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

Bradford District Care NHS Foundation Trust

Bradford Teaching Hospital NHS Foundation Trust

AHFT

BDCFT

BTHFT

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.

 

DrugIndicationOriginatorReview dateAPC Date
(n) = New
(a) = Amendment
AcamprosateMaintenance of abstinence in alcohol-dependent patientsSWYAPC 11 December 2020
AgomelatineMajor depressive episodesSWYAPCDecember 2018
AmiodaroneFor the treatment of ventricular and supraventricular arrhythmias for adultsLTHT1st April 202418th March 2020
Atomoxetine For attention-deficit hyperactivity disorder (ADHD) in school-age children, adolescents and adultsSWYAPCDecember 2018
AzathioprineRheumatology
COVID-19
Azathioprine - COVID19
AzathioprineLicensed 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)
SWYAPC17 July 2018
AzathioprinePost-transplantSearch for azathioprine/a>
AzathioprineOff-label indications: bullous pemphigoid, eczema, vasculitis and Behcet's syndromeLTHT *
Azathioprine Paediatric Inflammatory Bowel Disease (IBD) / Rheumatology LTHT*
BicalutamideLocally 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
SWYAPC17 July 2018
CiclosporinRheumatology
COVID-19
Ciclosporin COVID-19
CiclosporinLicensed indications: rheumatoid arthritis, psoriasis.
Off-label indication: psoriatic arthritis (PA)
SWYAPC17 July 202220th September 2019
CiclosporinLicensed 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 RheumatologyLTHT*
CiclosporinPost-transplantLTHT *
CinacalcetHypercalcaemia of primary hyperparathyroidism or parathyroid carcinoma SWYAPC18 September 201827th November 2019 (a)
CinacalcetSecondary hyper-parathyroidism in patients with end-stage renal disease on maintenance dialysis therapyLTHT *
Colistimethate sodium - (Colomycin®)Cystic fibrosis (CF) managementAmber - 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 *
CyproteroneAnti-androgen for Gender Dysphoria in adultsLTHT27th September 2019 (n)
CyproteroneProstate cancerRed for new patients
Amber for existing patients only
SWYAPC
01 February 2014
*Extension agreed 18 August 2018*
DalteparinSee low molecular weight heparins (LMWH)See low molecular weight heparins (LMWH)
DapsoneLicensed indication - dermatitis herpetiformis. Off-label indications - dermatoses (leucocytoclastic vasculitis, Sweet's syndrome, pyoderma gangrenosum)SWYAPC18 September 202231st July 2019 (a)
DegarelixProstate CancerSee GnRH analoguesOctober 2020
DenosumabPrevention of osteoporosisSWYAPC
18 October 2020
Dexamfetamine and lisdexamfetamine For attention-deficit hyperactivity disorder (ADHD) in school-age children, adolescents and adultsSWYAPCDecember 2018
DisulfiramManagement of patients with alcohol dependenceSWYAPC 11 December 2020
Dornase alfaCystic fibrosis (CF)LTHT
Enoxaparin
See low molecular weight heparins (LMWH)See low molecular weight heparins (LMWH)
GlycopyrroniumHypersalivation (adults and children)LTHT *
GnRH analogues (Leuprorelin or Triptorelin) Endometriosis or uterine fibroidsSWYAPC18 September 2018
GnRH analogues
(Goserelin, Leuproelin, Triptorelin and Degarelix)
Prostate cancer SWYAPCOctober 2020
GoserelinProstate cancerSee GnRH analogues
LTHT *
October 2020
GuanfacineAttention deficit hyperactivity disorder in school age children, adolescents and adultsSWYAPC4 January 2020
HydroxycarbamideHaematological conditionsSWYAPCApril 2019
HydroxycarbamideOff-label indication: psoriasisLTHT *
HydroxychloroquineRheumatology
COVID-19
Hydroxychloroquine - COVID-19
HydroxychloroquineRheumatoid arthritis, systemic and discoid lupus erythematosus (and related connective tissue diseases – - off-label)LTHT*27 August 201822nd January 2020 (a)
LanthanumHyperphosphataemia in chronic renal failureLTHT *
LeflunomideRheumatology
COVID-19
Leflunomide - COVID-19
LeflunomideRheumatoid arthritis (RA) and psoriatic arthritis (PA)SWYAPC17 July 2018 *Please note: awaiting regional update of guidelines*
LeuprorelinEndometriosis or uterine fibroidsSWYAPC18 September 2018
LeuprorelinProstate cancer See GnRH analogues October 2020
LiothyronineHypothyroidismSWYAPCMay 202231st July 2019 (a)
Lisdexamfetamine and Dexamfetamine For attention-deficit hyperactivity disorder (ADHD) in school-age children, adolescents and adultsDexamfetamine-LisdexamfetamineSCG SWYAPCDecember 2018
LithiumRheumatology
COVID-19
Lithium COVID-19
LithiumTreatment and prophylaxis of mania, bipolar disorder and recurrent depressionSWYAPC
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 tinzaparinExtended treatment & prophylaxis of VTE in adult patients with solid tumoursAmber 22 March 2021
Low Molecular Weight Heparin (LMWH) - this includes: dalteparin, enoxaparin and tinzaparinTreatment 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.

SWYAPC22 March 2021
Melatonin MR Treatment of sleep disorders in children and young people under 18 yearsSWYAPC. Leaflet for patients Crushing Circadin tablets leafletAugust 2019 extend by one year to August 202031st July 2019 (a)
MercaptopurineRheumatology
COVID-19
Mercaptopurine - COVID-19
MercaptopurineInflammatory bowel disease: unresponsive and frequently relapsing cases of Crohn’s Disease and Ulcerative Colitis. Auto-immune hepatitisSWYAPC 19 June 2021
MercaptopurineFor the treatment of Inflammatory Bowel Disease in ChildrenLTHT*
MethotrexateRheumatology
COVID-19
Methotrexate - COVID-19
Methotrexate (oral)Licensed indications – rheumatoid arthritis, psoriatic arthritis.
Off-label indications - other inflammatory arthritides, connective tissue disease
(see below for dermatological indications)
SWYAPC18 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 adultsSWYAPCDecember 2018
ModafinilFor the treatment of excessive sleepiness associated with narcolepsy with or without cataplexySWYAPC7 August 2020
MycophenolateOff-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
SWYAPC01 June 2018 *Please note: awaiting regional update of guidelines*
MycophenolatePost-transplantLTHT *
Mycophenolate Paediatric rheumatology LTHT*
MycophenolateFor the prevention of relapse in frequently relapsing nephrotic syndrome in paediatricsLTHT*
NaltrexoneMaintain abstinence in alcohol-dependent patientsSWYAPC 11 December 2020
PenicillamineRheumatology
COVID-19
Penicillamine - COVID-19
PenicillamineRheumatoid arthritis (RA)SWYAPC17 July 202220th September 2019 (a)
PhenelzineTreatment resistant depressionSWYAPCOctober 2016
RiluzoleTreatment of Motor Neurone Disease for patients with Amyotrophic Lateral Sclerosis (ALS)LTHT2nd September 202418th March 2020 (a)
SevelamerHyperphosphataemia in patients on haemodialysis and peritoneal dialysisLTHT *
SirolimusPost-transplantLTHT *
Sodium aurothiomalate (IM gold)Rheumatoid arthritis (RA)Discontinuation17 July 201831st July 2019 (a)
SomatropinAdults
*Please note that Omnitrope® is what we commission in adults as growth hormone product of choice*
LTHT1st December 202218th March 2020 (a)
SulfasalazineRheumatology
COVID-19
Sulfasalazine - COVID-19
Sulfasalazine Licensed - rheumatoid arthritis (RA).
Off-label use - other inflammatory arthritides
SWYAPC17 July 202220th September 2019 (a)
SulfasalazinePaediatric rheumatologyLTHT*
TacrolimusPost-transplantLTHT *
Tacrolimus (Adoport®))Treatment of Crohns Disease unresponsive to other immunosuppressants (off-label use) Tacrolimus SCG LTHT
TinzaparinSee low molecular weight heparins (LMWH)See low molecular weight heparins (LMWH)
Tobramycin (Tobi®) nebuliser solutionCystic fibrosis (CF)LTHT *
TriptorelinEndometriosis or uterine fibroidsSee GnRH analogues (Leuprorelin or Triptorelin) 18 September 2018
TriptorelinPrecocious pubertyAmber - SCG not available. Please see Amber classification definition for further information and seek advice from requesting consultant for monitoring requirements.
TriptorelinProstate cancer See GnRH analogues October 2020