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Decisions 3rd September 2024
New Drug Requests
- Prasterone (DHEA) gel for vulvovaginal atrophy in postmenopausal women who are taking an aromatase inhibitor or as a last line option in women who are intolerant to other formulary options i.e. allergy or issues with oral absorption. (TLS Red)
- Doxepin 5% cream
In September 2024, JFG approved For use in localised neuropathic pain, specifically notalgia paraesthetica, brachioradial pruritus, and post-herpetic neuralgia. Use in diabetic neuropathy was not approved due to lack of an evidence base at this time. (TLS Amber Specialist Recommended)
For use in pruritis, please see 13.6 pruritis page where it is TLS Red. - Teriparatide injection for treating postmenopausal women and men aged >50 years for where romosozumab is indicated but contraindicated (TLS Red)
- Chloroprocaine solution for day case spinal anaesthesia for surgery lasting less than 40 minutes (TLS Red)
Shared Care Protocols
Updated SCPs:
- Budesonide orodospersible tablets (Jorveza) for eosinophilic oesophagitis in adults (>18 years old), maintenance treatment (following 12 week induction period)
- Testosterone (Sustanon and Nebido) for hypogonadism SCPs have been combined
Traffic Light Status changes
- Amantadine for Parkinsons Disease and Multiple Sclerosis to Amber Specialist Initiated (SCP removed)
- Sodium clodronate for hypercalcaemia of malignancy, bone metastases in breast cancer changed from Green to Amber Specialist Initiated and change brands from Bonefos to Loron and Clasteon.
- Cyproterone acetate – confirmed TLS should be Amber 3 months.
Other Decisions
- Methylphenidate shared care protocol for ADHD update was discussed and will be uploaded in due course.
- Amiodarone TLS was discussed and to come back to a future JFG.
- Melatonin - Following on from the December 2022 JFG meeting:
For both adult and paediatric patients, the Formulary now covers the prescribing of melatonin for intrinsic sleep disorder with one of:- Autism Spectrum Disorder (ASD) diagnosis,
- Learning Disability (LD) diagnosis,
- a neurodevelopmental disorder / disability (e.g. cerebral palsy) (excluding those with Attention Deficit Hyperactivity Disorder as a standalone diagnosis)
- or REM sleep disorder
Further information is available in the updated shared care protocol, available on both the adult and paediatric formulary pages. Clinicians should familiarise themselves with this document which provides information on formulations and many other common prescribing issues.
For Noting
- Removal of Calcipotriol scalp solution (discontinued)
- Omeprazole 1mg/ml liquid- new licensed strength (noted as non-formulary)
- Abrysvo vaccine- add as TLS Green to adult formulary in line with new NHS vaccination programme against respiratory syncytial virus (RSV) for pregnant individuals (over 28 weeks) and older adults (September 24 launch)
- Removal of Testim® 50mg/5g gel tubes and shared care protocol for testosterone (discontinued)