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Decisions 9th July 2024
Decisions 9th July 2024
New Drug Requests:
- Macimorelin for diagnosis of growth hormone deficiency testing (TLS red)
- Cytisinicline (Cytisine) for the treatment of tobacco dependency (reduction of nicotine withdrawal and cravings) (TLS Green) for use as part of a smoking cessation programme.
- Amikacin for intravesical administration for treatment of recurrent UTI (TLS red) restricted to use where there is microbiologically proven resistance to gentamicin and on the advice of the complex UTI MDT.
- Spironolactone for Hidradenitis Suppurativa (TLS Amber Specialist Initiated)
for treatment of Hidradenitis Suppurativa in female patients with coexisting acne and/or PCOS.
Shared Care Protocols:
- Modafinil for excessive sleepiness associated with narcolepsy with or without cataplexy and idiopathic hypersomnia shared care protocol updated
Traffic light status changes:
- Desmopressin (Noqdirna) for nocturia due to idiopathic nocturnal polyuria in adults TLS change to Amber Specialist Recommended
- Opicapone for the management of Parkinson's Disease TLS change to Amber Specialist Initiated
- Sildenafil for Digital Ulceration for Systemic Sclerosis TLS change to Amber Specialist Initiated
Bladder and Urinary Disorders page- changes
- Solifenacin TLS Blue to TLS Green
- Oxybutynin standard release keep as TLS Blue
- Tolterodine standard release TLS Green to TLS Blue
- Tolterodine modified release- remove from formulary, to make 'non-formulary'
- Trospium standard release- TLS Blue for patients where solifenacin is not tolerated
- Trospium modified release- TLS Blue for patients where trospium is effective but compliance issues with twice daily dosage
- Mirabegron- indication expansion: TLS Blue 'For use in patients after bladder training and where antimuscarinics are contraindicated/ patient or clinician does not want to trial anticholinergics due to anticholinergic burden or where one antimuscarinic has been tried at maximum recommended dose and proved ineffective or where two antimuscarinics have been tried at suboptimal dose but not tolerated due to adverse effects.'
- Oxybutynin (transdermal)- keep as TLS Blue, for patients unable to swallow oral formulations
- Oxybutynin modified release- keep as TLS Blue
Further details added to formulary page and will be supported through development of local guideline (expected Autumn 2024).
Cardiovascular pages: Arrhythmias, Bleeding Disorders, Blood Clots, Myocardial ischaemia, oedema- changes
- Edoxaban TLS Green indications changed to TLS Blue
- Tirofibran added to 2.3.2 page for completeness
- Removal of IV GTN infusion from UHBW Only
- Further information added unde rivaroxaban TLS Red indication for prophylaxis of DVT in patients placed in lower limb immobilisation
- Layout of DOAC page updated following feedback
Other decisions and discussions:
- Atogepant for preventing migraine (TLS Amber Specialist Initiated) in line with NICE TA9733
- Methylphenidate for Attention Deficit Hyperactivity Disorder (ADHD) shared care protocol was discussed. This requires further work before inclusion on the Joint Formulary
- Aspirin to reduce the risk of colorectal cancer in people with Lynch Syndrome (off label) added to the formulary.