Medicines Formulary - Chapter 1.5: Chronic bowel disorders

Chapters

Drug name	NICE TAs	Comments
Adalimumab	TA187 - Infliximab and adalimumab for the treatment of Crohn's disease TA329 - Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy (including a review of TA140 and TA262)
Asacol M/R 400mg, 800mg
Azathioprine tablets		ESCA
Balsalazide		Consultant initiation - only when other agents have been ineffective
Budesonide 1mg orodispersible tablets (Jorveza®)	TA708 - Budesonide orodispersible tablet for inducing remission of eosinophilic oesophagitis
Budesonide 2mg rectal foam (2mg per 1 metered dose) (Budenofalk®)		Approved to support the shortage of Colifoam (June 2018)
Budesonide 9mg prolonged-release tablets (Cortiment®)
Budesonide capsules (Budenofalk capsules 3mg)		Consultant initiation only
Budesonide MMX (Cortiment®)
Ciclosporin intravenous		Hospital only - MHRA specify that oral ciclosporin must be prescribed and dispensed by brand as bioavailability differences exist between brands.
Ciclosporin oral		Hospital only - MHRA specify that oral ciclosporin must be prescribed and dispensed by brand as bioavailability differences exist between brands.
Eluxadoline (Truberzi®)	TA471 - Eluxadoline for treating irritable bowel syndrome with diarrhoea	To be used in line with NICE TA 471. Specialist initiation, and transfer prescribing to GP using RICaD (in development).
Filgotinib (Jyseleca®)	TA792: Filgotinib for treating moderately to severely active ulcerative colitis
Hydrocortisone foam (Colifoam)
Hydrocortisone injection
Hydrocortisone tablets
Infliximab	TA329 - Infliximab, adalimumab and golimumab for treating moderately to severely active ulcerative colitis after the failure of conventional therapy
Mercaptopurine tablets		ESCA
Mesalazine (Octasa®)		Octasa is preferred brand of choice
Methotrexate tablets (2.5mg)		ESCA. Methotrexate tablets - use 2.5mg strength only. Methotrexate injection - Metoject is APC preferred brand. Check cytotoxic disposal arrangements locally.
Mezavant XL
Mirikizumab (Omvoh®)
Ozanimod (Zeposia®)	TA828 - Ozanimod for treating moderately to severely active ulcerative colitis
Ozanimod (Zeposia®)	TA828: Ozanimod for treating moderately to severely active ulcerative colitis
Pentasa 1g suppositories
Pentasa M/R 500mg
Prednisolone foam enema
Prednisolone retention enema
Prednisolone suppositories
Prednisolone tablets		For exacerbations
Salofalk foam enema
Salofalk granules
Sulfasalazine
Teduglutide (Revestive®)	TA804: Teduglutide for treating short bowel syndrome
Tofacitinib (Xeljanz®)	TA547 - Tofacitinib for moderately to severely active ulcerative colitis
Upadacitinib (Rinvoq®)	TA856 - Upadacitinib for treating moderately to severely active ulcerative colitis TA907 - Deucravacitinib for treating moderate to severe plaque psoriasis
Ustekinumab (Stelara®)	TA456 - Ustekinumab for moderately to severely active Crohn’s disease after previous treatment TA456 - Ustekinumab for treating moderately to severely active ulcerative colitis
Vedolizumab	TA342 - Vedolizumab for treating moderately to severely active ulcerative colitis TA352 - Vedolizumab for treating moderately to severely active Crohn's disease after prior therapy	Hospital only - use in line with NICE Off label use - for the treatment of refractory immunotherapy-related colitis

Drug status key

Formulary drugs are allocated a traffic light status. This provides guidance on where clinical and prescribing responsibilities lie in regard to the initiation and maintenance of prescribing.

Grey

Positive NICE TA and/or awaiting local clarification on place in therapy. Please contact your medicines optimisation team for more information.

Red

Initiation and maintenance of prescribing by specialists only.

Amber

Initiation and maintenance of prescribing by specialists and transfer to primary care prescribing when appropriate, or in primary care following a specialists recommendation. Prior to initiation some medicines may require committee agreement or a framework to support safe transfer and maintenance.

Green

Initiation and maintenance of prescribing by specialists, GPs and other qualified clinicians.

Blue

Under review at University Hospitals Birmingham NHS Foundation Trust.