Clomifene is used in the treatment of female infertility. The gonadatrophins found in this section (but not listed) are only used |
by specialist centres who should retain all the prescribing – GPs should not be asked to prescribe. |
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RED Clomifene tablets 50mg |
RED All gonadatrophins listed in section 6.5.1 of the BNF |
RED Human Chorionic Gonadotropin (Gonasi®) [unlicensed medicine, for use by endocrinolgoy only] |
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Corticotrophins |
RED Tetracosactide 250microgram injection (Synacthen®) |
RED Tetracosactide 1mg depot injection (Synacthen depot®) |
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Growth hormone |
In line with NICE guidelines for adults and children. |
AMBER Somatropin injection |
(all brands included within section 6.5.1 of the BNF - Omnitrope is the least costly brand) |
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Growth hormone receptor antagonists |
Only to be initiated and prescribed by tertiary referral centres |
RED Pegvisomant (Somavert®) |
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NICE TA863 Somatrogon [Engenla] |
Somatrogon is recommended, within its marketing authorisation, as an option for treating growth disturbance caused by |
growth hormone eficiency in children and young people aged 3 years and over.
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If people with the condition and their clinicians consider somatrogon to be 1 of a range of suitable treatments (including |
any preparation of somatropin) discuss the advantages and disadvantages of the available treatments. After that discussion, if
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more than 1 treatment is suitable, choose the leastexpensive. Take account of administration costs, dosage, price per dose
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and commercial arrangements. |
RED Sonatrogon (Engenla®) ICB Commissioned, Blueteq required |
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6.5.2 Posterior pituitary hormones and antagonists |
Desmopressin |
Desmopressin is a synthetic analogue of vasopressin, and is indicated for treatment of primary nocturnal enuresis (PNE); |
nocturia associated with multiple sclerosis when other treatments have failed; and diagnosis and treatment of vasopressin- |
sensitive cranial diabetes insipidus; it is also indicated for establishment of renal concentration capacity. |
At the request of the MHRA, the indication for the treatment of primary nocturnal enuresis (PNE) has been removed from all |
desmopressin nasal spray products. Desmopressin nasal sprays remain available for the treatment of patients with cranial |
diabetes insipidus or nocturia associated with multiple sclerosis. In comparison with oral formulations of desmopressin, nasal |
forms were associated with the majority of serious adverse drug reactions (ADRs) reported in patients with PNE. |
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Rare, serious ADRs included hyponatraemia, water intoxication and convulsions. As the risk benefit profile of the oral |
formulations is more favourable than the nasal spray, the nasal form should no longer be used for the treatment of PNE in |
adults and children. |
|
Treatment of primary nocturnal enuresis (PNE) |
GREEN Desmopressin tablets 100, 200 microgram |
oral lyphilisate 120microgram (Desmomelt®) |
NB- 120microgram melt is equivalent to 200 microgram oral tablet) |
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BLACK Nasal spray 10microgram/metered spray (see notes above) |
|
Used for diagnosis and treatment of pituitary diabetes insipidus |
GREEN Desmopressin tablets 100, 200 microgram |
oral lyphilisate 120microgram (Desmomelt®) |
(NB- 120microgram melt is equivalent to 200 microgram oral tablet) |
nasal spray 10microgram/metered spray (see notes above) |
RED Desmopressin injection 4 microgram/mL |
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Used for bleeding oesophageal varices |
RED Terlipressin injection 1mg |
|
Used for treatment of hyponatraemia associated with inappropriate secretion of anti-diuretic hormone |
RED Demeclocycline 150mg capsules |
Existing patients to be referred back to secondary care. |
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Autosomal dominant polycystic kidney disease |
NICE TA358 Tolvaptan recommended as an option for treating autosomal dominant polycystic kidney disease |
|
RED Tolvaptan (Jinarc®) |
tablets 15mg, 30mg,45mg, 60mg, 90mg |
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Tolvaptan for treating SIADH in patients requiring cancer chemotherapy |
Consultant prescribing only. |
|
RED Tolvaptan (Samsca®) NHS England Commissioned | |
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Tolvaptan for the treatment of hyponatremia in adults, secondary to the syndrome of inappropriate antidiuretic hormone |
secretion, for patients NOT requiring chemotherapy. Only if:
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> treatment is initiated, titrated and monitored in hospital, by a specialist experienced in the treatment of SIADH, and |
> fluid restriction has been unsuccessful or is inappropriate, and |
> treatment with demeclocycline has been unsuccessful or is inappropriate. |
RED Tolvaptan (Samsca®) CCG Commissioned |
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All material in this section is aimed at health care professionals, but is information currently held in the public domain, members of the | public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service | Email: info.elmmb@nhs.net | Copyright© 2016 East Lancashire Medicines Management Board | All rights reserved. Disclaimer/Terms and conditions | |
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