For Dose and Administration please see: https://www.medicines.org.uk/emc/product/384/smpc 

Omnitrope approved at NEL FPG  as growth hormone replacement therapy in adult patients. 

Omnitrope will be available as an option or GH in suitable patients who can not use Genotropin

0.2mg – 0.5mg daily lifelong

Approved at DTC meeting for type 2 diabetes mellitus as dual therapy in adults as combination with either metformin, pioglitazone, a sulfonylurea or insulin (when treatment with these drugs alone fails to achieve glycaemic control), or as triple therapy in combination with metformin and either pioglitazone or insulin.

First-line choice in both Primary and Secondary Care. The case for removing saxagliptin from the Formulary was well made, and accepted by Committee members from both Primary and Secondary Care. Some patients might continue on saxagliptin where their clinical status was stable, although the opportunity for switching away from it would be grasped by all prescribers where it arose.

Dapagliflozin approved at NEL FPG for treating chronic heart failure with preserved or mildly reduced ejection fraction in line with NICE TA.

• NICE TA 902

Prescribing and monitoring according to NICE Guidance

https://www.nice.org.uk/guidance/ng28

Empagliflozin approved at NEL FPG for treating chronic heart failure with preserved or mildly reduced ejection fraction

Formulary Status: Amber

– To be initiated by or on the recommendation of a specialist

• NICE TA 929

Empagliflozin Approved at NEL FPG for treating chronic kidney disease

Formulary Status: Amber

– To be initiated by or on the recommendation of a specialist

• NICE TA 942

https://www.nice.org.uk/guidance/ta572

NICE TA583 : Ertugliflozin with metformin and a dipeptidyl peptidase-4 inhibitor for treating type 2 diabetes (June 2019)

NICE Type 1 Diabetes

• NICE Type 1 Diabetes

BLT Diabetes Handbook

• Diabetes Handbook.doc

HIGH STRENGTH 500 units per mL

Hospital only

• High Strength Insulin Procedure - BH May 2014.docx

This brand should only be prescribed under specialist supervision for patients under the care of tier 3 obesity services

Polycystic Ovary Syndrome (PCO): 500mg three times a day (starting at 250mg daily for 1-2weeks, then 500mg once a day for 1-2 weeks, increasing by 500mg every 1-2 weeks)

Semaglutide subcutaneous injection was APPROVED for DIABETES MELLITUS in the Drugs and Therapeutics Committee (DTC) in November 2020. 

Semaglutide oral tablets for Diabetes mellitus approved for use in May 2022 DTC.

 Semaglutide approved at NEL FPG as Hospital only as part of specialist Tier 3 or equivalent weight management service.

NB-Contact the formulary team for NEL ICB supply position statement.

• NICE TA 875

Tirzepatide approved at NEL FPG for treating type 2 diabetes in line with NICE TA.

Formulary Status: Amber

– to be initiated either:

• by or on the recommendation of a specialist

• by primary care prescriber(s) with specialist knowledge and/or has received training to prescribe this medicine

**Please contact the procurement team before prescribing to ensure stock availability. 

• NICE TA 924

Duloxetine is used for diabetic neuropathy.

Approved at NEL FPG (Nov 2022)

Betesil® 2.250mg medicated plaster is the only potent corticosteroid indicated in adults for the treatment of inflammatory skin disorders.

The plaster is licensed to use for a maximum of 30 days at a time, with a maximum of 6 plasters being used at any one time. Plasters may be changed once every 24 hours.

Amber-may be prescribed by or on the advice of a specialist 

Approved at NEL FPG in line with NICE TA 824.

Dexamethasone intravitreal implant (Ozurdex) is recommended as an option for treating visual impairment caused by diabetic macular oedema in adults only if their condition has not responded well enough to, or if they cannot have non-corticosteroid therapy.

This is an update and replacement of TA 349

• NICE TA 824

Idiopathic Pulmonary Fibrosis (IPF)

For full monograph-see section 6.3.2

corticoterlin

• Barts Endocrine webpage

FOR HOSPITAL USE ONLY

Screening test for Cushing's syndrome (un-licensed)

Dienogest approved at NEL FPG for treatment of endometriosis.

Formulary status: Amber (specialist initiation) 

-GP to continue prescribing following the first month of supply by the specialist. Patient to be reviewed by the specialist team at 1 month and at 6 months.  

Approved at December 2021 DTC 

Lenzetto is a transdermal estrogen spray indicated as Hormone Replacement Therapy (HRT) for oestrogen deficiency symptoms in postmenopausal women (in women at least 6 months since last menses or surgical menopause, with or without a uterus).

The experience in treating women older than 65 years is limited.

Striant® SR is non-formulary and not available in the UK therefore is an unlicensed product. If required please complete a DTC Chairman's Action Form. Please note that this is a controlled substance and will require import permit so lead time can be upto 8 weeks.

Testogel: ONE sachet contains 6.25mg testosterone/day- When used in Women for menopausal symptoms control use a peasize daily, with the aim to use a total of one full sachet in a week, not per day.

Skeletal related events in cancer

Approved  in hospital for secondary prevention of osteoporosis in men and women 60 years or over, who meet the following inclusion criteria:

1.    Patients with severe renal impairment.

2.    Patients who are intolerant and with contraindications to bisphosphonate therapy.

3.    Patients with severe vertebral osteoporosis.

Approved via chair's action 11th August 2022 DTC for treating severe osteoporosis in line with NICE TA 791

Hospital Only

Currently there is a shortage of Potassium Iodate tablets and therefore Potassium Iodide tablets have been procured instead. Potassium Iodate 85mg tablet provided approximately 50mg of Iodine as does Potassium Iodide 65mg tablet.

Reduction of thyroid gland vascularity prior to surgery (thyroidectomy):   85mg twice daily for ten days

For radioactive diagnostic scans (I-123 mIBG): 85mg twice a day starting one hour prior to the  scan for a total of 6 doses.

For 1-131 mIBG therapy of tumours:  85mg twice a day starting one day prior to the  scan for a total of 12 doses.

Reduction of thyroid gland vascularity prior to surgery (thyroidectomy):   85mg twice daily for ten days

For radioactive diagnostic scans (I-123 mIBG): 85mg twice a day starting one hour prior to the  scan for a total of 6 doses.

For 1-131 mIBG therapy of tumours:  85mg twice a day starting one day prior to the  scan for a total of 12 doses.

Alternative treatment  to carbimazole for elevated thyroid hormones.

Preferrable to Carbimazole in first trimester in women who are pregnant

FOR HOSPITAL USE ONLY for All indications except for treatment of prostate cancer 

Used for endometriosis and fibroids

HOSPITAL USE ONLY for ALL indications except for treatment of prostate cancer 

Approved at NEL FPG for Oral treatment of moderate to severe symptoms of uterine fibroids in line with NICE TA 832.

Use in patients who have failed or are unsuitable for conventional therapies (first line treatments).

• NICE TA 832