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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
09.01.04 Drugs used in autoimmune thrombocytopenic purpura
NICE CG39: Anaemia management in chronic kidney disease

Anagrelide 0.5mg (Xagrid®)
(Capsules)

RED
Restricted Drug Restricted

Restricted- prescribing by consultant Haematologists.

BNF BNFc SPC

Avatrombopag (Doptelet®)
(20 mg tablets)

RED
Restricted Drug Restricted

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

RESTRICTED to prescribing in accordance with the following NICE TA(s):

BNF BNFc SPC
NICE TA626 Avatrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure NICE TA853 Avatrombopag for treating primary chronic immune thrombocytopenia

Caplacizumab (Cablivi®)
(10 mg powder and solvent for solution for injection)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING - Blueteq or HIGH Cost Drug form requested - see link from Formulary Home page

To be used in accordance with the following NICE TA(s):-

BNF BNFc SPC
NICE TA 667 Caplacizumab with plasma exchange and immunosuppression for treating acute acquired thrombotic thrombocytopenic purpura

Eltrombopag 25mg, 50mg (Revolade®)
(Tablets)

RED
Restricted Drug Restricted

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

Approved in accordance with NICE TA293 for the treatment of chronic immune thrombocytopenic purpura

N.B. May interfere with bilirubin and creatinine test results. See MHRA link for further information. Any clinical concerns contact the Clinical Biochemistry team on bleep 237.

BNF BNFc SPC
MHRA Drug Safety Update (July 2018): Eltrombopag (Revolade): reports of interference with bilirubin and creatinine test results NICE TA293: Eltrombopag for treating chronic immune (idiopathic) thrombocytopenic purpura (review of technology appraisal 205)

Fostamatinib (Tavlesse®)
(100 and 150mg film-coated tablets)

RED
Restricted Drug Restricted

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

RESTRICTED to prescribing in accordance with the following NICE TA(s):

BNF BNFc SPC BlueTeq
NICE TA835: Fostamatinib for treating refractory chronic immune thrombocytopenia

Lusutrombopag (Mulpleo®)
(3mg Film-coated Tablets)

RED
Restricted Drug Restricted

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

RESTRICTED to prescribing in accordance with the following NICE TA(s):

BNF BNFc SPC BlueTeq
NICE TA 617 Lusutrombopag for treating thrombocytopenia in people with chronic liver disease needing a planned invasive procedure

Rituximab

 
Restricted Drug Restricted

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

Biosimilars to be prescribed (Truxima Preferred)

Mabthera (originator brand) for existing patients only.

Approved by Bedfordshire & Luton Joint Prescribing Committee, September 2015 (JPC bulletin 221) for the treatment of adults with idiopathic (immune) thrombocytopenic purpura (ITP). 

JPC Recommendation:

  • Steroids and intravenous immunoglobulin remain the first line treatments for ITP.
  • Second line treatment choices include rituximab, eltrombopag or romiplostim. Clinicians can use their clinical discretion when choosing the most appropriate second line treatment option for individual patients.

 

Entry reviewed: June 2025

BNF BNFc SPC BlueTeq

Romiplostim (Nplate®)
(125, 250 and 500microgram powder for solution for injection)

RED
Restricted Drug Restricted

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

Indicated for the treatment of chronic thrombocytopenic purpura

Recommended for the treatment of chronic immune thrombocytopenic purpura in accordance with NICE TA221


BNF BNFc SPC
NICE TA221: Thrombocytopenic purpura - romiplostim
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.