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REMEDY : BNSSG referral pathways & Joint Formulary


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BNSSG Paediatric Joint Formulary

1.1 Chronic bowel disorders

Checked: 28-08-2019 by Next Review: not set yet

1.1.1 Inflammatory bowel disease

First line drugs Second line drugs Specialist drugs Secondary care drugs

Aminosalicylates

  • Patients should not be switched between products without gastroenterology advice. All products are not considered interchangeable
  • The most cost-effective aminosalicylate preparation should be considered when initiating treatment.

     

Mesalazine modified-release (Octasa®) (TLS Amber Specialist Recommended)

Asacol® modified-release tablets / suppositories (TLS Amber Specialist Recommended)

Pentasa® tablets / modified-release granules (TLS Amber Specialist Recommended)

Salofalk® retention enema / suppositories / granules / foam enema (TLS Amber Specialist Recommended)

Mezavant XL® (TLS Amber Specialist Recommended)

  • For patients where Octasa® is unsuitable, and where a once daily regimen is required for compliance purposes

Sulfasalazine (TLS Amber 3 months) (SCP click here)

 

Corticosteroids

Link to chapter 6

Recommended:

Prednisolone (TLS Green)

  • Oral 5mg tablets, (25mg tablets in specific patients)

Prednisolone suppository (TLS Amber Specialist Recommended)

Prednisolone rectal aerosol (Predfoam®) (TLS Amber Specialist Recommended)

Prednisolone retention enema (TLS Amber Specialist Recommended)

Specific indications:

Budesonide (oral) (Budenofalk®) (TLS Red)

  • Terminal ileal or ileocolonic Crohn's Disease and lymphocytic colitis

 

Drugs Affecting Immune Response

Recommended:

Azathioprine IBD BRHC (TLS Amber 1 month) (SCP click here)

Mercaptopurine IBD BRHC (TLS Amber 1 month) (SCP click here)

Methotrexate IBD (TLS Amber 1 month) (SCP click here)

Tacrolimus (TLS Red)

  • Autoimmune enteropathy and 3rd line for IBD

Ciclosporin (TLS Red)

Mycophenolate (TLS Red)

 

Monoclonal Antibodies 

When local procurement has been finalised and as per NICE’s biosimilar position statement, if the originator biologic product is on the BNSSG joint formulary, the new biosimilar product will also be included on the formulary in accordance with its UK licence when it becomes commercially available 

BCH Treatment of children with inflammatory bowel diseases

Adalimumab (TLS Red)

Infliximab (TLS Red)

  • Specify brand when prescribing Remicade®, Inflectra®, Remsima®

Risankizumab (TLS Red)

  • NHSE SCC 2364 for the treatment of adolescent patients aged 16 to 17 years with moderately to severely active Crohn's disease

 

1.1.2 Irritable bowel syndrome

Peppermint oil (TLS Green)

 

1.1.3 Intestinal Failure

Intestinal Failure Registry available via this link: https://ifregistry.streetsheaver.thirdparty.nhs.uk/ifregistry/login