Drugs requiring initiation by a specialist, but with the potential to transfer to primary care, within written and agreed shared care frameworks, and according to the agreed process for transfer of care. Transfer to primary care is expected to be the normal practice. Those drugs:
- Requiring short or medium term specialist monitoring of efficacy
- Requiring short or medium term specialist monitoring of toxicity
- Requiring specialist assessment to enable patient selection
If the general practitioner is unwilling to accept the responsibility for prescribing the amber drug, then the consultant should be informed within one week of receipt of the framework. In such cases the GP must provide information to the consultant of all medical information regarding the patient and any changes to the patient’s medication irrespective of indication.
- SCFs approved by Humber Area Prescribing Committee are found on the Humber APC webpage (Humber APC Guidance – Humber Area Prescribing Committee (northernlincolnshireapc.nhs.uk))
- Currently Humber APC have approved SCFs for Dementia, Ibandronate in post-menopausal women with breast cancer, Ibandronate for metastatic bone disease, Lithium in cluster headache, Modafinil, Riluzole, Amiodaron and Verapamil for cluster headache.
Documents marked with an (*) require review. Please contact a specialist for further information.
Documents marked with (**) are valid until January 2022 as approved by HERPC May 2021.
| Drug Name | BNF Classification and Indication |
|---|---|
| Acamprosate | Alcohol withdrawal |
| Anastrazole | Chemoprevention of Familial Breast Cancer |
| Apomorphine | Dopaminergic drug - Parkinson's disease |
| Atomoxetine | Treatment of ADHD |
| Azathioprine and 6-mercaptopurine | Inflammatory Bowel Disease |
| Azathioprine** | Immunosuppression |
| Ciclosporin for Immunosuppression** | Immunosuppression in adults |
| Ciclosporin in Renal Transplant | Renal |
| Cinacalcet | Secondary hyperparathyroidism in end stage Renal disease |
| Degarelix | Treatment of adult male patients with advanced hormone-dependent prostate cancer |
| Dementia Medicines | Treatment and management of dementia |
| Denosumab | Primary and secondary prevention of osteoporotic fractures in postmenopausal women |
| Dexamphetamine | Treatment of ADHD |
| Disulfiram | Alcohol Relapse Prevention |
| Erythropoetin | Renal Anaemia |
| Fulvestrant | Breast Cancer |
| Grazax | Treatment of grass pollen allergies |
| Guanfacine | Attention Deficit Hyperactivity Disorder |
| Hydroxychloroquine | DMARD and immunosupression* |
| Isocarboxazid | Treatment of depressive illness |
| Leflunomide** | Disease modifying anti-rheumatic drug |
| Liothyronine | Hypothyroidism |
| Lisdexamfetamine | Attention Deficity Hyperactivity Disorder |
| Lithium | Affective disorders |
| Melatonin | Sleep disorders |
| Methotrexate for Immunosuppression** | Immunosuppression |
| Methylphenidate | Treatment of ADHD |
| Mycophenolate Mofetil | Immunosuppression |
| Mycophenolate Mofetil or Mycophenolic Acid (Myfortic) Post Solid Organ Transplant | Post renal transplant |
| Naltrexone in Alcohol Relapse Prevention | Alcohol relapse prevention |
| Naltrexone in Relapse Prevention (Opioid Dependence) | Treatment of narcotic addiction |
| Penicillamine** | Disease-modifying anti-rheumatic drug - rheumatoid arthritis |
| Phenelzine | Treatment of depressive illness |
| Raloxifiene | Chemoprevention of famillial breast cancer |
| Sandostatin Analogues | Management of High Output Stoma (Off label Use) |
| Sirolimus | Immunosuppressant post renal transplant |
| Sodium Aurothiomalate (Gold Injection) in Rheumatoid Arthritis** | Disease-modifying anti-rheumatic drug - rheumatoid arthritis |
| Sulphasalazine** | DMARD and immunosupression |
| Tacrolimus | Immunosuppression post transplant |
| Tamoxifen | Chemoprevention of familial breast cancer |
| Testosterone | Treatment of male hypogonadism and menopausal symptoms in women |
| Tranylcypromine | Treatment of depressive illness |