Section 8: Cytotoxic Drugs

Section Description

Misc 1

Drugs for cytotoxic-induced side-effects

BNF 8.1.1

Alkylating drugs

BNF 8.1.2

Cytotoxic antibiotics

BNF 8.1.3

Antimetabolites

BNF 8.1.4

Vinca alkaloids and etoposide

BNF 8.1.5

Other antineoplastic drugs

BNF 8.2.1

Cytotoxic immunosuppressants

BNF 8.2.2

Corticosteroids and other immunosuppressants

BNF 8.2.3

Anti-lymphocyte monoclonal antibodies

BNF 8.2.4

Other immunomodulating drugs

BNF 8.3

Sex hormones and hormone antagonists in malignant disease

BNF 8.3.1

Oestrogens

BNF 8.3.2

Progestogens

BNF 8.3.4.1

Breast Cancer

BNF 8.3.4.2

Prostate cancer and gonadorelin analogues

BNF 8.3.4.3

Somatostatin analogues

Drugs for cytotoxic-induced side-effects

Calcium folinate
(Calcium leucovorin)

Tablets & Injection

For initiation by an oncology consultant as antidote to methotrexate.

Mesna

Tablets & Injection

For initiation by an oncology consultant to prevent haemorrhagic cystitis with cyclophosphamide and ifosfamide.


BNF 8.1.1 Alkylating drugs
 
 

Bendamustine

Specialist/ Hospital prescribing only

Indications

NICE Guidance (Bendamustine for the first-line treatment of chronic lymhocytic leukaemia) NICE TA216

Obinutuzumab with bendamustine for treating follicular lymphoma refractory to rituximab NICE TA472

Busulfan (busulphan)

Specialist/ Hospital prescribing only

Indications

  • Chronic myeloid leukaemia

Carmustine

Specialist/ Hospital prescribing only

Indications

  • Multiple myeloma
  • Non-Hodgkin’s lymphoma
  • Brain tumours

Chlorambucil

Specialist/ Hospital prescribing only

Indications

  • Chronic lymphocytic leukaemia
  • Indolent non-Hodgkin’s lymphoma
  • Hodgkin’s disease
  • Ovarian cancer

Cyclophosphamide

Specialist/ Hospital prescribing only

Indications

  • Chronic lymphocytic leukaemia
  • Lymphomas
  • Solid tumours

Ifosfamide

Specialist/ Hospital prescribing only

Indications

  • Related to cyclophosphamide and given intravenously

Lomustine

Specialist/ Hospital prescribing only

Indications

  • Hodgkins disease

Melphalan

Specialist/ Hospital prescribing only

Indications

  • Advanced adenocarcinoma of ovary
  • Multiple myeloma
  • Advanced breast cancer
Treosulfan

Specialist/ Hospital prescribing only

Indications:

  • ovarian cancer

BNF 8.1.2 Cytotoxic antibiotics

Bleomycin

Specialist/ Hospital prescribing only

Indications

  • Squamous cell carcinoma
  • Metastatic germ cell cancer
  • Non-Hodgkins lymphoma

Doxorubicin

Specialist/ Hospital prescribing only

Indications

NICE Guidance (Ovarian cancer (advanced) - paclitaxel, pegylated liposomal doxorubicin hydrochloride and topotecan (review)) NICE TA91 - recommended option in advanced disease depending largely upon platinum sensitivity, resistance, tolerance, and allergy.

Epirubicin

Specialist/ Hospital prescribing only

Indications

  • Breast cancer
  • By bladder instillation as for doxorubicin.
Idarubicin

Specialist/ Hospital prescribing only

Indications:

  • acute leukaemias
  • advanced breast cancer after failure of first-line chemotherapy (not including anthracyclines)  

Mitomycin

Specialist/ Hospital prescribing only

Indications

  • Upper gastrointestinal and breast cancers
  • By bladder instillation for superficial bladder tumours
Mitoxantrone

Specialist/ Hospital prescribing only

Indications:

  • treatment of non-Hodgkin's lymphoma
  • adult acute non-lymphocytic leukaemia
  • non-resectable primary hepatocellular carcinoma 
Pixantrone

Specialist/ Hospital prescribing only

Pixantrone monotherapy for treating multiply relapsed or refractory aggressive non-Hodgkin's B-cell lymphoma NICE TA306

BNF 8.1.3 Antimetabolites

Azacitidine 

Specialist/ Hospital prescribing only 

Azacitidine for the treatment of myelodysplastic syndromes, chronic myelomonocytic leukaemia and acute myeloid leukaemia NICE TA218

Capecitabine

Specialist/ Hospital prescribing only 

Guidance on the use of capecitabine and tegafur with uracil for metastatic colorectal cancer NICE TA61  

Capecitabine for the treatment of advanced gastric cancer NICE TA191

Cladribine 

Specialist/ Hospital prescribing only

Cladribine tablets for treating relapsing–remitting multiple sclerosis NICE TA493

Fludarabine

Specialist/ Hospital prescribing only 

Guidance on the use of fludarabine for B-cell chronic lymphocytic leukaemia NICE TA29  

Gemcitabine

Specialist/ Hospital prescribing only  

Guidance on the use of gemcitabine for the treatment of pancreatic cancer NICE TA25

Gemcitabine for the treatment of metastatic breast cancer NICE TA116  

Pemetrexed

Specialist/ Hospital prescribing only

Pemetrexed for the treatment of malignant pleural mesothelioma NICE TA135

Pemetrexed for the first-line treatment of non-small-cell lung cancer NICE TA181

Pemetrexed for the maintenance treatment of non-small-cell lung cancer NICE TA190

Pemetrexed maintenance treatment following induction therapy with pemetrexed and cisplatin for nonsquamous non-small-cell lung cancer NICE TA309 

Pemetrexed maintenance treatment for non-squamous non-small-cell lung cancer after pemetrexed and cisplatin NICE TA402

Trifluridine–tipiracil 

Specialist/ Hospital prescribing only

Trifluridine–tipiracil for previously treated metastatic colorectal cancer NICE TA405
 

BNF 8.1.4 Vinca alkaloids and etoposide

Etoposide

Specialist/ Hospital prescribing only

Indications

  • Small cell carcinoma of the bronchus
  • Lymphomas
  • Testicular cancer

Vinblastine
Vincristine
Vindesine

Specialist/ Hospital prescribing only

Indications

  • Acute leukaemia
  • Lymphomas
  • Some solid tumours e.g. breast and lung cancer

Vinorelbine

Specialist/ Hospital prescribing only

Indications

NICE Guidance (vinorelbine for advanced non-small cell lung cancer) NICE CG121

NICE Guidance (vinorelbine as 2nd or 3rd line treatment for advanced breast cancer) NICE CG81

BNF 8.1.5 Other antineoplastic drugs

Afatinib

Specialist/ Hospital prescribing only

Afatinib for treating epidermal growth factor receptor mutation-positive locally advanced or metastatic non-small-cell lung cancer NICE TA310

Amsacrine

Specialist/ Hospital prescribing only

  • Acute myeloid leukaemia
Atezolizumab 

Specialist/ Hospital prescribing only  

Atezolizumab for untreated locally advanced or metastatic urothelial cancer when cisplatin is unsuitableNICE TA492 

Bortezomib

Specialist/ Hospital prescribing only

Bortezomib monotherapy for relapsed multiple myeloma NICE TA129

Bortezomib and thalidomide for the first-line treatment of multiple myeloma NICE TA228

Bortezomib for induction therapy in multiple myeloma before high-dose chemotherapy and autologous stem cell transplantation NICE TA311

Bosutinib

Specialist/ Hospital prescribing only

Bosutinib for previously treated chronic myeloid leukaemia NICE TA400

Brentuximab

 

Specialist/ Hospital prescribing only

Brentuximab vedotin for treating CD30-positive Hodgkin lymphoma NICE TA446

Brentuximab vedotin for treating relapsed or refractory systemic anaplastic large cell lymphoma NICE TA478

Cabazitaxel

Specialist/ Hospital prescribing only

Cabazitaxel for hormone-relapsed metastatic prostate cancer treated with docetaxel NICE TA391

Carboplatin

Specialist/ Hospital prescribing only

  • Advanced ovarian cancer
  • Lung cancer
Ceritinib

Specialist/ Hospital prescribing only

Ceritinib for previously treated anaplastic lymphoma kinase positive non small- cell lung cancer NICE TA395

Cetuximab

Specialist/ Hospital prescribing only

Cetuximab for the treatment of locally advanced squamous cell cancer of the head and neck NICE TA145

Cetuximab for the first-line treatment of metastatic colorectal cancer NICE TA176

Cetuximab for treating recurrent or metastatic squamous cell cancer of the head and neck NICE TA473  

Cisplatin

Specialist/ Hospital prescribing only

  • Testicular, lung, cervical, bladder, head and neck and ovarian cancer
Crizotinib

Specialist/ Hospital prescribing only

Crizotinib for untreated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer NICE TA406

Crizotinib for previously treated anaplastic lymphoma kinase-positive advanced non-small-cell lung cancer NICE TA422  

Dabrafenib

Specialist/ Hospital prescribing only

Dabrafenib for treating unresectable or metastatic BRAF V600 mutation-positive melanoma NICE TA321

Dasatinib

Specialist/ Hospital prescribing only

Dasatinib, nilotinib and high-dose imatinib for treating imatinib-resistant or intolerant chronic myeloid leukaemia NICE TA425 

Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia NICE TA426 

Docetaxel

Specialist/ Hospital prescribing only

Docetaxel for non-small cell lung cancer NICE CG121

Docetaxel for the adjuvant treatment of early node-positive breast cancer NICE TA109

Docetaxel for the treatment of hormone-refractory metastatic prostate cancer NICE TA101

Eribulin

Specialist/ Hospital prescribing only

Eribulin for treating locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens NICE TA423  

Erlotinib

Specialist/ Hospital prescribing only

Erlotinib for non-small-cell lung cancer NICE TA162

Erlotinib for the first-line treatment of locally advanced or metastatic EGFR-TK mutation-positive non-small cell lung cancer NICE TA258

Everolimus

Specialist/ Hospital prescribing only

Everolimus with exemestane for treating advanced breast cancer after endocrine therapy NICE TA421 

Everolimus for advanced renal cell carcinoma after previous treatment NICE TA432 

Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease NICE TA449 

Gefitinib

Specialist/ Hospital prescribing only

Gefitinib for the first-line treatment of locally advanced or metastatic non-small-cell lung cancer NICE TA192

Hydroxycarbamide

Specialist/ Hospital prescribing only

  • Chronic myeloid leukaemia
  • Polycythaemia
Ibrutinib

Specialist/ Hospital prescribing only

Ibrutinib for previously treated chronic lymphocytic leukaemia and untreated chronic lymphocytic leukaemia with 17p deletion or TP53 mutation NICE TA429

Ibrutinib for treating Waldenstrom’s macroglobulinaemia NICE TA491 

Idelalisib

Specialist/ Hospital prescribing only

Idelalisib for treating chronic lymphocytic leukaemia NICE TA359

Imatinib

Specialist/ Hospital prescribing only

Imatinib for chronic myeloid leukaemia NICE TA70

Imatinib for the treatment of unresectable and/or metastatic gastro-intestinal stromal tumours NICE TA86: imatinib recommended first-line for management of people with KIT (CD117)-positive unresectable and/or metastatic GISTs. Doses above imatinib 400mg daily not recommended NICE TA209

Imatinib for the adjuvant treatment of gastrointestinal stromal tumours NICE TA326

Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia NICE TA426 

Ipilimumab 

Specialist/ Hospital prescribing only

Ipilimumab for previously treated advanced [unresectable or metastatic] melanoma NICE TA268

Nivolumab in combination with ipilimumab for treating advanced melanoma NICE TA400

Irinotecan

Specialist/ Hospital prescribing only

Irinotecan, oxaplatin and ralitrexed for advanced colorectal cancer NICE CG131

Pegylated liposomal irinotecan for treating pancreatic cancer after gemcitabine NICE TA440  

Nilotinib 

Specialist/ Hospital prescribing only

Recommended as an option under a patient access scheme onyl - see NICE Guidance (leukaemia - chronic myeloid, first line) NICE TA251

Dasatinib, nilotinib and high-dose imatinib for treating imatinib-resistant or intolerant chronic myeloid leukaemia NICE TA425 

Dasatinib, nilotinib and imatinib for untreated chronic myeloid leukaemia NICE TA426 

Nivolumab

Specialist/ Hospital prescribing only

Nivolumab for treating advanced (unresectable or metastatic) melanoma NICE TA384

Nivolumab in combination with ipilimumab for treating advanced melanoma NICE TA400 

Nivolumab for previously treated advanced renal cell carcinoma NICE TA417 

Nivolumab for treating relapsed or refractory classical Hodgkin lymphoma NICE TA462 

Nivolumab for previously treated squamous non-small-cell lung cancer NICE TA483 

Nivolumab for previously treated nonsquamous non-small-cell lung cancer NICE TA484 

Nivolumab for treating squamous cell carcinoma of the head and neck after platinum-based chemotherapy NICE TA490

Oxaliplatin

Specialist/ Hospital prescribing only

Irinotecan, oxaplatin and ralitrexed for advanced colorectal cancer) NICE CG131

Capecitabine and oxaliplatin in the adjuvant treatment of stage III (Dukes' C) colon cancer NICE TA100

Paclitaxel

Specialist/ Hospital prescribing only

Paclitaxel in the treatment of ovarian cancer NICE TA55

Paclitaxel, pegylated liposomal doxorubicin and topetecan for second-line or subsequent treatment of advanced ovarian cancer NICE TA91

Docetaxel, paclitaxel, gemcitabine and vinorelbine for non-small cell lung cancer NICE CG121

Paclitaxel as albumin-bound nanoparticles with gemcitabine for untreated metastatic pancreatic cancer NICE TA476

Palbociclib  

Specialist/ Hospital prescribing only

Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer NICE TA495 

Pazopanib  

Specialist/ Hospital prescribing only

Pazopanib for the first-line treatment of advanced renal cell carcinoma NICE TA215

Pegaspargase 

Specialist/ Hospital prescribing only

Pegaspargase for treating acute lymphoblastic leukaemia NICE TA408

Pembrolizumab

Specialist/ Hospital prescribing only

Pembrolizumab for untreated PDL1- positive metastatic non-small-cell lung cancer NICE TA447 

Pertuzumab 

Specialist/ Hospital prescribing only

Pertuzumab for the neoadjuvant treatment of HER2-positive breast cancer NICE TA424

Ponatinib  

Specialist/ Hospital prescribing only

Ponatinib for treating chronic myeloid leukaemia and acute lymphoblastic leukaemia NICE TA451 

Regorafenib

Specialist/ Hospital prescribing only

Regorafenib for previously treated unresectable or metastatic gastrointestinal stromal tumours NICE TA488 

Ribociclib 

Specialist/ Hospital prescribing only

Ribociclib with an aromatase inhibitor for previously untreated, hormone receptorpositive, HER2-negative, locally advanced or metastatic breast cancer NICE TA496  

Ruxolitinib

Specialist/ Hospital prescribing only

Ruxolitinib for treating disease-related splenomegaly or symptoms in adults with myelofifibrosis NICE TA386

Sorafenib

Specialist/ Hospital prescribing only 

Sorafenib for treating advanced hepatocellular carcinoma NICE TA474  

Sunitinib

Specialist/ Hospital prescribing only

Sunitinib for the first-line treatment of advanced and/or metastatic renal cell carcinoma  NICE TA169

Sunitinib for the treatment of gastrointestinal stromal tumours NICE TA179

Everolimus and sunitinib for treating unresectable or metastatic neuroendocrine tumours in people with progressive disease NICE TA449 

Talimogene laherparepvec

Specialist/ Hospital prescribing only

Talimogene laherparepvec for treating unresectable metastatic melanoma NICE TA410

Temozolomide

Specialist/ Hospital prescribing only

Temozolomide for the treatment of recurrent malignant glioma (brain cancer) NICE TA23

Carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma NICE TA121

Topotecan

Specialist/ Hospital prescribing only

Paclitaxel, pegylated liposomal doxorubicin and topetecan for second-line or subsequent treatment of advanced ovarian cancer NICE TA91

Topotecan for the treatment of recurrent and stage IVB cervical cancer NICE TA183

Topotecan for the treatment of relapsed small-cell lung cancer NICE TA184

Trabectedin

Specialist/ Hospital prescribing only

Trabectedin for the treatment of advanced soft tissue sarcoma NICE TA185

Trametinib

Specialist/ Hospital prescribing only

Trametinib in combination with dabrafenib for treating unresectable or metastatic melanoma NICE TA396 

Trastuzumab

Specialist/ Hospital prescribing only

Trastuzumab for the treatment of advanced breast cancer NICE TA34

Trastuzumab for the adjuvant treatment of early-stage HER2-positive breast cancer NICE TA107

Trastuzumab for the treatment of HER2-positive metastatic gastric cancer NICE TA208

Trastuzumab emtansine for treating HER2-positive advanced breast cancer after trastuzumab and a taxane NICE TA458 

Tretinoin

Specialist/ Hospital prescribing only

Induction of remission in acute promyelocytic leukaemia

Vemurafenib 

Specialist/ Hospital prescribing only

Vemurafenib for treating locally advanced or metastatic BRAF V600 mutation-positive malignant melanoma NICE TA269

Venetoclax

Specialist/ Hospital prescribing only

Venetoclax for treating chronic lymphocytic leukaemia NICE TA487  

BNF 8.2.1 Cytotoxic immunosuppressants

Azathioprine

Prescribed as part of a shared care agreement

Mycophenolate mofetil (Cellcept®)


Hospital/specialist only (no new shared care patients from May 2018)

Immunosuppressive therapy for renal transplantation in adults NICE TA85

Renal transplantation - immunosuppressive regimens for children and adolescents NICE TA99

Mycophenolic acid (Myfortic®)


Hospital/specialist only (no new shared care patients from May 2018)

Immunosuppressive therapy for renal transplantation in adults NICE TA85

Renal transplantation - immunosuppressive regimens for children and adolescents NICE TA99

BNF 8.2.2 Corticosteroids and other immunosuppressants

Basiliximab

Specialist/ Hospital prescribing only

For induction therapy in the prophylaxis of organ rejection in combination with a calcineurin inhibitor NICE TA85

Renal transplantation - immunosuppressive regimens for children and adolescents NICE TA99

Ciclosporin

Specialist/ Hospital prescribing only

Immunosuppressive therapy for renal transplantation in adults NICE TA85

Renal transplantation - immunosuppressive regimens for children and adolescents NICE TA99

Sirolimus

Hospital/specialist only (no new shared care patients from May 2018)

Immunosuppressive therapy for renal transplantation in adults NICE TA85

Renal transplantation - immunosuppressive regimens for children and adolescents NICE TA99

Tacrolimus

Hospital/specialist only (no new shared care patients from May 2018) 

Immunosuppressive therapy for renal transplantation in adults NICE TA85

Renal transplantation - immunosuppressive regimens for children and adolescents NICE TA99

BNF 8.2.3 Anti-lymphocyte monoclonal antibodies

Alemtuzumab Alemtuzumab for treating relapsing-remitting multiple sclerosis NICE TA312
Blinatumomab  Blinatumomab for previously treated Philadelphia-chromosome-negative acute lymphoblastic leukaemia NICE TA450 
Obinutuzumab Obinutuzumab with bendamustine for treating follicular lymphoma refractory to rituximab NICE TA472
Rituximab

Rituximab for the treatment of relapsed or refractory stage III or IV follicular non-Hodgkin's lymphoma NICE TA137

Rituximab for the first-line treatment of chronic lymphocytic leukaemia NICE TA174

Rituximab for the treatment of relapsed or refractory chronic lymphocytic leukaemia NICE TA193

Rituximab for the first-line maintenance treatment of follicular non-Hodgkin's lymphoma NICE TA226

Rituximab for the first-line treatment of stage III-IV follicular lymphoma NICE TA243

Rituximab for aggressive non-Hodgkins's lymphoma NICE TA65

BNF 8.2.4. Other immunomodulating drugs

Bacillus Calmette-Guerin
Specialist/ Hospital prescribing only OncoTICE® bladder instillation
Daclizumab 

Specialist/ Hospital prescribing only

Daclizumab for treating relapsing–remitting multiple sclerosis NICE TA441

 
Dimethyl fumarate

Specialist/ Hospital prescribing only

NICE Guidance (Dimethyl fumarate for treating relapsing-remitting multiple sclerosis) NICE TA320

 
Fingolimod 

Specialist/ Hospital prescribing only

NICE Guidance (multiple sclerosis [relapsing-remitting] - fingolimod) NICE TA254

Gilenya®

Interferon alfa

Specialist/ Hospital prescribing only

NICE Guidance (interferon alfa (pegylated and non-pegylated) and ribavirin for the treatment of chronic hepatitis C) NICE TA75

Interferon αlfa-2a (Roferon-A®)
Interferon αlfa-2b (Viraferon®; IntronA®)

Lenalidomide

Specialist/ Hospital prescribing only

NICE Guidance (lenalidomide for the treatment of multiple myeloma) NICE TA171

NICE guidance (lenalidomide for treating myelodysplastic syndromes associated with an isolated deletion 5q cytogenetic abnormality) NICE TA322

Revlimid®

Natalizumab 

Specialist/ Hospital prescribing only

NICE Guidance (natalizumab for the treatment of adults with highly active relapsing-remitting multiple sclerosis) NICE TA127

Tysabri®

Peginterferon alfa

Specialist/ Hospital prescribing only

NICE Guidance (adefovir dipivoxil and peginterferon alfa-2a for the treatment of chronic hepatitis B) NICE TA96


Peginterferon alfa-2b (Pegasys®; ViraferonPeg®)

Teriflunomide

Specialist/ Hospital prescribing only

NICE Guidance (teriflunomide for treating relapsing-remitting multiple sclerosis) NICE TA303

 
Thalidomide

Specialist/ Hospital prescribing only

NICE Guidance (Bortezomib and Thalidomide for the first-line treatment of multiple myeloma) NICE TA228

Thalidomide Celgene® 

BNF 8.3 Sex hormones and hormone antagonists in malignant disease

BNF 8.3.1 Oestrogens

Diethylstilbestrol

 

Previously known as stilboestrol

Ethinylestradiol

 

Use in palliative care

BNF 8.3.2 Progestogens

Medroxyprogesterone acetate
Megestrol acetate
Norethisterone

BNF 8.3.4.1 Breast Cancer

Anastrozole

NICE Guidance (Breast Cancer (early)- hormonal therapies) NICE TA112

Exemestane

NICE Guidance (Breast Cancer (early)- hormonal therapies) NICE TA112 Everolimus with exemestane for treating advanced breast cancer after endocrine therapy NICE TA421

Fulvestrant 

Specialist/ Hospital prescribing only

250mg into each buttock (total doe 500mg) by deep IM injection once a month. Approved by Cancer Drug Fund but is not recommended by NICE TA239

Letrozole

Prescribed as part of a shared care agreement
NICE Guidance (Breast Cancer (early)- hormonal therapies) NICE TA112

Tamoxifen

The CMS advise that tamoxifen in a dose of 20mg daily substantially increases survival in early breast cancer and that no further benefit has been demonstrated with higher doses. Patients should be told of the small risk of endometrial cancers (see BNF for details) and encouraged to report relevant symptoms early. The benefits of treatment far outweigh the risks.

BNF 8.3.4.2 Prostate cancer and gonadorelin analogues

Anti-androgens

Bicalutamide, cyproteroneand flutamide are used to cover tumour “flare” associated with initial gonadorelin analogue administration. Treatment should start 3 days before gonadorelin analogue administration and continue for 3 weeks.

Abiraterone acetate

Hospital prescribing only

For metastatic castration-resistant prostate cancer, prescribed in accordance with NICE TA259

Abiraterone for treating metastatic hormone-relapsed prostate cancer before chemotherapy is indicated NICE TA387 

Bicalutamide

Prescribed as part of a shared care agreement

Cyproterone

 
Enzalutamide

Hospital prescribing only

Enzalutamide for metastatic hormone-relapsed prostate cancer previously treated with a docetaxel-containing regimen NICE TA315

Enzalutamide for metastatic hormone-relapsed prostate cancer before chemotherapy is indicated NICE TA377

Flutamide

 
Gonadotrophin-Releasing Hormone Antagonists 
Degarelix

Hospital Prescribing Only.
Treating advanced hormone-dependent prostate cancer, only in adults with spinal metastases who present with signs or symptoms of spinal cord compression. 

Degarelix for treating advanced hormone-dependent prostate cancer NICE TA404

Gonadorelin Analogues

Triptorelin injection

1st line - suitable for prescribing in primary care following specialist/hospital initiation

Leuprorelin injection 2nd line - suitable for prescribing in primary care following specialist/hospital initiation

Goserelin injection

3rd line - suitable for prescribing in primary care following specialist/hospital initiation

BNF 8.3.4.3 Somatostatin analogues

Octreotide

 

Specialist/ Hospital prescribing only

Hospital do not stock depot preparation