North East and North Cumbria
ICS Formulary
 
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3 Respiratory system

*Important*

The NENC ICB Respiratory Network recommends that all inhalers should be prescribed by brand for patient safety, to ensure that the correct device is dispensed to support correct technique and avoid patient confusion and medication errors.

Choice of inhaler device should be based on patient ability to use. Devices should be chosen based on availability for the type of drug to be prescribed and the patient’s ability to use it.

Refer to local guidelines for information on preferred options.

Note: All new patients should be started on the updated formulary choices as per local/national guidelines.

When inhalers are removed from the formulary, existing, stable, patients should continue to receive the non-formulary device. Treatment should not be changed unless a full face to face review has been conducted.

03-11 Antifibrotics

Methotrexate
Formulary

2.5mg tablets

Link  NENC Shared Care Protocol - Methotrexate (oral and subcutaneous) for patients in adult services (excluding cancer care)
Link  MHRA Drug Safety Update (August 2023): Methotrexate: advise patients to take precautions in the sun to avoid photosensitivity reactions
Link  MHRA Drug Safety Update (Sept 2020): Methotrexate once weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing

Cytotoxic Drug  Amber View adult BNF  View SPC online  View childrens BNF
Nintedanib Ofev®
Formulary

  • Approved for treating idiopathic pulmonary fibrosis

  • Approved for treating progressive fibrosing interstitial lung diseases in line with NICE

Link  NICE TA379:Nintedanib for treating idiopathic pulmonary fibrosis
Link  NICE TA747: Nintedanib for treating progressive fibrosing interstitial lung diseases

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Pirfenidone
Formulary

 

    • Approved for the treatment of idiopathic pulmonary fibrosis in line with NICE and NHS England Commissioning Policy

 

Link  MHRA Drug Safety Update Nov 2020: Pirfenidone (Esbriet): risk of serious liver injury; updated advice on liver function testing
Link  NICE TA504: Idiopathic pulmonary fibrosis - pirfenidone

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