6.7 Other endocrine drugs

6.7 Other endocrine drugs

6.7.1. Bromocriptine and other dopaminergic drugs

First line

AMBER Cabergoline tablets 500 microgram

Second line

AMBER Bromocriptine tablets 2.5mg

6.7.2. Drugs affecting gonadotrophins

Danazol has been discontinued - available as an unlicensed special

Danazol combines androgenic, antioestrogenic and antiprogestogenic activity

RED Danazol capsules 100mg, 200mg [unlicensed special]

Gonadorelin analogues:-

Goserelin and leuprorelin are recommended for use within their licensed indications, with goserelin recommended as the first

line product. Any unlicensed uses (e.g. precocious puberty) should not be transferred to primary care prescribers –prescribing

should be retained by secondary care. There are two shared care protocols in place for the use of goserelin (the preferred

LHRH analogue). One covers the use in gynaecology, the other covers the use in oncology settings (breast & prostate cancer),

and they can be accessed online at www.elmmb.nhs.uk/shared-care .

First Line

AMBER with SHARED CARE Goserelin injection 3.6mg, 10.8mg

Second Line

AMBER with SHARED CARE Leuprorelin injection 3.75mg, 11.25mg

(currently no shared care protocols exist for the use of leuprorelin locally as it is a second line agent)

RED Triptorelin SR 3mg

(currently no shared care guideline available for triptorelin)

Specialist initiation only. For use in patients with locally advanced, non-metastatic prostate cancer, as an alternative to surgical

castration.

Moderate to severe symptoms of uterine fibroids

Relugolix-estradiol-norithisterone acetate - for treating moderate to severe symptoms of uterine fibroids in adults of

reproductive age is recommended, within its marketing authorisation as an option in NICE TA832

AMBER Relugolix-estradiol–norethisterone acetate [Ryeqo] ICB Commissioned

6.7.3 Other endocrine drugs

Management of Cushing's Syndrome (specialist supervision in hospital)

RED Metyrapone capsules 250mg

Management of foot ulcers in the diabetic population

RED VACOcast Diabetic Boot

To be initiated by specialist and prescribing retained within secondary care.

All patients should be under the care of a diabetic foot team. The appropriate point of supply for the VACOcast Diabetic Boot

is this specialist service. The VACOcast Diabetic Boot is recommended for the management of foot ulcers in the diabetic

population where a total contact cast is contra-indicated (presence of infection/ ischaemia / daily inspection required),not

tolerated or until casting can be provided (NICE NG19).

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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