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Home > Formulary : Paediatric > Paediatric Chapters > 8. Malignant Disease and Immunosuppression >

BNSSG Paediatric Joint Formulary

8.1 Immune system

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Last edited: 31-01-2024

First line drugs Second line drugs Specialist drugs Secondary care drugs

8.1.1 Immune system disorders and transplantation

 

Antimetabolites

Azathioprine (oral & parenteral)

Azacitidine (parenteral)

  • Via NHS England for myelodysplastic syndromes

 

Calcineurin Inhibitors and Related Drugs

Ciclosporin (oral & parenteral)

  • Prescribe by brand

Sirolimus (oral)

  • Renal Consultant, haematology, BMT physician use only

Tacrolimus (oral & parenteral)

  • Prescribe by brand
  • NICE TA482 Immunosuppressive therapy for kidney transplant in children and young people

 

Immunoglobulins

Antithymocyte globulin (ATG) (rabbit)

  • Renal, Immunology, Haematology and BMT Consultant use only, as per Trust protocol

Antithymocyte globulin (ATG) (horse)

  • NHS England funded

 

Monoclonal Antibodies (Anti-lymphocyte)

Basiliximab (parenteral)

  • Basiliximab may only be prescribed in line with the Renal Unit protocol.
  • NICE TA482 Immunosuppressive therapy for kidney transplant in children and young people

 

Purine Synthesis Inhibitors

Mycophenolate mofetil (oral & parenteral)

  • NICE TA482 Immunosuppressive therapy for kidney transplant in children and young people.
  • Also used for immunomodulation / immunosuppression (unlicensed) under the supervision of Specialists in:

Neurology - see Chapter 10

Rheumatology - see Chapter 10

Gastroenterology - see Chapter 1

Ophthalmology- see Chapter 11

Renal (non-transplant use)

Dermatology - see Chapter 13

Respiratory

IV and oral in BMT specialist use

Alternative to mycophenolate mofetil:

Mycophenolic acid (as mycophenolate sodium) (oral)

 

Anti-lymphocyte Monoclonal Antibodies

Alemtuzumab (parenteral)

  • Pre-transplant immunosuppression and CLL according to NHS England guidance only
  • Treatment of relapsed or refractory chronic lymphocytic leukaemia
  • 1st line treatment of chronic lymphocytic leukaemia in patients with 17p deletion
  • 2nd line treatment of chronic lymphocytic leukaemia in patients with 17p deletion previously treated with chemotherapy but not alemtuzumab
  • 1st line treatment of T-cell prolymphocytic leukaemia
  • 2nd line treatment of T-cell prolymphocytic leukaemia

 

8.1.2 Other

Canakinumab (TLS Red)

 

Anakinra (TLS Red)