Shared care guidelines
The following shared care guidelines have been developed by the Area Prescribing Committee in conjunction with primary and secondary care specialists.
Key
| Organisation | Abbreviation |
| Airedale NHS Foundation Trust | AHFT |
| Calderdale and Huddersfield NHS Foundation Trust | CHFT |
| Leeds Teaching Hospitals NHS Foundation Trust | LTHT |
| Mid Yorkshire Hospitals NHS Foundation Trust | MYHT |
| South West Yorkshire Area Prescribing Committee | SWYAPC |
| South West Yorkshire Partnership NHS Foundation Trust | SWYPFT |
Shared care guidelines
* The Area Prescribing Committee may accept shared care guidelines that have been produced by other organisations.
Please note that the links below can only be accessed from an NHS linked PC – for users who cannot access these guidelines and require a copy please contact us.
To access the relevant shared care guideline – input the desired drug into the relevant section of the search engine
Please note that only the shared care guidelines that are listed on the shared care guideline main page have been accepted by the Area Prescribing Committee for use within this health economy area.
Please check the expiry dates on the links.
| Drug | Indication | Originator | Review date | APC Date (n) = New (a) = Amendment |
|---|---|---|---|---|
| Acamprosate | Maintenance of abstinence in alcohol-dependent patients | SWYAPC | 11 December 2020 | |
| Agomelatine | Major depressive episodes | SWYAPC | December 2018 | |
| Apomorphine | Parkinson's disease | LTHT* | 18 September 2023 | 01.05.2019 (a) |
| Atomoxetine | For attention-deficit hyperactivity disorder (ADHD) in school-age children, adolescents and adults | SWYAPC | December 2018 | |
| Azathioprine | Licensed indications: rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis and polymyositis, auto-immune hepatitis. Off-label indications: systemic vasculitis, inflammatory bowel diseases (Crohn’s Disease, ulcerative colitis, microscopic colitis) | SWYAPC | 17 July 2018 | |
| Azathioprine | Post-transplant | Search for azathioprine/a> | ||
| Azathioprine | Off-label indications: bullous pemphigoid, eczema, vasculitis and Behcet's syndrome | LTHT * | ||
| Azathioprine | Paediatric Inflammatory Bowel Disease (IBD) / Rheumatology | LTHT* | ||
| Bicalutamide | Locally advanced prostate cancer at high risk of disease progression. Locally advanced non-metastatic prostate cancer when surgical castration or other medical intervention inappropriate Ongoing monotherapy for prostate cancer in patients wishing to preserve sexual function Maximum androgen blockade – use continuously in conjunction with LHRH analogue for three months | SWYAPC | 17 July 2018 | |
| Ciclosporin | Licensed indications: rheumatoid arthritis, psoriasis. Off-label indication: psoriatic arthritis (PA) | SWYAPC | 17 July 2022 | 20th September 2019 |
| Ciclosporin | Licensed indications: severe psoriasis and atopic dermatitis. May be used for longer than the licensed 8 weeks Off-label indications: pyoderma gangrenosum, hidradenitis suppurativa, bullous pemphigoid, pemphigus and lupus | LTHT * | ||
| Ciclosporin | Paediatric Rheumatology | LTHT* | ||
| Ciclosporin | Post-transplant | LTHT * | ||
| Cinacalcet | Hypercalcaemia of primary hyperparathyroidism or parathyroid carcinoma | SWYAPC | 18 September 2018 | |
| Cinacalcet | Secondary hyper-parathyroidism in patients with end-stage renal disease on maintenance dialysis therapy | LTHT * | ||
| Colistimethate sodium - (Colomycin®) | Cystic fibrosis (CF) management | Amber - SCG not available for this indication. Please see Amber classification definition for further information and seek advice from requesting consultant for monitoring requirements. | ||
| Colistimethate sodium - (Promixin®) | Cystic fibrosis (CF) | LTHT * | ||
| Colistimethate sodium - (Colomycin®) | Pseudomonas infection in the lungs | LTHT * | ||
| Cyproterone | Prostate cancer | Red for new patients Amber for existing patients only SWYAPC | 01 February 2014 *Extension agreed 18 August 2018* | |
| Dalteparin | See low molecular weight heparins (LMWH) | See low molecular weight heparins (LMWH) | ||
| Dapsone | Licensed indication - dermatitis herpetiformis. Off-label indications - dermatoses (leucocytoclastic vasculitis, Sweet's syndrome, pyoderma gangrenosum) | SWYAPC | 18 September 2022 | 31st July 2019 (a) |
| Degarelix | Prostate Cancer | See GnRH analogues | October 2020 | |
| Denosumab | Prevention of osteoporosis | SWYAPC | 18 October 2020 | |
| Dexamfetamine and lisdexamfetamine | For attention-deficit hyperactivity disorder (ADHD) in school-age children, adolescents and adults | SWYAPC | December 2018 | |
| Disulfiram | Management of patients with alcohol dependence | SWYAPC | 11 December 2020 | |
| Dornase alfa | Cystic fibrosis (CF) | LTHT | ||
| Enoxaparin | See low molecular weight heparins (LMWH) | See low molecular weight heparins (LMWH) | ||
| Glycopyrronium | Hypersalivation (adults and children) | LTHT * | ||
| GnRH analogues (Leuprorelin or Triptorelin) | Endometriosis or uterine fibroids | SWYAPC | 18 September 2018 | |
| GnRH analogues (Goserelin, Leuproelin, Triptorelin and Degarelix) | Prostate cancer | SWYAPC | October 2020 | |
| Goserelin | Prostate cancer | See GnRH analogues LTHT * | October 2020 | |
| Guanfacine | Attention deficit hyperactivity disorder in school age children, adolescents and adults | SWYAPC | 4 January 2020 | |
| Hydroxycarbamide | Haematological conditions | SWYAPC | April 2019 | |
| Hydroxycarbamide | Off-label indication: psoriasis | LTHT * | ||
| Hydroxychloroquine | Rheumatoid arthritis, systemic and discoid lupus erythematosus (and related connective tissue diseases - off-label) | SWYAPC | 27 August 2018 | |
| Lanthanum | Hyperphosphataemia in chronic renal failure | LTHT * | ||
| Leflunomide | Rheumatoid arthritis (RA) and psoriatic arthritis (PA) | SWYAPC | 17 July 2018 *Please note: awaiting regional update of guidelines* | |
| Leuprorelin | Endometriosis or uterine fibroids | SWYAPC | 18 September 2018 | |
| Leuprorelin | Prostate cancer | See GnRH analogues | October 2020 | |
| Liothyronine | Hypothyroidism | SWYAPC | May 2022 | 31st July 2019 (a) |
| Lisdexamfetamine and Dexamfetamine | For attention-deficit hyperactivity disorder (ADHD) in school-age children, adolescents and adults | Dexamfetamine-LisdexamfetamineSCG SWYAPC | December 2018 | |
| Lithium | Treatment and prophylaxis of mania, bipolar disorder and recurrent depression | SWYAPC To refer patients back into the service who have been discharged - please see the link to the SWYPFT Service directory | 19 June 2021 | |
| Low Molecular Weight Heparin (LMWH) - this includes: dalteparin, enoxaparin and tinzaparin | Extended treatment & prophylaxis of VTE in adult patients with solid tumours | Amber | 22 March 2021 | |
| Low Molecular Weight Heparin (LMWH) - this includes: dalteparin, enoxaparin and tinzaparin | Treatment of adult patients with venous thromboembolism (VTE) presenting clinically as deep vein thrombosis (DVT), pulmonary embolism (PE) or both. LMWH under this guideline may be used in: - •Patients unable to take warfarin and in whom a direct oral anticoagulant (DOAC) is not appropriate or contraindicated. •Patients in whom it has not been possible to stabilise on oral anticoagulant therapy and in whom a DOAC is not appropriate or contraindicated (for example: a patient with a replacement metal mitral heart valve and a sub-therapeutic INR and ‘bridging’ therapy is required). •IV drug users (where warfarin is generally considered inappropriate) and in whom a DOAC is not appropriate or contraindicated. | SWYAPC | 22 March 2021 | |
| Melatonin MR | Treatment of sleep disorders in children and young people under 18 years | SWYAPC. Leaflet for patients Crushing Circadin tablets leaflet | August 2019 extend by one year to August 2020 | 31st July 2019 (a) |
| Mercaptopurine | Inflammatory bowel disease: unresponsive and frequently relapsing cases of Crohn’s Disease and Ulcerative Colitis. Auto-immune hepatitis | SWYAPC | 19 June 2021 | |
| Mercaptopurine | For the treatment of Inflammatory Bowel Disease in Children | LTHT* | ||
| Methotrexate (oral) | Licensed indications – rheumatoid arthritis, psoriatic arthritis. Off-label indications - other inflammatory arthritides, connective tissue disease (see below for dermatological indications) | SWYAPC | 18 September 2018 | |
| Methotrexate (oral) | Licensed indication: severe uncontrolled psoriasis. Off-label conditions: e.g pemphigoid, pemphigus, sarcoidosis, scleroderma, dermatomyositis, eczema. See shared care guideline for further indications | LTHT * | ||
| Methotrexate (oral) | Non cancer indications in paediatrics | LTHT* | ||
| Methylphenidate | For attention-deficit hyperactivity disorder (ADHD) in school-age children, adolescents and adults | SWYAPC | December 2018 | |
| Modafinil | For the treatment of excessive sleepiness associated with narcolepsy with or without cataplexy | SWYAPC | 7 August 2020 | |
| Mycophenolate | Off-label indications –systemic lupus erythematosus (SLE), particularly lupus nephritis, other connective tissue diseases and systemic vasculitis. Treatment of myasthenia gravis in patients intolerant or non-responding to azathioprine | SWYAPC | 01 June 2018 *Please note: awaiting regional update of guidelines* | |
| Mycophenolate | Post-transplant | LTHT * | ||
| Mycophenolate | Paediatric rheumatology | LTHT* | ||
| Mycophenolate | For the prevention of relapse in frequently relapsing nephrotic syndrome in paediatrics | LTHT* | ||
| Naltrexone | Maintain abstinence in alcohol-dependent patients | SWYAPC | 11 December 2020 | |
| Penicillamine | Rheumatoid arthritis (RA) | SWYAPC | 17 July 2022 | 20th September 2019 (a) |
| Phenelzine | Treatment resistant depression | SWYAPC | October 2016 | |
| Riluzole | Amylotropic lateral sclerosis | SWYAPC | May 2019 | |
| Sevelamer | Hyperphosphataemia in patients on haemodialysis and peritoneal dialysis | LTHT * | ||
| Sirolimus | Post-transplant | LTHT * | ||
| Sodium aurothiomalate (IM gold) | Rheumatoid arthritis (RA) | Discontinuation | 17 July 2018 | 31st July 2019 (a) |
| Somatropin | Adults *Please note that Omnitrope® is what we commission in adults as growth hormone product of choice* | SWYAPC | 20 March 2018 *Extension agreed 18 August 2018* | |
| Sulfasalazine | Licensed - rheumatoid arthritis (RA). Off-label use - other inflammatory arthritides | SWYAPC | 17 July 2022 | 20th September 2019 (a) |
| Sulfasalazine | Paediatric rheumatology | LTHT* | ||
| Tacrolimus | Post-transplant | LTHT * | ||
| Tacrolimus (Adoport®)) | Treatment of Crohns Disease unresponsive to other immunosuppressants (off-label use) | Tacrolimus SCG LTHT | ||
| Tinzaparin | See low molecular weight heparins (LMWH) | See low molecular weight heparins (LMWH) | ||
| Tobramycin (Tobi®) nebuliser solution | Cystic fibrosis (CF) | LTHT * | ||
| Triptorelin | Endometriosis or uterine fibroids | See GnRH analogues (Leuprorelin or Triptorelin) | 18 September 2018 | |
| Triptorelin | Precocious puberty | Amber - SCG not available. Please see Amber classification definition for further information and seek advice from requesting consultant for monitoring requirements. | ||
| Triptorelin | Prostate cancer | See GnRH analogues | October 2020 |