Corticosteroids and Immunosuppressants
Drug Safety Update
May 2025: Thiopurines and intrahepatic cholestasis of pregnancy
April 2019: Belimumab (Benlysta▼): increased risk of serious psychiatric events seen in clinical trials
February 2018: Mycophenolate mofetil, mycophenolic acid: updated contraception advice for male patients
November 2017: Oral tacrolimus products: reminder to prescribe and dispense by brand name only
December 2015: Mycophenolate mofetil, mycophenolic acid: new pregnancy-prevention advice for women and men
January 2015: Mycophenolate mofetil (CellCept) and mycophenolic acid: risk of hypogammaglobulinaemia and risk of bronchiectasis
December 2014: Mycophenolate mofetil: pure red cell aplasia
December 2009: Ciclosporin: must be prescribed and dispensed by brand name
NICE Guidance (also see drug specific links to guidance below)
NG130: Ulcerative colitis: management, May 2019
NG129: Crohn’s disease: management, May 2019
CG153: Psoriasis: assessment and management, September 2017
TA481: Immunosuppressive therapy for kidney transplant in adults, October 2017
TA1128: Targeted-release budesonide for treating primary IgA nephropathy
TA1131: Obinutuzumab with mycophenolate mofetil for treating lupus nephritis
Corticosteroids are also powerful immunosuppressants. They are used to prevent organ transplant rejection and in high doses used to treat rejection episodes. For this indication, they are Specialist initiation only.
Budesonide (Kinpeygo) is for renal consultant prescribing only at EKHUFT as per NICE 1128.
Obinutuzumab is for consultant nephrologist prescribing only.
The immunosuppressants azathioprine, ciclosporin, tacrolimus, mycophenolate mofetil, mycophenolic acid and sirolimus are all classed as HCDs when used for the indication of immunosuppression after renal transplant and reimbursed via NHSE. All prescribing for this indication should remain within secondary care.
| Pack |
|---|
| 100 tablet (10 x 10 tablets) |
| 28 tablet |
| Pack |
|---|
| 100 tablet (10 x 10 tablets) |
| 56 tablet (7 x 8 tablets) |
| Pack |
|---|
| 1 vial |
Brands available are as follows: Capimune, Capsorin, Deximune, Neoral, Sandimune and Vanquoral
| Pack |
|---|
| 60 capsule |
| Pack |
|---|
| 30 capsule (6 x 5 capsules) |
| Pack |
|---|
| 30 capsule (6 x 5 capsules) |
| Pack |
|---|
| 30 capsule (6 x 5 capsules) |
| Pack |
|---|
| 50 ml |
| Pack |
|---|
| 10 ampoule |
| Pack |
|---|
| 10 ampoule |
Use post-transplant - BNF specifies not to change formulation of immunosuppressant’s except on the advice of a transplant specialist. Renal patients under the care of specialist Renal units- the renal unit will supply all medication required for immunosuppressant therapy.
| Pack |
|---|
| 120 tablet |
| Pack |
|---|
| 120 tablet |
Brands available are: CellCept, Myfenax (250mg capsules, 500mg tablets)
| Pack |
|---|
| 100 capsule |
| Pack |
|---|
| 50 tablet (5 x 10 tablets) |
| Pack |
|---|
| 175 ml |
| Pack |
|---|
| 4 vial |
If newly initiating, please prescribe Adoport brand.
| Pack |
|---|
| 50 capsule (5 x 10 capsules) |
| Pack |
|---|
| 50 capsule (5 x 10 capsules) |
| Pack |
|---|
| 30 capsule |
| 60 capsule |
| Pack |
|---|
| 50 capsule (5 x 10 capsules) |
| Pack |
|---|
| 50 capsule (5 x 10 capsules) |
| Pack |
|---|
| 50 capsule (5 x 10 capsules) |
| Pack |
|---|
| 50 sachet |
| Pack |
|---|
| 50 sachet |
| Pack |
|---|
| 50 capsule |
| Pack |
|---|
| 100 capsule |
| 50 capsule |
| Pack |
|---|
| 10 ampoule |
| Pack |
|---|
| 30 tablet (3 x 10 tablets) |
| Pack |
|---|
| 30 tablet (3 x 10 tablets) |
| Pack |
|---|
| 30 tablet (3 x 10 tablets) |
| Pack |
|---|
| 1 ml |
| 100 ml |
| 50 ml |
This should ONLY be started by regional rheumatology MDT under recommendation of specialist centre East Kent
| Pack |
|---|
| 180 capsule |
| Pack |
|---|
| 1 pre-filled disposable injection |
Renal consultant prescribing only at EKHUFT as per NICE TA1128.
| Pack |
|---|
| 120 capsule |
For consultant nephrologist prescribing only
| Pack |
|---|
| 1 vial |
EKHUFT consultant nephrologist prescribing only. For treatment of nephrotic syndrome in adults secondary to minimal change disease (MCD) or focal segmental glomerular sclerosis (FSGS) in frequently relapsing steroid responsive disease.
| Pack |
|---|
| 1 vial |
| 2 vial |
- On Formulary Preferred
- On Formulary Second Line
- On Formulary Third Line
- Specialist Initiation
- Secondary Care Only
- Not Approved for Formulary