SACT (Systemic anticancer therapy)

ABEMACICLIB

Important: Therapy notes

MHRA advice: CDK4/6 inhibitors (abemaciclib, palbociclib, ribociclib): reports of interstitial lung disease and pneumonitis, including severe cases  (June 2021) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Tablets 50mg, 100mg, 150mg 

Dosage:

See SMC advice 2179.

ABIRATERONE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 500mg (specialist use only)

Dosage:

1000mg once daily continued until disease progression or unacceptible toxicity
See SMC advice 2215.

ACALABRUTINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Hard capsules 100mg (hospital use only)

Dosage:

See SMC advice 2346, 2347 and 2348.

Notes:

Homecare is the preferred option - contact nhsh.homecare@nhs.scot

AFATINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 20mg, 30mg, 40mg, 50mg (specialist use only)

Dosage:

See SMC advice 920/13.

AFLIBERCEPT

Important: Therapy notes

MHRA advice: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection (July 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 25mg/mL (specialist use only)

Dosage:

See SMC advice 878/13.

ALECTINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Capsules 150mg (specialist use only)

Dosage:

See SMC advice 2012.

AMSACRINE

Important: Therapy notes

Important: Formulation

Injection 50mg/mL unlicensed

ARSENIC TRIOXIDE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 1mg/ml (specialist use only)

Dosage:

See SMC advice 2181.

ASCIMINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets film-coated 20mg, 40mg (hospital use only)

Dosage:

See SMC advice 2482.

ATEZOLIZUMAB

Important: Therapy notes

MHRA advice: Atezolizumab (Tecentriq) and other immune-stimulatory anti-cancer drugs: risk of severe cutaneous adverse reactions (SCARs) (June 2021) (www.gov.uk).

Risk minimisation materials

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 840mg, 1,200mg (hospital use only)

Dosage:

See SMC advice 23792349 and 2492.

AXITINIB

Important: Therapy notes

MHRA advice: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection (July 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Tablets 1mg, 5mg (specialist use only)

Dosage:

See SMC advice 855/13.  For use after failure of prior treatment with sunitinib or pazopanib off-label or a cytokine.

AZACITIDINE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Powder for suspension for injection 100mg

Dosage:

See SMC advice 589/09.

BENDAMUSTINE

Important: Therapy notes

Also for selected patients with indolent (FCC, MCL, MZL, SLL, LPC) non-Hodgkin’s lymphoma.
MHRA advice: Bendamustine (Levact): increased risk of non-melanoma skin cancer and progressive multifocal encephalopathy (PML) (March 2021) (www.gov.uk).
MHRA advice: Bendamustine (Levact): increased mortality observed in recent clinical studies in off-label use; monitor for opportunistic infections, hepatitis B reactivation (July 2017) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Powder for concentrate for solution for infusion 25mg, 100mg (specialist use only)

Dosage:

See SMC advice 694/11.

BEVACIZUMAB

Important: Therapy notes

MHRA advice: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection (July 2020) (www.gov.uk).
MHRA advice: Bevacizumab and sunitinib: risk of osteonecrosis of the jaw (December 2014) (www.gov.uk).
MHRA advice: Bevacizumab (Avastin): hypersensitivity and infusion reactions (December 2014) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Solution for infusion 25mg/mL (specialist use only)

Dosage:

See SMC advice 878/13, 1135/16.

BLEOMYCIN

Important: Therapy notes

Important: Formulation

Powder for solution for injection 15,000 units (specialist use only)

BORTEZOMIB

Important: Therapy notes

For administration by subcutaneous or intravenous injection.

Important: Formulation and dosage details

Formulation:

Powder for solution for injection 3·5mg (specialist use only)

Dosage:

See SMC advice 126/04, 302/06, 822/12, 927/13, 1075/15.

BOSUTINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 100mg, 500mg (specialist use only)

Dosage:

See SMC advice 910/13.

BRENTUXIMAB VEDOTIN

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Powder for concentrate for solution for infusion 50mg (hospital use only)

Dosage:

See SMC advice 845/122229 and 2310.

BRIGATINIB

Important: Therapy notes


Risk minimisation materials

Important: Formulation and dosage details

Formulation:

Tablets 30mg, 90mg, 180mg (hospital use only)

Dosage:

See SMC advice 2147 and 2314.

BUSULFAN

Important: Therapy notes

Important: Formulation

Tablets 2mg (specialist use only)

CABAZITAXEL

Important: Therapy notes

MHRA advice: Cabazitaxel (Jevetana): risk of medication error resulting in overdose (December 2014) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 40mg/mL (specialist use only)

Dosage:

See SMC advice 735/11.

CABOZANTINIB

Important: Therapy notes

MHRA advice: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection (July 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Tablets 20mg, 40mg, 60mg (specialist use only)

Dosage:

As per SMC advice 1234/17  and SMC advice 2386.

CALCIUM FOLINATE

Important: Formulation

Tablets 15mg (specialist use only)

CAPECITABINE

Important: Therapy notes

MHRA advice: 5-fluorouracil (intravenous), capecitabine, tegafur: DPD testing recommended before initiation to identify patients at increased risk of severe and fatal toxicity (October 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Tablets 150mg, 500mg (specialist use only)

Dosage:

See SMC advice 34/03, 193/05, 401/07, 507/08 and NICE guidance TA61, CG81, TA100.

CAPLACIZUMAB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Powder and solvent for solution for injection 10mg (specialist use only)

Dosage:

See SMC advice 2266.

CARBOPLATIN

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 10mg/mL (specialist use only)

Dosage:

See NICE guidance CG121.

CARFILZOMIB

Important: Therapy notes

MHRA advice: Carfilzomib (Kyprolis): risk of reactivation of hepatitis B virus (November 2019) (www.gov.uk).
MHRA advice: Carfilzomib (Kyprolis): reminder of risk of potentially fatal cardiac events (August 2019) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Powder for solution for infusion 10mg, 30mg, 60mg (specialist use only)

Dosage:

See SMC advice 1242/17 and 2290.

CERITINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Capsules 150mg (specialist use only)

Dosage:

See SMC advice 1097/15.

CETUXIMAB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Solution for infusion 5mg/mL (specialist use only)

Dosage:

See SMC advice 155/05, 279/06, 543/09, 1012/14.

CHLORAMBUCIL

Important: Therapy notes

Important: Formulation

Tablets 2mg (specialist use only)

CISPLATIN

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 1mg/mL (specialist use only)

Dosage:

See NICE guidance NG122.

CLADRIBINE

Important: Therapy notes

MHRA advice: Cladribine (Mavenclad): new advice to minimise risk of serious liver injury (March 2022) (www.gov.uk).

Risk minimisation materials

Important: Formulation and dosage details

Formulation:

Solution for subcutaneous injection 2mg/mL (specialist use only)

Dosage:

See SMC advice 537/09.

CRISANTASPASE

Important: Therapy notes

Crisantaspase is the enzyme asparaginase produced by Erwinia chrysanthemi.

Important: Formulation

Powder for solution for injection 10,000 units (specialist use only)

CRIZOTINIB

Important: Therapy notes

MHRA advice: Cirzotinib (Xalkori): risk of cardiac failure (November 2015) (www.gov.uk).

Risk minimisation materials

Important: Formulation and dosage details

Formulation:

Capsules 200mg, 250mg (specialist use only)

Dosage:

See SMC advice 865/13, 1152/16.

CYCLOPHOSPHAMIDE

Important: Therapy notes

Important: Formulation

Tablets 50mg (specialist use only)

Important: Formulation

Powder for solution for injection 1 gram (specialist use only)

CYTARABINE

Important: Therapy notes

MHRA advice: Liposomal and lipid-complex formulations: name change to reduce medication errors (July 2020) (www.gov.uk).

Important: Formulation

Intrathecal injection 20mg/mL (specialist use only) 

Important: Formulation

Injection 100mg/mL (specialist use only)

DABRAFENIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Capsules 50mg, 75mg (specialist use only)

Dosage:

See SMC advice 1023/15.

DACARBAZINE

Important: Therapy notes

Important: Formulation

Injection 200mg, 500mg (specialist use only)

DACOMITINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 15mg, 30mg and 45mg (specialist use only)

Dosage:

45mg once daily until disease progression or toxicity.
See SMC advice 2184.

DACTINOMYCIN

Important: Formulation

Powder for solution for injection 500 micrograms (specialist use only)

DARATUMUMAB

Important: Therapy notes

MHRA advice: Daratumumab (Darzalex): risk of reactivation of hepatitis B virus  (August 2019) (www.gov.uk).

Risk minimisation materials

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 20mg/mL (specialist use only)

Dosage:

See SMC advice 1205/17 and 2302.

Important: Formulation and dosage details

Formulation:

Solution for injection 120mg/mL (15mL) (hospital use only)

Dosage:

See SMC advice 2447.

DAROLUTAMIDE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 300mg (specialist use only)

Dosage:

See SMC advice 2297.

DASATINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 20mg, 50mg, 80mg, 100mg, 140mg (specialist use only)

Dosage:

See SMC advice 370/07.

DAUNORUBICIN

Important: Therapy notes

MHRA advice: Liposomal and lipid-complex formulations: name change to reduce medication errors (July 2020) (www.gov.uk).

Important: Formulation

Powder for solution for infusion 20mg (specialist use only)

DISODIUM FOLINATE

Important: Formulation

Injection 50mg/mL (specialist use only)

DOCETAXEL

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 20mg/mL (specialist use only)

Dosage:

See NICE guidance CG81, TA101, NG101,  NG121.

DOSTARLIMAB

Important: Therapy notes

Risk minimisation materials

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 500mg (hospital use only)

Dosage:

See SMC advice 2404.

DOXORUBICIN

Important: Therapy notes

MHRA advice: Liposomal and lipid-complex formulations: name change to reduce medication errors. (July 2020) (www.gov.uk).

Important: Formulation

Solution for injection 2mg/mL (specialist use only)

DOXORUBICIN, PEGYLATED LIPID FORMULATION

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 2mg/mL (Caelyx pegylated-liposomal®) (specialist use only)

Dosage:

See SMC advice 84/03 and NICE guidance TA389.

ENCORAFENIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Capsules 50mg, 75mg (hospital use only)

Dosage:

450mg once daily plus binimetanib 45mg twice daily
See SMC advice 2238 and 2312.

ENTRECITINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Capsules 100mg, 200mg (hospital use only)

Dosage:

See SMC advice 2294 and 2295.

EPIRUBICIN

Important: Therapy notes

Important: Formulation

Solution for infusion 2mg/mL (specialist use only)

ERIBULIN

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Solution for injection 0·44mg/mL (specialist use only)

Dosage:

See SMC advice 1065/15.

ERLOTINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 100mg, 150mg (specialist use only)

Dosage:

See SMC advice 220/05.

ETOPOSIDE

Important: Therapy notes

Important: Formulation

Capsules 50mg, 100mg (specialist use only)

Important: Formulation

Concentrate for solution for infusion 20mg/mL (specialist use only)

EVEROLIMUS

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 2·5mg, 5mg, 10mg (hospital use only)

Dosage:

See SMC advice 595/10, 872/13

FEDRATINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Capsules 100mg (hospital use only)

Dosage:

See SMC advice 2462.

FLUDARABINE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 10mg (specialist use only)

Dosage:

See SMC advice 176/05 and NICE guidance TA29.

Important: Formulation and dosage details

Formulation:

Powder for solution for injection or infusion 50mg (specialist use only)

Dosage:

See SMC advice 176/05 and NICE guidance TA29.

FLUOROURACIL

Important: Therapy notes

MHRA advice: 5-fluorouracil (intravenous), capecitabine, tegafur: DPD testing recommended before initiation to identify patients at increased risk of severe and fatal toxicity (October 2020) (www.gov.uk).

Important: Formulation

Solution for infusion 25mg/mL, 50mg/mL (specialist use only)

Important: Formulation

Cream 5% (specialist use only)

FOSTAMATINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets, film coated 100mg, 150mg (hospital use only)

Dosage:

As per SMC advice 2300.

FULVESTRANT

Important: Therapy notes


Important: Formulation and dosage details

Formulation:

Solution for injection 250mg (specialist recommendation or initiation only)

Dosage:

For use as monotherapy see SMC advice 114/04.
For use with palbociclib (SMC advice 2149) see fulvestrant shared care protocol.

GEMCITABINE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 200mg, 1 gram (specialist use only)

Dosage:

See SMC advice 154/05 and NICE guidance NG85, NG122

GEMTUZUMAB OZOGAMICIN

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Powder for concentrate for solution for infusion 5mg (specialist use only)

Dosage:

See SMC advice 2089.

GILTERITINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets film-coated 40mg (hospital use only)

Dosage:

See SMC advice 2252.

HYDROXYCARBAMIDE

Important: Therapy notes


Risk minimisation materials

Important: Formulation

Capsules 500mg (specialist use only)

Important: Formulation and dosage details

Formulation:

Oral solution 100mg/mL (hospital use only)

Dosage:

See SMC advice 2271.

IBRUTINIB

Important: Therapy notes

MHRA advice: Ibrutinib (Imbruvica) reports of ventricular tachyarrhythmia; risk of hepatitis B reactivation and or opportunistic infections (August 2017) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Capsules 140mg (specialist use only)

Dosage:

Homecare is the preferred option - contact  nhsh.homecare@nhs.scot
See SMC advice 1150/16, 1151/16.

IDARUBICIN

Important: Therapy notes

Important: Formulation

Capsules 5mg, 10mg (specialist use only)

Important: Formulation

Powder for solution for injection 10mg (specialist use only)

IDELALISIB

Important: Therapy notes

MHRA advice: Idelalisib (Zydelig): updated indications and advice on minimising the risk of infection (September 2016) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Tablets 100mg, 150mg (specialist use only)

Dosage:

See SMC advice 1026/15, 1039/15.

IFOSFAMIDE

Important: Therapy notes

Important: Formulation

Powder for concentrate for solution for injection 1 gram, 2 grams (specialist use only)

IMATINIB

Important: Therapy notes

For use in adult patients with Philadelphia chromosome-positive acute lymphoblastic leukaemia (Ph+ALL).

Important: Formulation and dosage details

Formulation:

Tablets 100mg, 400mg (specialist use only)

Dosage:

See SMC advice 01/02, 08/02, 26/02, 584/09 and NICE guidance TA70, TA86.

IRINOTECAN

Important: Therapy notes

MHRA advice: Liposomal and lipid-complex formulations: name change to reduce medication errors (July 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 20mg/mL (specialist use only)

Dosage:

See NICE guidance CG131.

ISATUXIMAB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 20mg/ml (specialist use only)

Dosage:

See SMC advice 2303.

LENVATINIB

Important: Therapy notes

MHRA advice: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection (July 2020) (www.gov.uk).


Important: Formulation and dosage details

Formulation:

Capsules 4mg, 10mg (specialist use only)

Dosage:

See SMC advice 1179/16 and 2199.

LIPOSOMAL DAUNORUBICIN AND CYTARABINE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Powder for concentrate for solution for infusion 44mg/100mg (specialist use only)

Dosage:

See SMC advice 2130.

LOMUSTINE

Important: Therapy notes

Important: Formulation

Capsules 40mg (specialist use only)

LORLATINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 25mg, 100mg (hospital use only)

Dosage:

See SMC advice 2239 and 2415.

MELPHALAN

Important: Therapy notes

Important: Formulation

Tablets 2mg (specialist use only)

MERCAPTOPURINE

Important: Therapy notes

Important: Formulation

Tablets 50mg (specialist use only)

Important: Formulation and dosage details

Formulation:

Oral suspension 100mg/mL (specialist use only)

Dosage:

See SMC advice 798/12.

MESNA

Important: Therapy notes

Important: Formulation

Tablets 400mg (specialist use only)

Important: Formulation

Solution for injection 100mg/mL (specialist use only)

METHOTREXATE

Important: Therapy notes

MHRA advice: Methotrexate once-weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing (September 2020) (www.gov.uk).

Risk minimisation materials

Important: Formulation

Oral solution 10mg/5mL specialist use only)

Important: Formulation

Solution for injection 25mg/mL, 100mg/mL (specialist use only)

Important: Formulation

Intrathecal injection 50mg/2mL (specialist use only)

MIDOSTAURIN

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 50mg (specialist use only)

Dosage:

See SMC advice 1330/18.

MITOMYCIN

Important: Therapy notes

Mitomycin 40mg is given as a bladder instillation.  

Important: Formulation

Powder for solution for injection 10mg, 20mg, 40mg (specialist use only)

MITOXANTRONE

Important: Therapy notes

Important: Formulation

Concentrate for solution for infusion 2mg/mL (specialist use only)

NILOTINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Capsules 150mg, 200mg (specialist use only)

Dosage:

See SMC advice 440/08, 709/11.

NINTEDANIB

Important: Therapy notes

MHRA advice: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection (July 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Capsules (Vargetef®) 100mg, 150mg (specialist use only)

Dosage:

See SMC advice 1027/15.

NIRAPARIB

Important: Therapy notes

MHRA advice: Niraparib (Zejula): reports of severe hypertension and posterior reversible encephalopathy syndrome (PRES), particularly in early treatment (October 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Capsules 100mg (hospital use only)

Dosage:

See SMC advice 1341/81SMC2338

OBINUTUZUMAB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 25mg/mL

Dosage:

See SMC advice 1008/14.

OLAPARIB

Important: Therapy notes


Important: Formulation and dosage details

Formulation:

Capsules 50mg (specialist use only)

Dosage:

See SMC advice 1047/15.

Important: Formulation and dosage details

Formulation:

Film-coated tablets 100mg, 150mg (hospital use only)

Dosage:

See SMC advice 2209 and 23662367 and 2368.

OSIMERTINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 40mg, 80mg (hospital use only)

Dosage:

See SMC advice 1214/17.
See SMC advice 2382 and 2383.

Important: Formulation

Film-coated tablets 40mg, 80mg (hospital use only)

OXALIPLATIN

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 5mg/mL (specialist use only)

Dosage:

See SMC advice 211/05 and NICE guidance CG131, TA100.

PACLITAXEL

Important: Therapy notes

MHRA advice: Paclitaxel formulations (conventional and nab-paclitaxel): caution required due to potential for medication error (January 2022) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 6mg/mL (specialist use only)

Dosage:

See NICE guidance CG81, TA55, TA389, NG101, NG122.

PALBOCICLIB

Important: Therapy notes

MHRA advice: CDK4/6 inhibitors (abemaciclib, palbociclib, ribociclib): reports of interstitial lung disease and pneumonitis, including severe cases  (June 2021) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Capsules 75mg, 100mg, 125mg (specialist use only)

Dosage:

See SMC advice 1276/17 and 2144.

PANITUMUMAB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Concentrate for intravenous infusion 20mg/mL (specialist use only)

Dosage:

See NICE MTA 439.

PANOBINOSTAT

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Capsules 10mg, 15mg, 20mg (specialist use only)

Dosage:

See SMC advice 1122/16.

PAZOPANIB

Important: Therapy notes

MHRA advice: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection (July 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Tablets 200mg, 400mg (specialist use only)

Dosage:

See SMC advice 676/11.

PEMIGATINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 4.5mg, 9mg, and 13.5mg (hospital use only)

Dosage:

See SMC advice 2399.

PEMETREXED

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Injection, powder for concentrate for solution for infusion 100mg, 500mg (specialist use only)

Dosage:

See SMC advice 192/05, 268/06, 342/07, 531/09, 770/12.

PENTOSTATIN

Important: Therapy notes

Important: Formulation

Powder for solution for injection 10mg (specialist use only)

PERTUZUMAB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Solution for infusion 420mg (specialist use only)

Dosage:

See SMC advice 2119 and 2284.

PERTUZUMAB WITH TRASTUZUMAB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Solution for injection (Phesgo) 600mg/600mg, 1200mg/600mg (specialist use only)

Dosage:

See SMC advice 2364.

POLATUZUMAB VEDOTIN

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Powder for concentrate for solution for infusion 140mg (hospital use only)

Dosage:

See SMC advice 2282.

PONATINIB

Important: Therapy notes

MHRA advice: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection (July 2020) (www.gov.uk).
MHRA advice: Ponatinib (Iclusig): reports of posterior reversible encephalopathy syndrome (October 2018) (www.gov.uk).
MHRA advice: Ponatinib (Iclusig): risk of vascular occlusive events - updated advice on possible dose reduction (April 2017) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Tablets 15mg, 45mg (specialist use only)

Dosage:

See SMC advice 1032/15.

PROCARBAZINE

Important: Therapy notes

Important: Formulation

Capsules 50mg (specialist use only)

RADIUM-223 DICHLORIDE

Important: Therapy notes

MHRA advice: Radium-223 dichloride (Xofigo): new restrictions on use due to increased risk of fracture and trend for increased mortality seen in clinical trial (September 2018) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Solution for injection 1,000kBq/mL (specialist use only)

Dosage:

See SMC advice 1077/15.

RALTITREXED

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Powder for solution for infusion 2mg (specialist use only)

Dosage:

See NICE guidance CG131.

REGORAFENIB

Important: Therapy notes

MHRA advice: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection (July 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Tablets 40mg (specialist use only)

Dosage:

See SMC advice 1031/15.

RIBOCICLIB

Important: Therapy notes

MHRA advice: CDK4/6 inhibitors (abemaciclib, palbociclib, ribociclib): reports of interstitial lung disease and pneumonitis, including severe cases  (June 2021) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Tablets 200mg (specialist use only)

Dosage:

600mg once daily for 3 weeks, repeat every 28 days
See SMC advice 1295/18.

RUCAPARIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 200mg, 250mg, 300mg (specialist use only)

Dosage:

See SMC advice 2224.

RUXOLITINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 5mg, 10mg, 15mg, 20mg (specialist use only)

Dosage:

See SMC advice 867/13 and 2213.

SACITUZUMAB GOVITECAN

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Powder for concentrate for solution for infusion 180mg (hospital use only)

Dosage:

See SMC advice 2446.

SELPERCATINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Capsules 40mg and 80mg (hospital use only)

Dosage:

See SMC advice 2370.

SORAFENIB

Important: Therapy notes

MHRA advice: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection (July 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Tablets 200mg (specialist use only)

Dosage:

See SMC advice 482/08.

SOTORASIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Film-coated tablets 120mg (hospital use only)

Dosage:

See SMC advice 2443.

SUNITINIB

Important: Therapy notes

MHRA advice: Systemically administered VEGF pathway inhibitors: risk of aneurysm and artery dissection (July 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Capsules 12·5mg, 25mg, 50mg (specialist use only)

Dosage:

See SMC advice 275/06 and NICE guidance TA169.

TEGAFUR WITH GIMERACIL WITH OTERACIL

Important: Therapy notes

MHRA advice: 5-fluorouracil (intravenous), capecitabine, tegafur: DPD testing recommended before initiation to identify patients at increased risk of severe and fatal toxicity (October 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Capsules (Teysuno®) 15mg/4·35mg/11·8mg, 20mg/5·8mg/15·8mg (specialist use only)

Dosage:

See SMC advice 802/12.

TEMOZOLOMIDE

Important: Therapy notes

MHRA advice: Temozolomide: risk of hepatic injury, including fatal hepatic failure - updated warnings and monitoring guidance (December 2014) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Capsules 5mg, 20mg, 100mg, 250mg (specialist use only)

Dosage:

See SMC advice 244/06 and NICE guidance TA23.

TOPOTECAN

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Powder for concentrate for solution for infusion 1mg (specialist use only)

Dosage:

See NICE guidance TA389.

TRABECTEDIN

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Powder for concentrate for solution for infusion 0·25mg, 1mg (specialist use only)

Dosage:

See SMC advice 2283.

TRAMETINIB

Important: Therapy notes

MHRA advice: Trametinib (Mekinist): risk of gastrointestinal perforation and colitis (March 2016) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Tablets 500 micrograms, 2mg (hospital use only)

Dosage:

See SMC advice 1161/16 and 2328.

TRASTUZUMAB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Solution for subcutaneous injection 600mg (specialist use only)

Dosage:

See SMC advice 278/06, 623/10, 928/13, and NICE guidance TA34, NG101.

TRASTUZUMAB DERUXTECAN

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Powder for concentrate for solution for infusion 100mg (hospital use only)

Dosage:

See SMC advice 2388.

TRASTUZUMAB EMTANSINE

Important: Therapy notes


Risk minimisation materials

Important: Formulation and dosage details

Formulation:

Powder for concentrate for solution for infusion 100mg, 160mg (specialist use only)

Dosage:

See SMC advice 990/14 and 2298 and NICE guidance TA458.

TRETINOIN

Important: Therapy notes

Important: Formulation

Capsules 10mg (specialist use only)

TRIFLURIDINE AND TIPIRACIL

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets (Lonsurf®) 15mg/6·14mg, 20mg/8·19mg (hospital use only)

Dosage:

See SMC advice 1221/17 and 2329.

TUCATINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Tablets 50mg, 150mg (hospital use only)

Dosage:

See SMC advice 2398.

VEMURAFENIB

Important: Therapy notes

MHRA advice: Vemurafenib (Zelboraf(: risk of potentiation of radiation toxicity (November 2015) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Tablets 240mg (specialist use only)

Dosage:

See SMC advice 792/12.

VENETOCLAX

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Film-coated tablets 10mg, 50mg, 100mg (hospital use only)

Dosage:

See SMC advice 1249/17, 2166, 2293 and 2412.

VINBLASTINE

Important: Therapy notes

Important: Formulation

Solution for injection 10mg (specialist use only)

VINCRISTINE

Important: Therapy notes

Important: Formulation

Solution for injection 1mg/ml (specialist use only)

VINDESINE

Important: Therapy notes

Important: Formulation

Powder for solution for injection 5mg (specialist use only)

VINORELBINE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Capsules 20mg, 30mg (specialist use only)

Dosage:

See SMC advice 179/05, 324/06 and NICE guidance CG81.

Important: Formulation and dosage details

Formulation:

Concentrate for solution for infusion 10mg/mL (specialist use only)

Dosage:

See NICE guidance CG81.

ZANUBRUTINIB

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Capsules 80mg (hospital use only)

Dosage:

See SMC advice 2528.