6.5.1 Hypothalamic and anterior pituitary hormones and anti-oestrogens

Anti-oestrogens

Clomifene
  • Tablets 50mg (£9.47 = 28 tablets)

Anterior pituitary hormones

Corticotrophins

Tetracosactide
  • Injection 250 micrograms/ml
  • Depot injection 1mg/ml

Gonadotrophins

Chorionic gonadotrophin
  • Injection 1500 unit, 5000 unit

Growth hormone

Somatropin
  • See BNF for preparations

Notes

  1. Norditropin NordiFlex and Norditropin FlexPro supply shortage (January 2023):
    1. No new patients should be initiated on either Norditropin NordiFlex or Norditropin FlexPro
    2. Existing patients should be referred to their specialist for review and switching to a suitable alternative e.g. Omnitrope SurePal.
    3. Patients on Norditropin NordiFlex should be transferred to an alternative growth hormone preparation as soon as possible. Existing supplies are very limited, and no further supplies are expected until Quarter 1 2024 at the earliest.
    4. Stock issues affect all Norditropin products; do not switch patients from one Norditropin product to another Norditropin product.
    5. Norditropin SimpleXx was discontinued in the UK from September 2022.
    6. For further information, refer to the letter to healthcare professionals.
  2. Refer to individual shared care guidelines for use in Endocrine conditions
  3. Prescribe by brand. A biosimilar medicine is a biological medicine that is highly similar and clinically equivalent (in terms of quality, safety, and efficacy) to an existing biological medicine however they cannot be considered generic equivalents of the originator biological medicine. Because they are not identical, biological medicines must be prescribed by brand. The decision which brand to prescribe rests with the responsible clinician in consultation with the patient. Automatic substitution of brands at the point of dispensing is not appropriate for biological medicines.
  4. NICE TA64: Recombinant human growth hormone (somatropin) treatment is recommended for the treatment of adults with growth hormone (GH) deficiency only if they fulfil the criteria of the NICE TA (August 2003)
  5. NICE TA188: Somatropin (recombinant human growth hormone) is recommended as a treatment option for children with growth failure when used in line with the NICE TA (May 2010) (NHS England Commissioned)
Somatrogon
  • Solution for injection pre-filled pens 24mg in 1.2ml, 60mg in 1.2ml

Notes

  1. NICE TA863: Somatrogon (Ngenla) is recommended, within its marketing authorisation, as an option for treating growth disturbance cause by growth hormone deficiency in children and young people aged 3 years and over (February 2023)

    Hypothalamic hormones

    Gonadorelin
    • Injection 100 microgram

     

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