SHARED CARE GUIDELINES (SCG)
September 2014
For any drug listed the status will be red if using for an unlicensed indication unless the
indication is specifically mentioned below. Expired SCGs may be used at the
discretion/risk of the responsible prescriber.
Drugs marked ** differ from the GMMMG overarching RAG list.
Drug (proprietary
examples)
Acamprosate
Agomelatine**
Indications & Rationale
Expiry date
Maintenance of alcohol abstinence
Adults with major depressive
disorder where therapy initiated
before July 2011 when NICE gave a
negative assessment
Antibiotics – nebulised Colomycin®,
Expired but
drug is only
to be used
for preexisting
patients
September
2015
Guideline
(if available)
Red as no SCP
provided to
SCCG
Pennine 3346
Agomelatine for the treatment of major d
Colomycin SCP. Sep
13.pdf
Promixin®,
Antipsychotic
injections
(Schizophrenia)
Tobramycin - Tobi® Podhaler
Only for those patients under the
care of a community psychiatric
nurse.
Apomorphine injection
Parkinson’s disease
Red as no SCP
provided to
SCCG
Expired
antipsychotics
including LA injections
Expired
Apomorphine
Oct2011.pdf
Atomoxetine
ADHD (Adults and children over 6)
Specialist to initiate and only
request SCP when patient is on a
stable dose >3 months
Expired
Atomoxetine_in_child
_and_adolescent_ADHD_May_2012.pdf
Methylphenidate_an
d_atomoxetine_in_Adult_ADHD_Version_
Atypical
Antipsychotics (oral)
Use in dementia patients. Specialist
initiation and follow up required.
In
development
Atypical
antipsychotics (oral)
except clozapine
which is RED
Licensed indications (including
Aripiprazole) and unlicensed
indications as recommended by
NICE (i.e. psychotic depression or
anxiety in bipolar disorder)
Expired
Red as no SCP
approved by
SCCG
Antipsychotics SCP
Pennine
Azathioprine
Autoimmune disease (licensed) or
for maintenance therapy in
inflammatory bowel diseases
(unlicensed)
or
severe refractory eczema
(unlicensed)
or
Rheumatoid Arthritis -
April 2016
SCP Azathioprine
and Mercaptopurine.v1 Apr 14.pdf
No SCP
Expired
Azathioprine.pdf
Ciclosporin
Licensed indications
Rheumatoid Arthritis
Expired
Ciclosporin in RA.pdf
Cinacalcet
Dalteparin
Deferasirox
Denosumab
Other licensed indications
Transplant rejection
Atopic dermatitis or psoriasis
Nephrotic syndrome
NB Unlicensed use in ulcerative
colitis is RED
Primary hyperparathyroidism
NB For secondary
hyperparathyroidism the drug is
RED
See also Low Molecular weight
heparins
Christie SCP can be used by any
Trust for Cancer patients
Licensed indications only
For osteoporosis in post
menopausal women-Use 60mg/ml
All other
indications Red
as no SCP
provided to
SCCG
October
2016
Cinacalcet_Shared_C
are_Protocol v2 Oct 14.pdf
September
2014
Dalteparin for cancer
patients- Christie
Red as no SCP
provided to
SCCG
Expired
Denosumab.pdf
Disease Modifying
agents in Rheumatic
disease (DMARDs)
For bone metastases (120mg/ml)
NICE do not recommended use in
primary care so RED status applies
Gold Injections
Azathioprine
Penicillamine
Sulfasalazine
Ciclosporin
Hydroxychloroquine
Leflunomide
Methotrexate
All SCPs expire March 2013 but
review is in progress for Stepping
Hill Hospital Protocols
All SCGs
expired
Sodium
Aurothiomalate.pdf
Azathioprine.pdf
Penicillamine.pdf
Sulfasalazine.pdf
Ciclosporin in RA.pdf
Hydroxychloroquine.
pdf
Leflunomide.pdf
Disulfiram
Dornase alfa
Flutamide
Fulvestrant
Gonadorelin
analogues
Goserelin/ Leuprorelin
Gonadorelin
analogues-Goserelin/
Leuprorelin/
Triptorelin
Patients must be stable > 3 months
before care is shared. Public Health
funded
Cystic Fibrosis Drug is funded &
commissioned by NHS England not
CCGs no not locally funded.
For Prostate cancer
Grey listed – For use only where
patient started treatment before
December 2011 when NICE TA did
not recommend use
For new patients status is RED
Red as no SCP
agreed with
SCCG
Red as no SCP
with SCCG
Red as no SCP
provided to
SCCG
Expired
-No new
patients only
for patients
initiated
before Dec.
2011
Licensed indications only
endometriosis, pre-op management
prior to endometrial ablation/fibroid
surgery,
pituitary desensitisation-
Goseralin for Breast Ca
Fulvestrant inj.pdf
ALL Red as no
SCP provided to
SCCG
Red as no SCP
provided to
SCCG
Expired
Goserelin.pdf
All drugs licensed for Prostate
cancer
Red as no SCP
provided to
SCCG
Pre-op management prior to
endometrial ablation/ fibroid surgery
Red as no SCP
provided to
SCCG
Red for precocious puberty, male
hypersexuality or unlicensed
indications
Growth hormone
For use in children as per NICE
guidance
National shared
care SCP.
To be provided by
Hospital
Growth hormone
Histrelin
Hydroxycarbamide
For primary and secondary hypopituitarism
Red for any other indication in
adults
Palliative treatment of advanced
prostate cancer as per IPNTS
recommendations
Essential thrombocythaemia or
polycythaemia with high risk of
complications
Hydroxycarbamide
Sickle cell disease
Hydroxychloroquine
Drug is RED for Chronic Myeloid
Leukaemia
Also listed in DMARDS
Red as no SCP
provided to
SCCG
In
development
with SHH
Red as no SCP
provided to
SCCG
Red as no SCP
provided to
SCCG
Red as no SCP
provided to
SCCG
Expired
Hydroxychloroquine.
pdf
Ibandronic acid
Breast cancer
Expired
Ibandronate_shared
_care1final.pdf
Immunosuppressants
See individual drugs Ciclosporin
Tacrolimus and Sirolimus
Interferon alpha
Leukaemia and carcinoid tumours
Ketamine
Palliative Care use is unlicensed
Red as no SCP
provided to
SCCG
Can be used
under the
direction of a
palliative care
specialist without
a formal shared
care
Red as no SCP
provided to
SCCG
Use for Chronic Pain Management
is RED
Lanreotide /Octreotide
Licensed indications
Leflunomide
Also listed in DMARDs
Expired
Leflunomide.pdf
Lisdexamfetamine **
Lisdexamfetamine is an option as
per the licensed
Indication where methylphenidate is
not tolerated or fails to achieve a
positive outcome. Use in adults is
unlicensed but may be considered
when all other treatments have
failed.
September
2015
isdexamfetamine-V109-2013.pdf
Lithium
November
2014
Lithium SCG ADULTS
Version 2 November 2012.pdf
Lithium SCG over 65
Version 2 November 2012.pdf
Low molecular weight
heparins ( Treatment
of VTE)
If in doubt about
status seek advice
from Medicines
Management
Low molecular weight
heparins**
If in doubt about
status seek advice
from Medicines
Management
Low molecular weight
heparins
If in doubt about
status seek advice
from Medicines
Management
Melatonin
Mercaptopurine
Extended treatment of VTE in
cancer patients i.e.Dalteparin as per
Christie SCG.
For prophylaxis of DVT in cancer
drug is RED
Expired
Dalteparin
Feb2011.pdf
Expired
Enoxaparin as per UHSM SCG
Please note this is an unlicensed
indication for this particular drug
NB Short term use for prophylaxis
in cancer is RED
DVT/PE treatment > 2 weeks after
event (anticoagulation required but
warfarin contraindicated).
Enoxaparin.pdf
Expired
Enoxaparin.pdf
Pregnancy – see Tinzaparin
(only this LMWH is licensed)
SCP under
consideration
Prophylactic use
e.g. immobile patients or those
deemed to be at particularly high
risk of DVT at home or in care
situation.
Red as no SCP
provided to NHS
SCCG
Pre and Postoperative prophylaxis
is RED and will be provided by the
operating Trust even as
replavement for warfarin
RED
Travel – over 8 hours by high risk
patients is allowed without shared
care
Paediatric patients e.g. sleep
disorders, ADHD once patient is
stabilised using the licensed
product (Circadin®)
Use of licensed product in adults
not recommended
Inflammatory bowel diseases Unlicensed but in BNF
Green following
specialist advice
In
development
April 16
SCP Azathioprine
and Mercaptopurine.v1 Apr 14.pdf
Methotrexate
Oral and parenteral**
Rheumatic disease
Expired
Methotrexate
Rheumatic Disease.pdf
Crohn’s disease-Unlicensed
indication but in the BNF
Methylphenidate
Psoriasis
Shared care should only be
accepted once the patient is
stabilised (> 3 months) by Pennine
Mental Health Team
Red as no SCP
provided to
SCCG
Expired
Methylphenidate_an
d_atomoxetine_in_Adult_ADHD_Version_
Expired
Methylphenidate &
dexamfetamine_for_child_and_adolscen
Modafinil
Sleepiness associated with
narcolepsy
Modafinil for
sleepiness associated with narcolepsy.pd
NB: For Postural Hypotension,
idiopathic sleepiness or excessive
sleepiness associated with sleep
apnoea or shift work disorder
(unlicensed) are all designated RED
by GMMMG
Mycophenolate
mofetil
RED of any indication without a
shared care.
Expired
Mycophenolate
Mofetil for RA.pdf
Octreotide/ Lanreotide
Licensed indications
Pegvisomant
Licensed indications
Penicillamine
Rheumatoid arthritis
Red as no SCP
provided to
SCCG
Red as no SCP
provided to
SCCG
Expired
Penicillamine.pdf
Rheumatology
DMARDS
Rheumatoid arthritis- see under
DMARD or individual drug
All Expired
Riluzole
Risperidone consta
Red as no SCP
provided to
SCCG
Long acting injection of this atypical
antipsychotic
Expired
antipsychotics
including LA injections
Sirolimus
Licensed indications
Sulfasalazine
For use in Rheumatoid
conditions see under DMARDs
Red as no SCP
provided to
SCCG
Expired
Sulfasalazine.pdf
For GI indications
Red as no SCP
provided to
SCCG
Tacrolimus
Licensed indications
Tinzaparin
Low molecular weight heparin
licensed for prophylactic use in
pregnancy but not for treatment of
DVT
Treatment of spasticity
Red as no SCP
provided to
SCCG
SCP under
consideration by
CCG
Tizanidine
Tuberculosis,
antibiotic therapy
Various drugs
Shared care no longer applies.
Drugs must be initiated by a
specialist but then can be
prescribed by a GP.
In
development
Red as no SCP
provided to
SCCG