Topical cytotoxics (Formulary: Malignant disease)

Warning

CHLORMETHINE

Important: Therapy notes

Important: Formulation and dosage details

Formulation:

Gel 160 micrograms/g (Ledaga®) (Restricted: Hospital use only)

Dosage:

Indication as per SMC 2318: for the topical treatment of mycosis fungoides-type cutaneous T cell lymphoma (MF-type CTCL) in adult patients. 

Place in therapy: To be used when there is insufficient response to topical steroid and phototherapy.

Notes:

Homecare is the preferred option. Contact: nhsh.homecare@nhs.scot

Storage: 

  • Unopened tube: Store and transport frozen (-15°C to -25°C) or refrigerated (+2°C to +8°C).
  • After defrosting: Store and transport refrigerated (+2°C to +8°C).

Disposal: A purple-lidded waste container must be used.

  • Ledaga is a cytotoxic medicinal product.
  • Caregivers must wear nitrile gloves when handling Ledaga®.  Patients and caregivers must wash hands after handling Ledaga®.
  • Ledaga® is an alcohol-based product and is flammable.  The recommended application instructions should be followed.
  • Unused refrigerated Ledaga® should be discarded after 60 days, together with the plastic bag.  Any unused medicinal product or waste material, including the plastic bag and the nitrile gloves used for application, must be disposed of in accordance with local requirements.

For full details, see: Ledaga 160 micrograms/g gel - Summary of Product Characteristics (SmPC) - (emc) | 10384

FLUOROURACIL

Important: Therapy notes


MHRA advice: 5-fluorouracil (intravenous), capecitabine, tegafur: DPD testing recommended before initiation to identify patients at increased risk of severe and fatal toxicity (October 2020) (www.gov.uk).

Important: Formulation and dosage details

Formulation:

Formulation:

Cream 5% (Efudix)

There is a known shortage with this product. See: Medicines shortage log (NHS Highland intranet access required)

Editorial Information

Last reviewed: 26/02/2026

Next review date: 31/03/2029

Version: 1

Approved By: TAM subgroup of the ADTC

Document Id: F400