MTW NHS Trust West Kent CCG

Drug Status Key

  • Preferred
  • Second Line
  • Third Line
  • Specialist Initiation
  • Hospital Only
  • Not Approved for Formulary

Immunosuppressants - GI

Drug Safety Update

April 2023: Janus kinase (JAK) inhibitors: new measures to reduce risks of major cardiovascular events, malignancy, venous thromboembolism, serious infections and increased mortality

 January 2015: Ustekinumab (Stelara): risk of exfoliative dermatitis

  April 2014: There is an increased risk of tuberculosis, or reactivation of latent tuberculosis, during treatment with tumour necrosis factor alpha (TNF-alpha) inhibitors. TNF-alpha inhibitors are contraindicated in patients with active tuberculosis or other severe infections.

NICE Guidance (also see drug-specific NICE links below)

  NG129: Crohn’s disease: management, May 2019

NG130: Ulcerative colitis: management, May 2019

Local Guidance

See here for local Inflammatory Bowel Disease (Adults) HCD pathway

Infliximab is approved for the treatment of ulcerative colitis/Crohn's disease when prescribed according to NICE TAs (see links attached to drugs below). It is also approved for the management of diarrhoea or colitis related to immune checkpoint inhibitor (ICPI) therapy (unlicensed indication).

The JAK inhibitors upadacitinib, tofacitinib and filgotinib are all approved for the treatment of ulcerative colitis and upadacitinib for treating moderately to severely active Crohn’s disease in adults in accordance with NICE TAs (see NICE links attached to drugs). They are for specialist use only.

Risankizumab is approved for previously treated moderately to severely active Crohn's disease in people 16 years and over in accordance with NICE TA 888 (see link next to drug below).

Mirikizumab is approved for treating moderately to severely active ulcerative colitis in accordance with NICE TA 925 (see link next to drug below).

Mercaptopurine/Methotrexate/ciclosporin/azathioprine for inflammatory bowel disease (IBD) should be initiated by a specialist and used according to NICE guidelines and local shared care guidelines. Mercaptopurine for IBD, methotrexate for severe Crohn's disease and ciclosporin for severe acute UC refractory to corticosteroid treatment are all unlicensed uses. Click drug links above for specific drug listings and cautions.

Also refer to the Kent and Medway position statement for prescribing oral methotrexate.

Pack Price
1 pre-filled disposable injection £158.40
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2 pre-filled disposable injection £633.60
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2 pre-filled disposable injection £633.60
Pack Price
2 pre-filled disposable injection £352.14
Pack Price
2 pre-filled disposable injection £704.28
Pack Price
2 pre-filled disposable injection £704.28
Pack Price
1 pre-filled disposable injection £704.28
Pack Price
2 pre-filled disposable injection £633.85
Pack Price
2 pre-filled disposable injection £633.85
Pack Price
7 capsule (1 x (4 caps + 3 caps)) £343.25
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4 capsule
Pack Price
3 capsule
Pack Price
28 capsule £1,373.00