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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 3 - Respiratory system 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
Links:
BLMK ICB Guidance: Chronic obstructive pulmonary disease guidelines for primary care BLMK ICB Guidance: Review of Inhaled Corticosteroids (ICS) in patients with COPD BLMK Paediatric Wheeze and Asthma Guidelines (Children Age 16 and under), Oct 2024 NICE NG115: COPD guideline NICE NG78: Cystic fibrosis: diagnosis and management. October 2017 Right Breathe Inhaler Prescribing Information
03.04.02 Allergen Immunotherapy

Benralizumab (Fasenra®)
(Injection)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved in accordance with NICE TA below.

 

For NICE TA1096 it can only be prescribed at Bedforshire NHS Trust if recommended by tertiary centre and a blueteq is provided. Bedfordshire NHS Trust cannot initate treatment.

BNF BNFc SPC
NICE TA565: Benralizumab for treating severe eosinophilic asthma

Birch tree pollen allergen extract (Betula verrucosa) (Itulazax® 12 SQ-Bet)
(sublingual lyophilisate)

RED
Restricted Drug Restricted

For use strictly in line with NICE TA1087 for for treating moderate to severe allergic rhinitis or conjunctivitis caused by birch tree pollen.

It should be initiated by physicians with experience in treatment of allergic diseases and the initial dose should be taken under medical supervision.

Entry reviewed October 2025

BNF BNFc SPC
NICE TA1087: Betula verrucosa for treating moderate to severe allergic rhinitis or conjunctivitis caused by tree pollen

Dupilumab (Dupixent®)
(For severe asthma with type 2 inflammation)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

 

Approved for use in accordance with the following NICE TA(s):

BNF BNFc SPC BlueTeq
MHRA DSU: Dupilumab (Dupixent▼): risk of ocular adverse reactions and need for prompt management NICE TA751 Dupilumab for treating severe asthma with type 2 inflammation NICE TA1134: Dupilumab for treating severe chronic rhinosinusitis with nasal polyps

House dust mite allergen extract (Acarizax® 12 SQ-HDM SLIT)
(oral lyophilisate)

RED
Restricted Drug Restricted

For use strictly in line with NICE TA1045 for treating allergic rhinitis caused by house dust mites.

NOT recommended by NICE for treating house dust mite allergic asthma.

It should be initiated by physicians with experience in treatment of allergic diseases and the initial dose should be taken under medical supervision.

Entry reviewed September 2025

BNF BNFc SPC
NICE TA1045: 12 SQ-HDM SLIT for treating allergic rhinitis and allergic asthma caused by house dust mites

Mepolizumab (Nucala®)

RED
Restricted Drug Restricted

To be prescribed by specialists according to NICE TA431 and NICE TA671.

BHT - Only to be prescribed for continuation of stable patients initiated by Cambridge Univeristy Hospital. CUH must supply their Blueteq number to BHT pharmacy to allow the cost to be reclaimed from NHS England.

BNF BNFc SPC
NICE TA 671 Mepolizumab for treating severe eosinophilic asthma NICE TA431: Mepolizumab for treating severe refractory eosinophilic asthma Jan2017

Reslizumab (Cinqair®)
(Intravenous infusion)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Approved in accordance with NICE TA479 for treating severe refractory eosinophilic asthma.

BNF BNFc SPC
NICE TA479: Reslizumab for treating severe eosinophilic asthma Oct 2017

Tezepelumab (Tezspire®)
(210 mg solution for injection in pre-filled syringe)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

 Approved for use in accordance with the following NICE TA(s):

BNF BNFc SPC BlueTeq
NICE TA880: Tezepelumab for treating severe asthma
03.04.02 Omalizumab
Classifications
GREEN
May be initiated in any care setting
Amber SPA
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Amber SPIS
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
SCG
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
RED
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
DNP
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
SELF
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.