Greater Glasgow and Clyde Medicines

Restrictions:

See Prescribing notes for Formulary indications and restrictions on use.

Prescribing Notes:

Formulary Indications:

• Osteoporosis: Use in the treatment of osteoporosis in postmenopausal women in restricted to use in those patients for whom oral bisphosphonates are unsuitable, contraindicated or not tolerated in accordance with local protocol.  A shared care agreement is in place for this indication and can be accessed here.
• Skeletal-related events: The prevention of skeletal related events in adults with bone metastases from solid tumours is restricted to specialist use in accordance with regional protocol where zoledronic acid is not appropriate (for example, due to renal impairment or venous access problems). Use for this indication remains specialist use only.

Non-Formulary indications:

• Bone loss in prostate cancer: Use in the treatment of bone loss associated with hormone ablation in men with prostate cancer at increased risk of fractures is not recommended by SMC and remains non-Formulary.
• Osteoporosis in men at increased risk of fractures is not recommended by SMC and remains non-Formulary.
• Giant cell tumour of bone: in adults and skeletally mature adolescents when the condition is unresectable or where surgical resection is likely to result in severe morbidity is not recommended by SMC and remains non-Formulary.
• Prevention of skeletal related events in adults with haematological malignancies involving bone is not recommended by SMC and is non-Formulary.
• Bone loss associated with long-term systemic glucocorticoid therapy in adult patients at increased risk of fracture is not recommended by SMC and remains non-Formulary.

SMC advice pertaining to denosumab can be accessed here

NICE Mutiple Technology Appraisals pertaining to denosumab can be accessed here

Near Patient Testing (NPT) arrangements for GPs may be in place for this medicine.  See the relevant section in the Prescribing Resources page for current information.

BNF Link