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

 

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.

 

Alphabetical listingIndicationOriginatorReview dateComment
AcamprosateMaintenance of abstinence in alcohol-dependent patientsSWYAPC 11 December 2020
AgomelatineMajor depressive episodesSWYAPCDecember 2018
ApomorphineParkinson's diseaseSWYAPC18 September 2018
Atomoxetine For attention-deficit hyperactivity disorder (ADHD) in school-age children, adolescents and adultsSWYAPCDecember 2018
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
AzathioprineOff-label indications: bullous pemphigoid, eczema, vasculitis and Behcet's syndromeLTHT *
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
CiclosporinLicensed indications: rheumatoid arthritis, psoriasis.
Off-label indication: psoriatic arthritis (PA)
SWYAPC17 July 2018
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 *
CiclosporinPost-transplantLTHT *
CinacalcetHypercalcaemia of primary hyperparathyroidism or parathyroid carcinoma SWYAPC18 September 2018
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 *
CyproteroneProstate cancerSWYAPC01 February 2014
*Extension agreed 18 August 2018*
DapsoneLicensed indication - dermatitis herpetiformis. Off-label indications - dermatoses (leucocytoclastic vasculitis, Sweet's syndrome, pyoderma gangrenosum)SWYAPC18 September 2018
DenosumabPrevention of osteoporosisSWYAPC (please note this shared care guideline has not been adopted by Bradford CCGs)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
FlutamideAdvanced prostate cancer patients for:
long term palliative therapy when LHRH analogues or orchidectomy is contraindicated, not tolerated or oral therapy preferred.
Hot flushes with LHRH analogue therapy or after orchidectomy
SWYAPC17 July 2018
GlycopyrroniumHypersalivation (children)LTHT *
GnRH analogues (Leuprorelin or Triptorelin) Endometriosis or uterine fibroidsSWYAPC18 September 2018
GnRH analogues
(Goserelin, Leuproelin, Triptorelin)
Prostate cancer SWYAPC October 2020
GoserelinProstate cancerSee GnRH analogues October 2020
GuanfacineAttention deficit hyperactivity disorder in school age children, adolescents and adultsSWYAPC4 January 2020
HydroxycarbamideHaematological conditionsSWYAPCApril 2019
HydroxycarbamideOff-label indication: psoriasisLTHT *
HydroxychloroquineRheumatoid arthritis, systemic and discoid lupus erythematosus (and related connective tissue diseases – - off-label)SWYAPC27 August 2018
LanthanumHyperphosphataemia in chronic renal failureLTHT *
LeflunomideRheumatoid arthritis (RA) and psoriatic arthritis (PA)SWYAPC17 July 2018
LeuprorelinEndometriosis or uterine fibroidsSWYAPC18 September 2018
LeuprorelinProstate cancer See GnRH analogues October 2020
Lisdexamfetamine and Dexamfetamine For attention-deficit hyperactivity disorder (ADHD) in school-age children, adolescents and adultsDexamfetamine-LisdexamfetamineSCG SWYAPCDecember 2018
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 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.

Extended treatment & prophylaxis of VTE in adult patients with solid tumours.
SWYAPC22 March 2021
Melatonin MR (Circadin®)Treatment of sleep disorders in children and young people under 18 yearsSWYAPC. Leaflet for patients Crushing Circadin tablets leafletAugust 2019
MercaptopurineInflammatory bowel disease: unresponsive and frequently relapsing cases of Crohn’s Disease and Ulcerative Colitis. Auto-immune hepatitisSWYAPC 19 June 2021
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 *
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
MycophenolatePost-transplantLTHT *
NaltrexoneMaintain abstinence in alcohol-dependent patientsSWYAPC 11 December 2020
PenicillamineRheumatoid arthritis (RA)SWYAPC17 July 2018
PhenelzineTreatment resistant depressionSWYAPCOctober 2016
RiluzoleAmylotropic lateral sclerosisSWYAPCMay 2019
SevelamerHyperphosphataemia in patients on haemodialysis and peritoneal dialysisLTHT *
SirolimusPost-transplantLTHT *
Sodium aurothiomalate (IM gold)Rheumatoid arthritis (RA)SWYAPC17 July 2018
SomatropinAdults
*Please note that Omnitrope® is what we commission in adults as growth hormone product of choice*
SWYAPC20 March 2018
*Extension agreed 18 August 2018*
Sulfasalazine Licensed - rheumatoid arthritis (RA).
Off-label use - other inflammatory arthritides
SWYAPC17 July 2018
TacrolimusPost-transplantLTHT *
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