Indication:All licensed indications
Fludarabine monotherapy, within its licensed indication, is not recommended for the first-line treatment of chronic lymphocytic leukaemia.
NICE TA 119
Fludarabine monotherapy for the first-line treatment of chronic lymphocytic leukaemia February 2007
Doctors, nurses, pharmacists and their staff must be made aware that the prescribing, dispensing and administering of oral
anti-cancer medicines should be carried out and monitored to the same standard as injected therapy. This requires that:
* Healthcare organisations should prepare local policies and procedures that describe the safe use of these oral
* Treatment should be initiated by a cancer specialist.
* All oral anti-cancer medicines should be prescribed only in the context of a written protocol and treatment plan.
* Non-specialists who prescribe or administer on-going oral anti-cancer medication should have ready access to
appropriate written protocols and treatment plans including guidance on monitoring and treatment of toxicity.
* Staff dispensing oral anti-cancer medicines should be able to confirm that the prescribed dose is appropriate for the
patient, and that the patient is aware of the required monitoring arrangements, by having access to information in the
written protocol and treatment plan from the hospital where treatment is initiated and advice from a pharmacist with
experience in cancer treatment in that hospital.
* Patients should be fully informed and receive verbal and up-to-date written information about their oral anticancer
therapy from the initiating hospital. This information should include contact details for specialist advice, which can be
shared with non-specialist practitioners. Written information, including details of the intended oral anti-cancer regimen,
treatment plan and arrangements for monitoring, taken from the original protocol should be given to the patient. When
shared with pharmacists and dispensing staff, this would enable the above dispensing requirements to be satisfied.
* Full use should also be made of NHS cancer centre web sites to provide information for healthcare staff, patients and carers to ensure the safe use of oral anti-cancer medicines.
Risks of incorrect dosing of oral anti-cancer medicines – NPSA January 2008