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 Formulary Chapter 24: Leeds Children's Hospital Formulary - Full Chapter
Notes:

The Leeds Children's Hospital Formulary is laid out in BNF chapter order. There are custom indexes for the following specialist areas:

Paediatric Intensive Care Unit (PICU)
Neonatal Intensive Care Unit (NICU)
Paediatric Cardiology

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24.08  Expand sub section  Malignant disease and immunosuppression (paediatric)
Adalimumab (Amgevita®, Humira®)
(paediatrics)
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Formulary
Red
  • Amgevita® is the brand of choice at LTHT
 
Link  Adalimumab PIL for paediatric IBD
Link  Paediatric Rheumatology prescribing guidance - Adalimumab
Link  PIL: biosimilar adalimumab (children) (LTHT access only)
   
Azathioprine
(paediatrics)
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Formulary
Amber 3
  • There are a number of different indications for azathioprine. Please see here for other indications. 
  • Link  Azathioprine Amber Drug Guidance - paediatric autoimmune hepatitis and solid organ transplant
    Link  Azathioprine Amber Drug Guidance - paediatric inflammatory bowel disease or rheumatological conditions
    Link  LTHT Patient Information Leaflet
       
    Basiliximab (Simulect®)
    ( paediatrics)
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    Formulary
    Red

    In line with NICE TA482 (below)

     
    Link  NICE TA482: Immunosuppressive therapy for kidney transplant in children and young people
       
    Ciclosporin
    (paediatrics)
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    Formulary
    Amber 3
    • There are a number of different indications for ciclosporin.
     
    Link  Ciclosporin Amber Drug Guidance - paediatric nephrotic syndrome
       
    Dinutuximab (Qarziba®)
    (paediatrics)
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    Formulary
    Red
    • For use in line with NICE guidance and NHSE commissioning position
    • Also for severe asthma in adolescents over 12 years and adults
     
    Link  NICE TA538: high-risk neuroblastoma in people aged 12 months and over
       
    Dupilumab (Dupixent®)
    (paediatrics)
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    Formulary
    Red
    • For severe atopic dermatitis (adolescents) in line with NICE TA534/SSC2082
     
    Link  NICE TA534: Dupilumab for treating moderate to severe atopic dermatitis
       
    Everolimus (Votubia® dispersible tablets)
    ( paediatrics)
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    Formulary
    Red
    • NHSE commission for refractory focal onset seizures associated with Tuberous Sclerosis Complex (TSC)
    • Dispersible tablets are not bioequivalent to standard tablets and are not interchangeable
     
       
    Gemtuzumab ozogamicin (Mylotarg®)
    (paediatrics)
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    Formulary
    Red
    • For use in line with NICE TA545: untreated acute myeloid leukaemia
     
       
    Infliximab (Inflectra®, Remicade®, Remsima®)
    (paediatrics)
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    Formulary
    Red
    High Cost Medicine
    • Prescribe by brand name: Inflectra® is the current biosimilar of choice at LTHT
    • Also for Kawasaki Disease resistant to steroids and immunoglobulin therapy
     
    Link  Paediatric rheumatology administration guide (infliximab)
    Link  Patient information leaflet: infliximab infusions for juvenile arthritis and uveitis in children and young people
    Link  Paediatric Infliximab dose banding
    Link  Paediatric Rheumatology prescribing guidance: Infliximab
    Link  Patient Info Leaflet: Infliximab for paediatric IBD (from Crohn’s and Colitis UK)
    Link  PIL: biosimilar infliximab (children) (LTHT access only)
    Link  UK Guidelines: IBD in children
    Link  MHRA Drug Safety Update Apr 2014: Tumour necrosis factor alpha inhibitors: risk of tuberculosis—screen all patients before starting treatment and monitor them closely
       
    Inotuzumab ozogamicin (Besponsa®)
    (paediatrics)
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    Formulary
    Red
    • For use in line with NICE TA541: treating relapsed or refractory B-cell acute lymphoblastic leukaemia
     
    Link  NICE TA541: Inotuzumab ozogamicin for treating relapsed or refractory B-cell acute lymphoblastic leukaemia
       
    Lanadelumab (Takhzyro®)
    (paediatrics)
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    Formulary
    Red
  • For preventing recurrent attacks of hereditary angioedema in line with NICE TA606 
  • Link  NICE TA606: Lanadelumab for preventing recurrent attacks of hereditary angioedema
       
    Leflunomide
    (paediatrics)
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    Formulary
  • for juvenile idiopathic arthritis (JIA) and chronic uveitis associated with JIA 
  •    
    Methotrexate
    (paediatrics)
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    Formulary
    Amber 3

    Amber3 - oral
    Red - injection

     
    Link  Amber Drug Guidance - non-oncology indications in paediatrics
    Link  LTHT Paediatric Rheumatology Intravenous Methotrexate administration guide
    Link  Paediatric Rheumatology prescribing guidance: methotrexate IV
    Link  Paediatric Rheumatology prescribing guidance: methotrexate SC
    Link  Patient Information Leaflet: methotrexate IV for non-oncology indications in children
    Link  Patient Information Leaflet: methotrexate oral for non-oncology indications in children
    Link  Patient Information Leaflet: methotrexate SC for non-oncology indications in children
    Link  PIL: Methotrexate in inflammatory bowel conditions
    Link  PIL: methotrexate in inflammatory bowel conditions - a guide for young people
    Link  UK Guidelines: IBD in children
       
    Mycophenolate mofetil
    (paediatrics)
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    Formulary
    Amber 3
  • Where Amber Drug Guidance is available, AMBER 3, otherwise RED
    Amber3 - Prevention of relapse in frequently Relapsing Nephrotic Syndrome
    Amber3 - Rheumatological conditions in children 
  • Link  Amber Drug Guidance - mycophenolate mofetil (Auto-Immune Hepatitis in children)
    Link  Amber Drug Guidance - mycophenolate mofetil (Frequently Relapsing Nephrotic Syndrome in Paediatrics)
    Link  Amber Drug Guidance - mycophenolate mofetil (paediatric renal transplant)
    Link  Amber Drug Guidance - mycophenolate mofetil (paediatric rheumatology)
    Link  Drug Safety Update: high rate of serious birth defects and increased risk of spontaneous abortion (Dec 15)
    Link  Drug Safety Update: new pregnancy-prevention advice for women and men (Feb 18)
    Link  Drug Safety Update: risk of hypogammaglobulinaemia and risk of bronchiectasis (Jan 2015)
    Link  Patient information leaflet: mycophenolate mofetil in paediatric rheumatological conditions (LTHT only)
       
    Rasburicase (Fasturtec®)
    (paediatrics)
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    Formulary  
    Link  LHP: Tumour lysis syndrome in adults with malignant disease
    Link  LHP: Tumour lysis syndrome in children with malignant disease
       
    Tacrolimus
    (paediatrics)
    View SPC online View childrens BNF
    Formulary
    Amber 3
  • Prescribe by brand name 
  • Link  Amber Drug Guidance - tacrolimus (liver transplant)
    Link  Amber Drug Guidance - tacrolimus (nephrotic syndrome)
    Link  Amber Drug Guidance - tacrolimus (post renal transplant)
    Link  Drug Safety Update: prescribe by brand name (Nov 17)
       
    Ustekinumab (Stelara®)
    ( paediatrics)
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    Formulary
    Red
    • For use in line with NICE guidance and NHSE Children's Policy
    • also for children with Crohn's Disease
     
    Link  NICE TA456: Ustekinumab for moderately to severely active Crohn’s disease after previous treatment
    Link  NICE TA633: Ustekinumab for treating moderately to severely active ulcerative colitis
       
     ....
    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
    SMC
    Scottish Medicines Consortium
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Green

    Medicines which are appropriate for initiation and ongoing prescribing in both primary and secondary care.  

    Amber 1

    Amber Level 1- Specialist Recommendation
    These medicines are considered suitable for GP prescribing following specialist recommendation.
     
    There is no requirement for full Amber Drug Guidance. Generic Amber Level 1 Drug Guidance detailing responsibilities and information sources is available here
      

    Amber 2

    Amber Level 2- Specialist Initiation but no monitoring requirements
    These medicines are considered suitable for GP prescribing following specialist initiation, including titration of dose and assessment of efficacy.
    Some Amber Level 2 products will have an associated Amber Level 2 Drug Guidance document, available by clicking on the traffic light symbol to the right of the drug name. If this is not available, generic Amber Level 2 Drug Guidance is available here  

    Amber 3

    Amber Level 3- Specialist Initiation with ongoing monitoring requirements (Full Amber Drug Guidance required)
    Medicines that should be initiated by a specialist, and which require significant monitoring on an ongoing basis. Full agreement to share the care of each specific patient must be reached under the amber drug agreement, and Amber Drug Guidance must be provided to the GP (available by clicking on the traffic light symbol to the right of the drug name).   

    Red

    Guidance on the responsibilities for Red Drugs can be found here. Red Drugs would usually by prescribed by the hospital for the duration of the course. Primary care prescriber initiation or continuation of treatment not recommended except by Specialist GP and community paediatric prescribing.   

    Grey

    Grey Drugs are locally-agreed medicines which are only recommended for restricted use within the Leeds Health Economy.   

    Black

    These drugs are not recommended for use within the Leeds Health Economy  

    Multiple

    Products shown as blue have different Traffic Light List classifications dependent on indication. See the accompanying text next to the product for further information the indications for which it has a Traffic Light List classification.  

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