BNF:

6.6.2

Status:

Do Not Prescribe (DNP), Red, Amber

Decision Date:

None

Comments

RED: 

• NICE TA265: Bone metastases - a recommended option instead of a bisphosphonate for preventing skeletal-related events in adults with bone metastases from solid tumours.  Not recommended for bone metastases from prostate cancer.  (Decision date - November 2012).

AMBER:

• NICE TA204: Prevention of osteoporotic fractures in post-menopausal women and men.  See shared care guideline.  (Decision date - December 2012).

DO NOT PRESCRIBE (DNP):

• NICE TA549: for preventing skeletal-related events in multiple myeloma.  (Terminated appraisal).  (Decision date - January 2019).

Denosumab 60mg (Prolia): increased risk of multiple vertebral fractures after stopping or delaying ongoing treatment. Patients should not stop denosumab without specialist review. (MHRA August 2020).

Do Not Prescribe (DNP) Drug Classifications

• 6: Have NICE guidance that recommends they should not be used

Red Drug Classifications

• 5: Is new to clinical practice and unfamiliar, necessitating a period of accumulation of experience, firstly (and most rapidly) by consultants/specialists

Amber Drug Classifications

• 1: Requiring specialist assessment to enable patient selection and initiation of treatment
• 6: Consideration of the drug/device is indicative of significant progression and a need for specialist input (usually as specified in a clinical guideline)

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