BNF:

8.2.2/13.5.8

Status:

Red, Green - after consultant initiation

Decision Date:

None

Comments

GREEN after consultant initiation: Topical tacrolimus

See local protocol for use of topical tacrolimus

RED^1,2,3:- NICE TA481 & NICE TA 482 - oral immunosuppressive therapy (includes basiliximab or immediate-release tacrolimus or mycophenolate mofetil) for kidney transplant in adults, children and young people. (Decision date - November 2017)

Prescribe and dispense oral tacrolimus by brand to minimise the risk of inadvertent switching between products, which has been associated with reports of toxicity and graft rejection. (MHRA, Nov 2017)

Oral therapy - NHS England drug, to be used in line with NHS England commissioning intentions.

NB. Prescribing in primary care may be considered in line with an out of area transplant centre approved shared care. See 'out of area' guidance.

 

Red Drug Classifications

• 1: Requiring specialist assessment to enable patient selection, initiation and ongoing treating
• 2: Requiring long term on-going monitoring of efficacy by a specialist and not suitable for shared care
• 3: Requiring long term on-going monitoring of toxicity by a specialist (either because of difficulty in recognising side effects or high cost of investigations to identify toxicity)

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