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BNSSG Adult Joint Formulary

5.6 Viral infection

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5.6.1 Hepatitis

First line drugs Second line drugs Specialist drugs Secondary care drugs

 

Hepatitis B, Chronic

Interferons

Interferon alfa (Roferon-A®) (parenteral) (TLS Red)

Peginterferon alfa (parenteral) (TLS Red)

  • NICE TA96 Adefovir dipivoxil and peginterferon alfa-2a for treatment of chronic hepatitis B (partially updated by CG165 Chronic hepatitis B)
  • NICE TA200 peginterferon (2a or 2b) and ribavirin for treatment of hepatitis C 
  • NICE TA300 Peginterferon alfa and ribavirin for the treatment of chronic Hepatitis C in children and young people

 

Nucleoside Analogues

Entecavir (oral) (TLS Red)

  • NICE TA153 Entecavir for the treatment of chronic hepatitis B
  • NICE CG165 for prophylaxis of hepatitis B during immunosuppressive therapy

Telbivudine (oral) (TLS Red)

Tenofovir disoproxil (oral) (TLS Red)

  • NICE TA173 Tenofovir disoproxil for the treatment of chronic hepatitis B
  • NICE CG165 for prophylaxis of hepatitis B during immunosuppressive therapy

Lamivudine (oral) (TLS Red)

  • NICE CG165 for prophylaxis of hepatitis B during immunosuppressive therapy

 

Nucleotide Analogues

Adefovir dipivoxil (oral) (TLS Red)

  • NICE TA96 Adefovir dipivoxil & pegylated interferon alpha-2a

 

Hepatitis C, Chronic

For patients with cirrhosis in accordance with NHS England Policy B07/P/a Treatment of Chronic Hepatitis C in patients with cirrhosis 

Hepatitis C: Direct acting antiviral drugs and combinations; NHS England funded via Prior Approval Scheme on Blueteq

 

Nucleoside Analogues

Ribavirin (oral) (TLS Red)

  • Secondary care restricted, see local guidelines
  • NICE TA200 Peginterferon alfa and ribavirin for the treatment of chronic hepatitis C
  • NICE TA300 Peginterferon alfa and ribavirin for the treatment of chronic Hepatitis C in children and young people
  • For chronic hepatitis E in post-renal transplant patients

 

Nucleotide Analogues

Sofosbuvir (oral) (TLS Red)

Sofosbuvir / Velpatasvir (TLS Red)

Sofosbuvir / Velpatasvir / Voxilaprevir (TLS Red)

 

 Ledipasvir / Sofosbuvir (TLS Red)

 

Protease Inhibitors (Hepatitis)

Glecaprevir / Pibrentasvir (oral) (TLS Red)

 

NS5A Inhibitor

Ombitasvir / Paritaprevir / Ritonavir (oral) (Viekirax®) (TLS Red)

Ombitasvir / Paritaprevir / Ritonavir with Dasabuvir (oral) (Exviera®) (TLS Red)

  • NICE TA365 Ombitasvir / paritaprevir / ritonavir with or without dasabuvir for treating chronic hepatitis C

Elbasvir / Grazoprevir (oral) (Zepatier®) (TLS Red)

  • NICE TA413 Elbasvir–grazoprevir for treating chronic hepatitis C

 

Hepatitis D, Chronic

NTCP Receptor Inhibitor

Bulevirtide (TLS Red)

  • NICE TA896 Bulevirtide for treating chronic hepatitis D

 

5.6.2 Herpesvirus infections

Nucleoside Analogues

Recommended:

Aciclovir (oral) (TLS Green)

Alternatives:

Aciclovir (parenteral) (TLS Red)

  • Secondary care restricted, see local guidelines

Famciclovir (oral) (TLS Blue)

Valaciclovir (oral) (TLS Blue)

 

Cytomegalovirus

 

Non-nucleoside Pyrophosphate Analogues

Foscarnet sodium (parenteral) (TLS Red)

  • Secondary care restricted, see local guidelines

Letermovir (oral) (TLS Red)

  • NICE TA591 - for preventing cytomegalovirus disease after a stem cell transplant

 

Nucleoside Analogues

All TLS Red

Cidofovir (parenteral)

  • Secondary care restricted, see local guidelines

Ganciclovir (parenteral)

  • Secondary care restricted, see local guidelines

Valganciclovir (oral)

  • Secondary care restricted, see local guidelines

Valganciclovir solution (oral)

  • Secondary care restricted, see local guidelines

 

Protein Kinase Inhibitors

Maribavir (TLS Red)

  • NICE TA860 Maribavir for treating refractory cytomegalovirus infection after transplant

 

5.6.3 HIV infection

 

Please see NHS England Circular SSC1460. HIV CRG guidance on non-antiretroviral prescribing. Appendix 1

And NHS England Circular SSC1614. HIV Treatments update February 2016

For Treatment as Prevention see NHS England Commissioning Policy F03/P/c

NHSE SSC 2355 National procurement for antiretrovirals for HIV treatment and prevention (pre-exposure prevention (PrEP) and post-exposure prevention (PEP))

Antiretroviral Therapy (ART) Prescribing Implementation Toolkit

Antiretroviral Therapy (ART) Prescribing Implementation Toolkit Generics

National procurement for antiretrovirals for HIV treatment and prevention (PrEP) FAQ

National procurement for antiretrovirals for HIV treatment and prevention (PrEP & PEP)

 

HIV-Fusion Inhibitors

Enfuvirtide (parenteral) (TLS Red)

 

HIV-Integrase Inhibitors

All TLS Red

Abacavir / Dolutegravir / Lamivudine (oral) (Triumeq®)

Bictegravir / Emtricitabine / Tenofovir Alafenamide (oral) (Biktarvy®)

Cabotegravir with Rilpivirine

  • NICE TA757 Cabotegravir with Rilpivirine for treating HIV-1

Dolutegravir (oral)

Dolutegravir / Lamivudine (oral) (Dovato®)

Dolutegravir / Rilpivirine (oral) (Juluca®)

Elvitegravir / Cobicistat / Emtricitabine / Tenofovir Alafenamide (oral) (Genvoya®)

Raltegravir (oral)

 

Non-Nucleoside Reverse Transcriptase Inhibitors

All TLS Red

Doravirine (oral)

Doravirine / Lamivudine / Tenofovir disoproxil fumarate (oral) (Delstrigo®)

Efavirenz (oral)

Etravirine (oral)

Nevirapine (oral)

Rilpivirine (oral)

Rilpivirine / Emtricitabine / Tenofovir Alafenamide (oral) (Odefsey®)

 

Nucleoside Reverse Transcriptase Inhibitors

All TLS Red

Abacavir (oral)

Cobicistat / Darunavir / Emtricitabine / Tenofovir (oral) (Symtuza®)

Didanosine (oral)

Emtricitabine (oral)

Emtricitabine / Tenofovir Alafenamide (oral) (Descovy®)

Emtricitabine / Tenofovir disoproxil

Lamivudine (oral)

Rilpivirine / Emtricitabine / Tenofovir (oral) (Eviplera®)

Stavudine (oral)

Tenofovir disoproxil (oral)

Tenofovir / Efavirenz / Emtricitabine (oral) (Atripla®)

Tenofovir / Efavirenz / Emtricitabine / Cobicistat (oral) (Stribild®)

Zidovudine (oral & parenteral)

 

Protease Inhibitors (TLS Red)

All TLS Red

NHS England Circular SSC1614. HIV Treatments update February 2016

Atazanavir (oral)

Atazanavir / Cobicistat (Evotaz®)

Darunavir (oral)

Darunavir / Cobicistat (Rezolsta®)

Indinavir (oral)

Lopinavir / Ritonavir (oral) (Kaletra®)

Nelfinavir (oral)

Ritonavir (oral)

Saquinavir (oral)

Tenofovir (oral)

 

CCR5 Inhibitors

Maraviroc (oral)

(Not routinely commissioned by NHSE for Natalizumab induced PML)

 

5.6.4 Influenza and Other

Neuraminidase Inhibitors

 

Oseltamivir (oral) (TLS green)

Zanamivir (oral) (TLS green)

Zanamivir (intravenous) (TLS Red)

  • Secondary care restricted in line with Public Health England Guidance for severe/complicated influenza (treatment), see local guidelines

Palivizumab (TLS Red)

  • In line with Public Health England Guidance; NHS England funded via Prior Approval Scheme on Blueteq

 

5.6.5 Monkeypox

Tecovirimat (TLS Red) 

In line with the national CAS alert and interim clinical commissioning policy for the treatment of patients hospitalised with Monkeypox infection.

 

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