Ipswich and East Suffolk CCG
North East Essex CCG
East Suffolk and North East Essex NHS Foundation Trust

 
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13 Skin
13-05-03 Drugs affecting the immune response

Pimecrolimus cream
Formulary
Link  NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
 

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Tacrolimus ointment
Formulary

MHRA:Possible risk of malignancies


Available as 

  • 0.03%
  • 0.1%
Link  NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
 

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Azathioprine
Formulary
Link  Azathioprine- Shared care
 

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Ciclosporin
Formulary

Use generic ciclosporin

Link  Ciclosporin (Dermatology) - Shared Care
 

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Methotrexate
Formulary

Hospital only guidance

Inpatient drug charts prescribing advice

  • It is prescribed weekly
  • If patient is taking folic acid, it must be given a minimum 24 hours after the methotrexate dose 
  • Endorse the chart with "CYTOTOXIC"
  • Quantity of 2.5mg tablets needed for each dose is specified e.g 4*2.5mg for 10mg dose
  • Allergy box has the following wording " Not for trimethoprim. Please check interactions with methotrexate before prescribing any new medicines".
  • Check bloods
    • eGFR
    • FBC
    • LFTs

Charts must be validated by a pharmacist before a supply can be made

See below for IHT newsletters

 

Primary care guidance

Risk of overdose

Please check records/clinic letters to ensure patient is not receiving any injectable methotrexate in secondary care

Link  Methotrexate- shared care
Link  IHT- Methotrexate safety: Tips for Drs and Nurses
Link  IHT- Methotrexate safety: Tips for pharmacy staff
 

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Mycophenolate
Formulary

MHRA:Updated contraception advice for male patients


Severe refractory eczema [unlicensed indication]

Link  SNEE ICS Mycophenolate Mofetil Shared Care Agreement (Adults) for use in rheumatology, dermatology, gastroenterology and Respiratory (Non-transplant)
 

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Apremilast Otezla®
Formulary
Link  NICE TA372: Apremilast for psoriatic arthritis
Link  NICE TA419: Apremilast for treating moderate to severe plaque psoriasis
Link  NICE TA433 : Apremilast for treating active psoriatic arthritis
 

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Dimethyl fumarate tabs
Formulary

Must be prescribed as Skilarence

Link  NICE TA475: Dimethyl fumarate for treating moderate to severe plaque psoriasis
 

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Omalizumab
Formulary
Link  Omalizumab for previously treated chronic spontaneous urticaria
 

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Efalizumab Raptiva®
Non Formulary

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Hydroxychloroquine
Non Formulary

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