admitted on therapy.  

Black

Not recommended for use.  

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