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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 8 - Malignant disease and immunosuppression 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
08.03.04.02 Prostate cancer and gonadorelin analogues
NICE CG175: Prostate cancer
08.03.04.02 Gonadorelin analogues
08.03.04.02 Anti-androgens
NICE CG175: Prostate cancer

Abiraterone 250mg
(Tablets)

RED
Formulary

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

Approved in accordance with NICE TA259 & TA387 for the treatment of metastatic prostate cancer.

BNF BNFc SPC
MHRA Drug Safety Update (Dec 2017): Radium-223 dichloride (Xofigo▼): do not use in combination with abiraterone and prednisone/prednisolone, following clinical trial signal of increased risk of death and fractures NICE TA259: Abiraterone for castration resistant prostate cancer NICE TA387: Abiraterone for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated NICE TA951: Olaparib with abiraterone for untreated hormone-relapsed metastatic prostate cancer NICE TA1032: Niraparib with abiraterone acetate and prednisone for untreated hormone-relapsed metastatic prostate cancer (TERMINATED APPRAISAL) NICE TA1110: Abiraterone (originator and generics) for treating newly diagnosed high-risk hormone‑sensitive metastatic prostate cancer

Apalutamide (Erleada®)
(60 mg film coated tablets)

RED
Restricted Drug Restricted

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

 

For use in accordance with the following NICE TA(s):-

BNF BNFc SPC BlueTeq
NICE TA 740 Apalutamide with androgen deprivation therapy for treating high-risk hormone-relapsed non-metastatic prostate cancer NICE TA 741 Apalutamide with androgen deprivation therapy for treating hormone-sensitive metastatic prostate cancer

Bicalutamide

Amber SPA
Formulary

50mg & 150mg Tablets

BNF BNFc SPC

Buserelin

RED
Formulary

5.5mg/5.5mL Injection

BNF BNFc SPC

Cyproterone tablets
(For malignancy indications)

GREEN
Formulary

50mg Tablets

BNF BNFc SPC

Darolutamide (NUBEQA®)
(300mg film-coated tablets)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or high cost drug form required - see link from formulary homepage.

For use in accordance with the following NICE TA(s) only:-

BNF BNFc SPC
NICE TA660: Darolutamide with androgen deprivation therapy for treating hormone-relapsed non-metastatic prostate cancer NICE TA903: Darolutamide with androgen deprivation therapy and docetaxel for treating hormone-sensitive metastatic prostate cancer NICE TA1109: Darolutamide with androgen deprivation therapy for treating hormone-sensitive metastatic prostate cancer

Enzalutamide 40mg (Xtandi®)
(Tablets)

RED
Formulary

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

Approved in accordance with the following NICE TAs only:

BNF BNFc SPC
NICE TA316: Enzalutamide for metastatic hormone‑relapsed prostate cancer previously treated with a docetaxel‑containing regimen NICE TA377: Enzalutamide for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated NICE TA712: Enzalutamide for treating hormone-sensitive metastatic prostate cancer NICE TA994: Enzalutamide for treating non-metastatic prostate cancer after radical prostatectomy or radiotherapy (TERMINATED APPRAISAL) NICE TA1130: Talazoparib with enzalutamide for untreated hormone-relapsed metastatic prostate cancer

Flutamide

Amber SPA
Formulary

250mg Tablets

BNF BNFc SPC

Goserelin (Zoladex®, Zoladex LA ®)
(For malignant indications)

Amber SPA
Formulary

 

Entry reviewed: June 2022

BNF BNFc SPC

Leuprorelin (Prostap SR® Prostap® Staladex®)
(For malignant indications)

Amber SPA
Formulary

Entry reviewed: June 2022

BNF BNFc SPC

Relugolix (Orgovyx®)
(120 mg film-coated tablets)

Amber SPA
Restricted Drug Restricted

To be used in accordance with the following NICE TA:

  

Entry reviewed: October 2024

BNF BNFc SPC
NICE TA995: Relugolix for treating hormone-sensitive prostate cancer

Triptorelin (Decapeptyl SR® Gonapeptyl ®)
(For malignant indications)

Amber SPA
Formulary

Entry reviewed: June 2022

BNF BNFc SPC
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.