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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 9 - Nutrition and blood 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
Links:
BLMK ICB: Oral nutritional supplements guidance Vitamin and Mineral Supplementation Post Bariatric Surgery Guideline
09.01.03 Drugs used in hypoplastic, haemolytic, and renal anaemias and in sickle cell disease
NICE CG39: Anaemia management in chronic kidney disease

Crovalimab (Piasky®)
(340 mg solution for injection/infusion)

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
NICE TA1019: Crovalimab for treating paroxysmal nocturnal haemoglobinuria in people 12 years and over

Danicopan (Voydeya®)
(50mg, 100mg 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
NICE TA1010: Danicopan with ravulizumab or eculizumab for treating paroxysmal nocturnal haemoglobinuria

Hydroxycarbamide 100mg tablet (Siklos®)
(Sickle Cell Disease)

RED
Formulary

100mg tablets

Restricted Item For paediatric use only

NB: Unlicensed for sickle cell if child is under 2 years of age

 

Entry checked: July 2025

BNF BNFc SPC

Hydroxycarbamide 100mg/mL oral solution sugar free (Xromi®)
(Sickle Cell Disease)

RED
Formulary

100mg/mL

Restricted Item For paediatric use only

Licensed for the prevention of vaso-occlusive complications of Sickle Cell Disease in patients over 9 months of age

Entry checked: July 2025

BNF BNFc SPC

Hydroxycarbamide 500mg capsule
(Haematology (thrombocythaemia or polycythaemia vera))

RED
Formulary

 Licensed for: essential thrombocythaemia or polycythaemia vera with a high risk for thromboembolic complications

Entry checked: July 2025

BNF BNFc SPC

Ravulizumab (Ultomiris®)
(300 mg/3 mL/1,100 mg/11 mL/ 300 mg/30 mL concentrate for solution for infusion)

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 TA698: Ravulizumab for treating paroxysmal nocturnal haemoglobinuria NICE TA710 Ravulizumab for treating atypical haemolytic uraemic syndrome NICE TA940: Ravulizumab for treating generalised myasthenia gravis (TERMINATED APPRAISAL) NICE TA941: Ravulizumab for treating AQP4 antibody-positive neuromyelitis optica spectrum disorder (TERMINATED APPRAISAL)

Rituximab (Truxima®)

RED
Restricted Drug Restricted

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

Primary warm AIHA, mixed AIHA and paroxysmal cold haemoglobinuria (off label) as a second line treatment if no response to prednisolone 1mg/kg/day after three weeks or relapse during or after steroid reduction.

Primary cold haemagglutinin disease (CHAD) (off label): first line treatment with rituximab if symptomatic anaemia, severe circulatory symptoms or transfusion dependence

 

Entry reviewed: April 2022

BNF BNFc SPC

Roxadustat (Evrenzo®)
(20mg, 50mg, 70mg, 100mg and 150mg Film-coated tablets)

RED
Restricted Drug Restricted

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

To be prescribed by renal specialists and used in accordance with the following NICE TA only:

BNF BNFc SPC BlueTeq
NICE TA807: Roxadustat for treating symptomatic anaemia in chronic kidney disease

Vadadustat (Vafseo®)
(150mg, 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 by the advanced kidney care clinic with the renal anaemia team, based at Lister hospital in accordance with the following NICE TA(s):

 

BNF BNFc SPC
NICE TA1035: Vadadustat for treating symptomatic anaemia in adults having dialysis for chronic kidney disease

Voxelotor (Oxbryta®)
(500 mg film-coated tablets)

RED
Restricted Drug Restricted

RESTRICTED FOR ALL PRESCRIBING - Blueteq or high cost drug form required - see link from Formulary homepage,

The NICE TA was approved June 24, but it is being withdrawn from the UK market.

Entry reviewed September 2024

BNF BNFc SPC BlueTeq
NICE TA981: Voxelotor for treating haemolytic anaemia caused by sickle cell disease MHRA Class 2 Medicines Recall: Pfizer Limited, Oxbryta 500mg Tablets (voxelotor), EL(24)A/44

Eculizumab

RED
Restricted Drug Restricted

SPECIALIST CENTRE REFERRAL REQUIRED

Cannot be initiated without Consultant Haematologist Approval 

Approved in accordance with the Clinical Commissioning Policy for the prevention and management of delayed haemolytic transfusion reactions and hyperhaemolysis in patients with haemoglobinopathies.

 

 

BNF BNFc SPC
Clinical Commissioning Policy; Rituximab and eculizumab for the prevention and management of delayed haemolytic transfusion reactions and hyperhaemolysis in patients with haemoglobinopathies [URN 1821] [200602P]
Non formulary items

Antithymocyte Immunoglobulin (Equine)

 
Non Formulary
BNF BNFc SPC

Crizanlizumab (Adakveo®) (10 mg/ml concentrate for solution for infusion)

DNP
Non Formulary

January 2024 - NICE has withdrawn this guidance. Novartis will stop marketing crizanlizumab (Adakveo) because its marketing authorisation has been withdrawn by the Medicines and Healthcare products Regulatory Agency (MHRA). Novartis has issued a direct letter to healthcare professionals specialising in haematology. No new people will start taking crizanlizumab in the UK. Healthcare professionals should discuss alternative treatment options with people currently having crizanlizumab.

BNF BNFc
NICE TA 743 Crizanlizumab for preventing sickle cell crises in sickle cell disease

Hydroxycarbamide 1 gram tablet (Siklos®)

 
Non Formulary

1000mg tablets

The 1,000 mg tablets have 3 score lines and can be split into 4 parts (each 250 mg).

Licensed for prevention of recurrent painful vaso-occlusive crises including acute chest syndrome in adults, adolescents and children older than 2 years suffering from symptomatic sickle cell syndrome.

 High cost - £16.67 per tablet

Entry checked: July 2025

BNF BNFc SPC

Hydroxycarbamide oral suspension and oral solution (Unlicensed specials)

DNP
Non Formulary

 

Unlicensed specials

 

Entry checked: July 2025

BNF BNFc SPC

Oxymetholone

 
Non Formulary
BNF BNFc SPC
09.01.03 Erythropoietin
09.01.03 Iron overload
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.