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Bedfordshire and Luton Joint Formulary
Bedford Hospital NHS Trust
Bedfordshire CCG
Luton & Dunstable University Hospital NHS Foundation Trust
Luton CCG
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 Formulary Chapter 4: Central nervous system - Full Chapter
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing

 Details...
04.01  Hypnotics and anxiolytics
04.01.01  Hypnotics
Melatonin 1mg/mL
(Oral Solution)
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Restricted Drug Restricted
Green

unlicensed unlicensed

Restricted: 3rd-line choice for children with tubes/those with severe swallowing difficulties where all medicines are liquids.

Restricted: Critically ill patients on ITU (see attached protocol).

 
Link  JPC SCG: Insomnia & Sleep disorders in Children & Adolescents - Melatonin
Link  Sleep Enhancement Protocol for Critical Care
   
Melatonin 2mg MR (Circadin®)
(Oral)
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Restricted Drug Restricted
Green

For children and adolescents. See Shared Care Guidelines.

Melatonin 2mg m/r tablets (Circadin®) should be used first line if the appropriate dose can be obtained by either swallowing whole or crushing into water/ soft food. It can be halved without losing modified release characteristics and crushed and mixed with water/juice/soft food for swallowing difficulties.


Please note: once crushed it will no longer be modified release.

 
Link  JPC SCG: Insomnia & Sleep disorders in Children & Adolescents - Melatonin
   
04.01.01  Benzodiazepines
Controlled Drug Temazepam
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Formulary
Green
When prescribing this product on TTA's and outpatient prescriptions, the quantity to be supplied must be stated in words and figures and counter signed in order to fulfill the legal requirements of controlled drug prescriptions. e.g. Supply fourteen (14) tablets (signed).

10mg Tablets
10mg/5mL Sugar free Elixir 
   
Loprazolam
(Tablets)
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Restricted Drug Restricted
Amber

For initiation by Mental Health specialist from ELFT only

 
   
Lormetazepam
(Tablets)
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Restricted Drug Restricted
Amber
For initiation by Mental Health specialist from ELFT only 
   
Nitrazepam 2.5mg/5mL
(Suspension)
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Restricted Drug Restricted
Amber

For Paediatric patients only

 
   
Nitrazepam 5mg
( Tablets)
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Restricted Drug Restricted
Green

No new initiations in Primary or Secondary care.

Exemption to exceptional use by Mental Health Trust.

 
   
04.01.01  Zaleplon, Zolpidem and Zopiclone
Zolpidem
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Formulary
Green
 
Link  NICE TA77: Zaleplon, zolpidem and zopiclone for the management of insomnia
   
Zopiclone
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Formulary
Green
3.75 & 7.5mg Tablets 
Link  MHRA Drug Safety Update (May 2014) - Zolpidem: risk of drowsiness and reduced driving ability
Link  NICE TA77: Guidance on the use of zaleplon, zolpidem and zopiclone for the short-term management of insomnia
   
04.01.01  Chloral and derivatives to top
Chloral Hydrate 500mg/5mL
(Oral Solution )
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Restricted Drug Restricted
Amber

Less suitable for prescribing. Prescribe only where there is no alternative.

Avoid prolonged use and abrupt withdrawal thereafter.

Standard strength liquid is 500mg/5ml as per RCPCH/NPPG guidance http://nppg.org.uk/position-statements/

 
   
04.01.01  Clomethiazole (Chlormethiazole)
04.01.01  Antihistamines
Promethazine Hydrochloride
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Formulary
Green
See Section 3.4.1

Less suitable for prescribing as a sedative (short term use).

 
   
04.01.01  Alcohol
04.01.01  Sodium oxybate
04.01.02  Anxiolytics to top
04.01.02  Benzodiazepines
Alprazolam
(Tablets)
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Restricted Drug Restricted
Amber

For initiation by Mental Health specialist from ELFT only

 
   
Diazepam
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Formulary
Green
2mg, 5mg & 10mg Tablets
2mg in 5mL Oral Solution
2.5mg, 5mg & 10mg Rectal Tube  
   
Oxazepam
(Tablets)
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Restricted Drug Restricted
Amber

For initiation by Mental Health specialist from ELFT only

 
   
Diazepam
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Formulary
Red
10mg/2mL Injection

Note: Diazepam injection comes in two forms - solution (IM or IV) and emulsion Diazemuls® (IV only). Emulsion is preferred for IV as it is less irritant to the vein. 
   
Lorazepam
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Formulary
Green
1mg & 2.5mg Tablets 
   
Lorazepam
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Formulary
Green
4mg/1mL Injection
 
   
Chlordiazepoxide
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Formulary
Red
5mg & 10mg Capsules
For alcohol detoxification a maximum of 3 doses can be supplied on a TTA.

 
   
04.01.02  Buspirone
Buspirone Hydrochloride
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Restricted Drug Restricted
Amber
Restricted - initiation by Psychiatric team only.

5mg Tablets

 
   
04.01.02  Beta blockers
04.01.02  Meprobamate
04.01.03  Barbiturates to top
04.02  Drugs used in psychoses and related disorders
04.02.01  Antipsychotic Drugs
Chlorpromazine
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Formulary
Amber
25mg, 50mg & 100mg Tablets
25mg/5mL Syrup
100mg/5mL Syrup 
   
Chlorpromazine
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Formulary
Red
50mg/2mL Injection 
   
Haloperidol
(Oral)
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Formulary
Green

1.5mg, 5mg & 10mg Tablets
500microgram Capsules

 
   
Haloperidol 5mg/1mL
(Injection)
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Formulary
Green

NOTE: Intravenous use is now an unlicensed use. All IV use restricted to Critical Care areas only.

Initiation in Primary Care for palliative care only

 
   
Levomepromazine
(Oral)
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Formulary
Green

25mg Tablets

Initiation in Primary Care for palliative care only

 
   
Benperidol (Anquil®)
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Restricted Drug Restricted
Red

For intitation and prescribing by ELFT Specialists only

 
   
Haloperidol
(Oral Liquid)
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Formulary
Green

Available as 5mg in 5mL and 10mg in 5mL.

 
   
Levomepromazine
(Injection)
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Formulary
Green

25mg/1mL Injection

Initiation in Primary Care for palliative care only

 
   
Pericyazine
(Tablets)
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Restricted Drug Restricted
Red

Restricted use in Mental Health Trusts

 
   
Pimozide
(Tablets)
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Restricted Drug Restricted
Red

For restricted use in Mental Health Trust

 
   
Sulpiride
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Formulary
Amber

200mg Tablets

 
   
Trifluoperazine
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Formulary
Amber

1mg & 5mg Tablets

N.B. Price increase, now very expensive.

For initiation by Mental Health specialist from ELFT only

 
   
Zuclopenthixol
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Formulary
Amber
2mg & 10mg Tablets  
   
Zuclopenthixol 50mg/1mL, 200mg/1mL (Clopixol Acuphase®)
(Injection (oily))
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Restricted Drug Restricted
Red
See Section 04.02.02 for depot preparations

Restricted - initiation by Consultant Psychiatrist (Mental Health Trust) only.
IMPORTANT NOTE:- when prescribing, dispensing or administering, check that this is the correct preparation - this preparation is usually used in hospital for an acute episode and should not be confused with depot preparations which are usually used in the community or clinics for maintenance treatment. 
   
04.02.01  First-Generation Antipsychotic Drugs
04.02.01  Second-Generation Antipsychotic Drugs
Amisulpride
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Formulary
Amber
50mg, 200mg & 400mg Tablets
100mg/1mL oral solution 
   
Aripiprazole
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Restricted Drug Restricted
Amber
5mg, 10mg, 15mg & 30mg Tablets
10mg & 15mg Orodispersible Tablets
1mg/1mL Solution

Restricted - to be prescribed in accordance with NICE TA213 and 292. 
Link  NICE TA213: Aripiprazole for the treatment of schizophrenia in people aged 15 -17 years
Link  NICE TA292: Bipolar disorder (children) - aripiprazole
   
Aripiprazole 7.5mg, 9.75mg
(Injection)
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Restricted Drug Restricted
Red
Only for continuation of treatment whist inpatient at Luton & Dunstable Hospital.
Initiation by Psychiatrist (Mental Health Trust) only, in line with NICE TA213 and 292 (as above).


 
   
Risperidone
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Formulary
Amber
0.5mg, 1mg, 2mg, 3mg, 4mg & 6mg Tablets
0.5mg, 1mg, 2mg & 3mg Orodispersible Tablet
1mg/1mL Oral Liquid  
   
Clozapine (Clozaril®)
(Prescribe by brand name)
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Restricted Drug Restricted
Red
Can only be prescribed by consultant Psychiatrist.

Supply of medication must be obtained from patient wherever possible - no stock kept at L&D Pharmacy. Must be dispensed by Mental Health Trust.

Prescriptions must include proprietary name. 
Link  DSU Oct 2017: Clozapine: reminder of potentially fatal risk of intestinal obstruction, faecal impaction, and paralytic ileus
   
Clozapine (Denzapine®)
(Prescribe by brand name)
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Restricted Drug Restricted
Red
Can only be prescribed by consultant Psychiatrist.

Supply of medication must be obtained from patient wherever possible - no stock kept at L&D Pharmacy. Must be dispensed by Mental Health Trust.

Prescriptions must include proprietary name. 
Link  DSU Oct 2017: Clozapine: reminder of potentially fatal risk of intestinal obstruction, faecal impaction, and paralytic ileus
   
Lurasidone (Latuda®)
(Tablets)
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Restricted Drug Restricted
Amber

Restricted use in Mental Health Trust, initiaition only by specialist Mental Health Prescribers

 
   
Olanzapine
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Formulary
Amber
2.5mg, 5mg, 7.5mg, 10mg & 20mg Tablets
5mg, 10mg, 15mg & 20mg Orodispersible Tablet

 
   
Paliperidone
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Restricted Drug Restricted
Red

For initiation and continuation by Mental Health specialists

 
   
Quetiapine
(Tablets)
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Formulary
Amber

25mg, 50mg, 100mg, 150mg, 200mg and 300mg tablets

Preferred formulation in primary care

 
   
Quetiapine XL
(Tablets)
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Formulary
Amber

Primary care: Most cost effective brand to be advised via ScriptSwitch/ Optimise. Reserved for use if patient is unable to tolerate immediate release formulation

Secondary care: hospital contract brand will be provided

 
   
04.02.02  Antipsychotic depot injections to top
04.02.03  Drugs used for mania and hypomania
04.02.03  Benzodiazepines
04.02.03  Antipsychotic drugs
04.02.03  Carbamazepine
04.02.03  Valproic acid to top
Valproic Acid 250mg, 500mg (Depakote®)
(EC Tablets)
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Restricted Drug Restricted
Amber
Also known as valproate semisodium.
Valproate should not be prescribed to female children, female adolescents, women of childbearing potential or pregnant women unless other treatments are ineffective or not tolerated. Initiation by Mental Health Trust. 
   
04.02.03  Lithium
Lithium Carbonate (Priadel®)
(Tablets )
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Formulary
Amber SCG

This medication must be prescribed via brand name due to differences in bioavailability - alternative brands may be ordered by Pharmacy if for continuation therapy only.

200mg & 400mg Sustained Release Tablets

 
   
Lithium Carbonate 400mg (Camcolit®)
(MR Tablets )
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Restricted Drug Restricted
Amber SCG

This medication must be prescribed via brand name due to differences in bioavailability - alternative brands may be ordered by Pharmacy if for continuation therapy only.

N.B The most expensive lithium brand. Priodel preferred. For continuation of treatment only.

 
   
Lithium Carbonate 450mg (Liskonum®)
(MR Tablets )
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Restricted Drug Restricted
Amber SCG

This medication must be prescribed via brand name due to differences in bioavailability - alternative brands may be ordered by Pharmacy if for continuation therapy only.

 
   
Lithium Citrate 520mg/5mL
(Oral Solution )
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Restricted Drug Restricted
Amber SCG
 
   
04.03  Antidepressant drugs
04.03.01  Tricyclic and related antidepressant drugs
04.03.01  Tricyclic antidepressants
Amitriptyline
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Formulary
Green
10mg, 25mg & 50mg Tablets
50mg/5mL Oral solution  
   
Clomipramine
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Formulary
Amber

10mg, 25mg & 50mg Capsules

 
   
Imipramine 10mg, 25mg
(Tablets)
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Restricted Drug Restricted
Amber

For initiation by Mental Health specialist from ELFT only. 

 
   
Lofepramine
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Formulary
Amber

70mg Tablets

 
   
Nortriptyline
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Restricted Drug Restricted
Amber
10mg & 25mg Tablets

Restricted - To be initiated by pain specialists only, where amitriptyline has effectively controlled the neuropathic pain but the patient is intolerant to the side effects.

 
   
04.03.01  Related antidepressants to top
Mianserin
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Restricted Drug Restricted
Amber

For initiation by Mental Health specialist from ELFT only

 
   
04.03.02  Monoamine-oxidase inhibitors
Isocarboxazid
(Tablets)
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Restricted Drug Restricted
Red

Restricted use in Mental Health Trust

 
   
04.03.02  Reverible MAOIs
Moclobemide 150mg, 300mg
(Tablets)
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Restricted Drug Restricted
Amber

For initiation by Mental Health specialist from ELFT only

 
   
04.03.03  Selective serotonin re-uptake inhibitors
Citalopram
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Formulary
Green
10mg, 20mg & 40mg Tablets
40mg/1mL Sugar-Free Oral Drops

Bioavailability of the oral drops is different to the tablets
8mg oral drops = 10mg tablet

Max 20mg in elderly patients due risk of QT prolongation - see MHRA warning below 
Link  MHRA Drug Safety Update (December 2011) - Citalopram and escitalopram: QT interval prolongation
Link  UKMI Q&A - What issues should be considered regarding drug induced QT prolongation?
   
Escitalopram  (Cipralex®)
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Formulary
Green

5mg, 10mg & 20mg Tablets
20mg/1mL Sugar-Free Oral Drops

Max 10mg in elderly patients due risk of QT prolongation - see MHRA warning below

 
Link  MHRA Drug Safety Update (December 2011) - Citalopram and escitalopram: QT interval prolongation
Link  UKMI Q&A - What issues should be considered regarding drug induced QT prolongation?
   
Fluoxetine
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Formulary
Green
20mg Capsules
20mg/5mL Oral Liquid

Fluoxetine (in combination with psychological therapy) is the first choice SSRI for initial treatment of moderate to severe depression in young people (12–18 years)


 
Link  MHRA Drug Safety Update (March 2010) - Fluoxetine: possible small risk of congenital cardiac defects
Link  NICE CG28: Depression in children and young people: identification and management
   
Fluvoxamine Maleate (Fluvoxamine®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber

For specialist initiation or on the advice of a Mental Health Specialist

 
   
Paroxetine
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Restricted Drug Restricted
Amber

For specialist initiation or on the advice of a Mental Health Specialist

 
   
Sertraline
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Formulary
Green
50mg & 100mg Tablets  
   
04.03.04  Other antidepressant drugs
Agomelatine (Valdoxan®)
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Restricted Drug Restricted
Red

For initiation and ongoing prescribing by ELFT Specialist only.

 
   
Duloxetine 30mg, 60mg
(Capsules)
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Restricted Drug Restricted
Amber

Specialist initiation for GAD or depression

 
   
Mirtazapine
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Formulary
Green
15mg & 30mg Tablets
15mg, 30mg & 45mg Orodispersible Tablets
 
   
Reboxetine (Edronex®)
(Tablets)
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Restricted Drug Restricted
Amber

For initiation by Mental Health specialist from ELFT only

 
   
Venlafaxine
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Formulary
Green
37.5mg & 75mg tablets
37.5mg modified release tablets
75mg & 150mg modified release capsules 
   
Vortioxetine
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Restricted Drug Restricted
Amber
Restricted - only to be initiated by a Consultant Psychiatrist for treating major depressive episodes in accordance with NICE TA367.

5mg, 10mg & 20mg Film Coated Tablets 
Link  NICE TA367: Vortioxetine for treating major depressive episodes
   
Flupentixol
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Formulary
Amber

500microgram & 1mg Tablets

 
   
04.04  CNS stimulants and other drugs used for attention deficit hyperactivity disorder to top
Atomoxetine
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Restricted Drug Restricted
Amber SCG

10mg & 25mg Capsules
Only to be initiated by specialist in ADHD according to NICE TA98.

Follow shared care guidance below.

 
Link  MHRA Drug Safety Update (January 2012) - Atomoxetine: increases in blood pressure and heart rate
   
Controlled Drug Dexamfetamine
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Formulary
Amber SCG

5mg Tablets
Only to be initiated by specialist in ADHD according to NICE TA98.

Follow shared care guidance below.

 
   
Guanfacine (Intuniv®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber SCG

Follow shared care guidance

 
Link  Bedfordshire and Luton Shared care guideline for the use of Guanfacine for the management of Attention-deficit hyperactivity disorder (ADHD) - Children & Young People (5-17 years of age)
   
Controlled Drug Lisdexamfetamine (Elvanse®)
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Restricted Drug Restricted
Amber SCG

Follow shared care guidance below

 
   
Controlled Drug Methylphenidate 5mg, 10mg & 20mg
(Tablets)
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Formulary
Amber SCG

Only to be initiated by specialist in ADHD according to NICE TA98.

Follow shared care guidance below.


 
Link  UKMI Q&A - Can methylphenidate be used for adults with attention deficit hyperactivity disorder (ADHD)?
   
Controlled Drug Methylphenidate Hydrochloride MR
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Formulary
Amber SCG

Only to be initiated by specialist in ADHD according to NICE TA98.

Follow shared care guidance below.

Modified / extended release tablets or capsules (various brands available)

 

 
Link  UKMI Q&A - Can methylphenidate be used for adults with attention deficit hyperactivity disorder (ADHD)?
   
04.04  Cocaine
04.05  Drugs used in the treatment of obesity
04.05.01  Anti-obesity drugs acting on the gastro-intestingal tract
Orlistat
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Formulary
Green
120mg Capsules 
Link  MHRA Drug Safety Update (March 2014) - Orlistat: theoretical interaction with antiretroviral HIV medicines
Link  NICE CG43: Obesity prevention
   
04.05.02  Centrally acting appetite suppressants
04.06  Drugs used in nausea and vertigo to top
04.06  Vomiting during pregnancy
04.06  Postoperative nausea and vomiting
04.06  Motion sickness
04.06  Other vestibular disorders
04.06  Cytotoxic chemotherapy to top
04.06  Palliative care
04.06  Migraine
04.06  Antihistamines
Cinnarizine 15mg
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Cyclizine 50mg
(Tablets)
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Formulary
Green
 
   
Cyclizine 50mg/1mL
(Injection)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Green
Reserved for palliative care and obstetric patients and patients who cannot have ondansetron. 
   
Promethazine hydrochloride
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Formulary
Green

For preparations see Section 03.04.01

 
   
04.06  Phenothiazines and related drugs
Chlorpromazine Hydrochloride
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Formulary
Red
50mg in 2mL Injection 
   
Chlorpromazine Hydrochloride
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Formulary
Green
25mg, 50mg & 100mg Tablets
100mg/5mL Syrup
 
   
Droperidol 2.5mg/1mL (Xomolix®)
(Injection)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red

Approved for off-label intramuscular injection of 5mg dose for the Emergency Department only. Prescribing to be by ED consultants or registrars.

 
   
Prochlorperazine
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Formulary
Green
5mg Tablets
5mg/5mL Syrup
 
   
Trifluoperazine
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Formulary
Amber

1mg & 5mg Tablets
5mg/5mL Solution

 
   
04.06  Domperidone and metoclopramide to top
Domperidone
View adult BNF View SPC online View childrens BNF
Formulary
Green
10mg Tablets
5mg/5mL Suspension

Restricted - MHRA have advised domperidone should only be used for nausea and vomiting. Its use is contraindicated in patients with underlying cardiovascular conditions and risk factors. Dose and duration have been revised to a maximum of 10mg three times daily for one week in adults. For more details see MHRA link below 
Link  MHRA Drug Safety Update (April 2016) - Apomorphine with domperidone: minimising risk of cardiac side effects
Link  MHRA Drug Safety Update (May 2014) - Domperidone: risks of cardiac side effects
   
Metoclopramide
View adult BNF View SPC online View childrens BNF
Formulary
Green
10mg Tablets
5mg/5mL Sugar Free Solution

Dot Metoclopramide should only be prescribed for short-term use (up to 5 days)
Dot Use of metoclopramide is contraindicated in children younger than 1 year
Dot In children, age 1–18 years, metoclopramide should only be used as a second-line option for prevention of delayed chemotherapy-induced nausea and vomiting, and for treatment of established postoperative nausea and vomiting

 
Link  MHRA Drug Safety Update (August 2013) - Metoclopramide risk of neurological adverse effects
   
Metoclopramide
View adult BNF View SPC online View childrens BNF
Formulary
Green
10mg/2mL Injection  
Link  MHRA Drug Safety Update (August 2013) - Metoclopramide risk of neurological adverse effects
   
04.06  5HT3 antagonists
Ondansetron 4mg/2mL, 8mg/4mL
(Injection)
View adult BNF View SPC online View childrens BNF
First Choice
Red

If a parenteral antiemetic is indicated please prescribe ondansetron 4mg 4-6 hourly (up to TDS) first-line unless patients have one of the following exclusion criteria:

•congenital long QT syndrome
•hypersensitivity to ondansetron or other 5HT3- receptor antagonists
•sub-acute intestinal obstruction or ileus (this is a caution not a contraindication in the SPC)

N.B. parenteral cyclizine is now very expensive (about 40 x that of ondansetron).

 
Ondansetron
(Oral)
View adult BNF View SPC online View childrens BNF
Formulary
Green

4mg & 8mg Tablets
4mg/5mL Syrup

4mg Orodispersible film - most cost-effective formulation

 
Link  MHRA Drug Safety Update (July 2013) - Ondansetron for intravenous use: dose-dependent QT interval prolongation
   
Palonosetron with netupitant (Akynzeo®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
For chemotherapy patients 
   
04.06  Neurokinin receptor antagonist
Aprepitant (Emend®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
Restricted - Chemotherapy use only

3 day pack - 125mg prior to chemotherapy followed by 80mg once daily for 2 days 
   
04.06  Cannabinoid
04.06  Hyoscine
Hyoscine Hydrobromide
View adult BNF View SPC online View childrens BNF
Formulary
Green
300microgram Tablets
1.5mg Patches (72 hour patch) - releases 1mg hyoscine/72 hours
 
   
04.06  Other drugs for Ménière's disease to top
Betahistine
View adult BNF View SPC online View childrens BNF
Formulary
Green
8mg & 16mg Tablets  
   
04.07  Analgesics
04.07.01  Non-opioid analgesics and compound analgesic preparations
04.07.01  Compound analgesic preparations
Paracetamol 500mg/ 50mL
(Solution for Infusion)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red

Restricted to paediatrics.

 
   
Aspirin
View adult BNF View SPC online View childrens BNF
Formulary
Green
300mg Dispersible Tablets
 
   
Paracetamol
View adult BNF View SPC online View childrens BNF
Formulary
Green

500mg Tablets
120mg & 250mg in 5mL Suspension (Sugar free solutions available)
120mg, 240mg & 1000mg Suppositories
500mg Soluble Tablets

For short term acute use in Primary Care patients should be advised to purchase over the counter

 
Link  UKMI Q&A - Can breastfeeding mothers take paracetamol?
   
Paracetamol 1g / 100mL
(Solution for IV infusion)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red

For adults

Restricted - only to be used when the oral route is not available. The rectal route is an alternative to the I.V. route where appropriate.

Please ensure weight is documented on ePMA and dose adjusted accordingly. N.B. for patients < 50kg maximum dose is 15mg/kg QDS.

 

Patient Group

 

Dose

 

Minimum dosing interval

 

Maximum daily dose

 

More than 50kg

 

1g max QDS

 

Every 4 hours

 

4g

 

 

Less than 50kg

 

15mg/kg max QDS

 

Every 4 hours

 

 

60mg/kg (or max 3g daily)

CrCl less than 30mL/min

According weight

(more than or less than 50kg)

 

Every 6 hours

According weight

(more than or less than 50kg)

 
Link  MHRA Drug Safety Update (July 2010) - Intravenous paracetamol: risk of accidental overdose
   
Paracetamol 500mg and codeine 30mg (Co-codamol® 30/500)
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green
Tablets and effervescent tablets 
   
Paracetamol 500mg and codeine 8mg (Co-codamol® 8/500)
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green
Tablets and effervescent tablets

 
   
Paracetamol and dihydrocodeine (Co-dydramol®)
View adult BNF View SPC online View childrens BNF
Formulary
Green
10mg/500mg Tablets 
   
04.07.02  Opioid analgesics
Controlled Drug Morphine Sulphate
(Injection)
View adult BNF View SPC online View childrens BNF
First Choice
Green

10mg/1mL, 15mg/1mL, 30mg/1mL

100mg/50mL IV Infusion

 
Controlled Drug Morphine Sulphate 10mg/ 5mL (Oramorph®)
(Oral Solution)
View adult BNF View SPC online View childrens BNF
First Choice
Green
First choice strong opiate. 
Controlled Drug Morphine Sulphate MR (Zomorph®)
(Modified Release Capsules)
View adult BNF View SPC online View childrens BNF
First Choice
Green
10mg, 30mg, 60mg & 100mg Sustained Release capsules

First choice strong opiate.



 
Controlled Drug Oxycodone 10mg, 20mg, 40mg, 80mg
(Modified Release Tablets)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted Green Traffic Light  Restricted - 2nd-line use. Only to be prescribed if morphine sulphate is not suitable. Prescribe as a regular dose.

Red Traffic Light  ENHANCED RECOVERY
Restricted - to initiation by Anaesthetics team and continuation by the Pain team and ward surgical and orthopaedic doctors, for pain management in enhanced recovery for hip and knee arthroplasty surgical patients, in accordance with Enhanced Recovery protocol (see link below). Maximum 5 days in total.

When prescribing this product on TTA's and outpatient prescriptions, the quantity to be supplied must be stated in words and figures and counter signed in order to fulfil the legal requirements of controlled drug prescriptions. e.g. Please supply twenty eight (28) tablets (signed).

 
Link  Discharge Medication for Enhanced Recovery Patients Following Primary Hip and Knee Arthroplasty
   
Controlled Drug Oxycodone 5mg/ 5mL
(Oral Solution)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Green
Restricted - for inpatient use only. Usually for ’prn’ use with regular oxycodone MR tablets.
For 2nd-line use only, where morphine sulphate is not appropriate or tolerated.

N.B. Must change to immediate release capsules on discharge if still required. 
   
Controlled Drug Oxycodone
(Injection)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber
10mg/1mL Injection
 
Restricted - Only to be prescribed 2nd line, if morphine sulphate is not suitable appropriate or tolerated.

50mg/1mL Injection - Ordered on a named patient basis only. Write patient's name and hospital number in CD order book.  
   
Controlled Drug Oxycodone 5mg, 10mg
(Capsules)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Green
Restricted - not for in-patient use. For 2nd-line use only, where morphine sulphate is not appropriate or tolerated.
Usually prescribed for ’prn’ dose e.g for enhanced recovery patients on discharge following knee or hip arthroplasty.

When prescribing this product on TTA's and outpatient prescriptions, the quantity to be supplied must be stated in words and figures and countersigned in order to fulfill the legal requirements of controlled drug prescriptions. 
Link  Discharge Medication for Enhanced Recovery Patients Following Primary Hip and Knee Arthroplasty
   
Controlled Drug Buprenorphine 200microgram, 400microgram
(Sublingual Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Amber

When prescribing this product on TTA's and outpatient prescriptions, the quantity to be supplied must be stated in words and figures and countersigned in order to fulfill the legal requirements of controlled drug prescriptions. e.g. Please supply Five (5) tablets (signed).

 
Link  NICE TA114: Methadone and buprenorphine for the management of opioid dependence
   
Controlled Drug Buprenorphine 35, 52.5, 70 microgram
(96 hour transdermal patches)
View adult BNF View SPC online View childrens BNF
Formulary
Green
Releasing 35micrograms per hour, 52.5micrograms per hour or 70micrograms per hour over 96 hours.For convenience of use, this can be changed twice a week at regular intervals.

When prescribing this product on TTA's and outpatient prescriptions, the quantity to be supplied must be stated in words and figures and counter signed in order to fulfil the legal requirements of controlled drug prescriptions. e.g. Please supply Four (4) patches (signed).
N.B. pack size is 4 patches. 
Link  NICE TA114: Methadone and buprenorphine for the management of opioid dependence
   
Controlled Drug Buprenorphine 5, 10 microgram (BuTrans® patch)
(7 day transdermal patch)
View adult BNF View SPC online View childrens BNF
Formulary
Green
Releasing 5micrograms/ hour over 7 days OR
Releasing 10micrograms/ hour over 7 days

When prescribing this product on TTA's and outpatient prescriptions, the quantity to be supplied must be stated in words and figures and counter signed in order to fulfil the legal requirements of controlled drug prescriptions. e.g. Please supply two (2) patches (signed). 
   
Codeine 15mg, 30mg
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
Link   MHRA Drug Safety Update (July 2013) -Codeine for analgesia: restricted use in children because of reports of morphine toxicity
Link  MHRA Drug Safety Update (June 2013) - Codeine: restricted use as analgesic in children and adolescents after European safety review
   
Codeine Phosphate
(Injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
60mg/1mL Injection  
Controlled Drug Injection Only
Link  MHRA Drug Safety Update (July 2013) - Codeine for analgesia: restricted use in children because of reports of morphine toxicity
Link  MHRA Drug Safety Update (June 2013) - Codeine: restricted use as analgesic in children and adolescents after European safety review
   
Controlled Drug Diamorphine 5mg, 10mg, 30mg, 100mg, 500mg
(Injection)
View adult BNF View SPC online View childrens BNF
Formulary
Green
Higher strengths (100mg & 500mg) ordered on a named patient basis only. Write patient's name and hospital number in CD order book.  
   
Controlled Drug Diamorphine 720microgram or 1600microgram/ actuation (Ayendi®)
(Nasal Spray)
View adult BNF View SPC online View childrens BNF
Formulary
Red

Approved for its licensed indication of treatment of acute severe pain in children in the Emergency Department. This is a controlled drug and there is a detailed SOP that must be followed for administration and documentation of this product in the Emergency Department.

 
   
Dihydrocodeine 30mg
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Controlled Drug Fentanyl
(72 hour Transdermal Patch)
View adult BNF View SPC online View childrens BNF
Formulary
Amber

Releasing 12microgram, 25microgram, 50microgram, 75microgram & 100microgram per hour over 72 hours.

When prescribing this product on TTA's and outpatient prescriptions, the quantity to be supplied must be stated in words and figures and counter signed in order to fulfil the legal requirements of controlled drug prescriptions. e.g. Please supply Five (5) patches (signed).

N.B. pack size is 5 patches.

 
Link  MHRA Drug Safety Update (July 2014) - Transdermal fentanyl “patches”: reminder of potential for life-threatening harm from accidental exposure, particularly in children
Link  MHRA DSU Oct 2018: Transdermal fentanyl patches: life-threatening and fatal opioid toxicity from accidental exposure, particularly in children
Link  UKMI Q&A - How should conversion from oral morphine to fentanyl patches be carried out?
   
Controlled Drug Fentanyl (Effentora® )
(Buccal tablets)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red

Restricted to initiation by palliative care team only.

100microgram, 200microgram & 400microgram Buccal Tablets

Not to be prescribed on TTA's. Not recommended by NHSEngland (guidance on low value medicines). 

 
   
Meptazinol (Meptid®)
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green
200mg Tablets  
   
Controlled Drug Morphine Sulphate (MST Continus®)
(Sustained Release Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green
5mg, 15mg sustained release tablets 
   
Controlled Drug Morphine Sulphate (Sevredol®)
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green
N.B. these are not sustained release and should be prescribed every 4 to 6 hours like Oramorph. 
   
Controlled Drug Morphine Sulphate 100mg/ 5mL
(Concentrated oral solution)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Controlled Drug Pethidine
(Injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
50mg/1mL Injection
100mg/2mL Injection 
   
Controlled Drug Tramadol
(Oral)
View adult BNF View SPC online View childrens BNF
Formulary
Green
50mg Capsules
50mg Soluble Tablets

When prescribing this product on TTA's and outpatient prescriptions, the quantity to be supplied must be stated in words and figures and counter signed in order to fulfil the legal requirements of controlled drug prescriptions. e.g. Please supply thirty (30) capsules (signed). 
Link  UKMI Q&A - What is the risk of developing Serotonin Syndrome following concomitant use of tramadol with selective serotonin reuptake inhibitors (SSRIs)?
   
Controlled Drug Tramadol
(Injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
100mg/2mL Injection  
   
04.07.03  Neuropathic pain to top
Amitriptyline
View adult BNF View SPC online View childrens BNF
Formulary
Green
10mg, 25mg & 50mg Tablets
50mg/5mL Oral Solution 
   
Carbamazepine
View adult BNF View SPC online View childrens BNF
Formulary
Green
100mg & 200mg Tablets
125mg & 250mg Suppositories
200mg & 400mg Sustained Release Tablets
100mg/5mL Suspension

Suppositories of 125 mg may be considered to be approximately equivalent in therapeutic effect to tablets of 100 mg but final adjustment should always depend on clinical response (plasma concentration monitoring recommended).
 
   
Duloxetine 60mg
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Green

Third-line choice for neuropathic pain or first-line for diabetic neuropathy in accordance with JPC guidance. See link below.

60mg capsules only for this indication.

 
Link  Primary Care Guidelines for the Management of Chronic Non-cancer Pain in Adults (Sep 18)
   
Controlled Drug Gabapentin
View adult BNF View SPC online View childrens BNF
Formulary
Green

100mg, 300mg & 400mg Capsules

Ensure loading regime is prescribed when initiated therapy for neuropathic pain to reduce side effects. 300mg OD 1/7, 300mg BD 1/7 then 300mg TDS thereafter.

 
Link  DSU Oct 2017: Gabapentin (Neurontin): risk of severe respiratory depression
   
Controlled Drug Gabapentin 250mg/ 5mL
(Oral Solution)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Green

Restricted - for adult patients with swallowing difficulties or Paediatric patients only.

For enteral tube administration - open the capsule, dissolve the contents in water, and give immediately.

 
Link  DSU Oct 2017: Gabapentin (Neurontin): risk of severe respiratory depression
   
Controlled Drug Pregabalin
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Green

25mg, 50mg, 75, 100mg, 300mg capsules.

Third-line choice for neuropathic pain in accordance with JPC guidance. See link below.

 
Link  Primary Care Guidelines for the Management of Chronic Non-cancer Pain in Adults (Sep 18)
   
04.07.03  Trigeminal neuralgia
04.07.03  Postherpetic neuralgia
04.07.03  Chronic facial pain
04.07.04  Antimigraine drugs
04.07.04.01  Treatment of the acute migraine attack to top
04.07.04.01  Analgesics
04.07.04.01  5HT1 agonists
Sumatriptan
(Nasal spray)
View adult BNF View SPC online View childrens BNF
First Choice
Green

10mg or 20mg per metered dose Nasal Spray

Not for children under 12 years

 
Sumatriptan 50mg & 100mg
(Tablets)
View adult BNF View SPC online View childrens BNF
First Choice
Green
 
Sumatriptan 6mg/0.5mL
(Subcutaneous injection)
View adult BNF View SPC online View childrens BNF
First Choice
Green

Stock is held in the L&D Emergency Drug Cupboard

 
Frovatriptan
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Green

Frovatriptan should only be prescribed for the prevention of menstrual related migraine and should not be prescribed for the acute treatment of migraine (local joint formulary decision)

 

 

 
   
Naratriptan 2.5mg
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Zolmitriptan 2.5mg
(Orodispersible sugar-free Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Zolmitriptan 2.5mg
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green
 
   
Rizatriptan 5mg, 10mg
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Amber

Last-line choice. Specialist recommendation only.

 
   
04.07.04.01  Ergot alkaloids
04.07.04.01  Anti-emetics
04.07.04.01  Other drugs for migrane to top
04.07.04.02  Prophylaxis of migraine
Pizotifen
View adult BNF View SPC online View childrens BNF
Formulary
Green
500microgram Tablets
1.5mg Tablets  
   
Clonidine
View adult BNF View SPC online View childrens BNF
Formulary
Green
25microgram Tablets
 
   
Propranolol
View adult BNF View SPC online View childrens BNF
Formulary
Green
10mg, 40mg & 80mg Tablets
80mg MR Tablets
10mg in 5mL Sugar-Free Solution
50mg in 5mL Sugar-Free Solution

Migraine prophylaxis: 80–240 mg daily in divided doses

 
   
Botulinum Toxin Type A (botox®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
Restricted - to be initiated under Consultant authorization and in accordance with NICE TA260

Must be prescribed by brand name

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link on Netformulary homepage.  
Link  NICE TA260: Botox for migraine prophylaxis
   
04.07.04.03  Cluster headache
04.08  Antiepileptics
04.08.01  Control of epilepsy
Brivaracetam (Briviact®)
(Oral)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber
10mg,25mg,50mg,75mg,100mg film-coated tablets
10mg/mL oral solution
Restricted to patients who cannot have levetiracetam. 
   
04.08.01  Partial seizures with or without secondary generalisation to top
04.08.01  Generalised seizures
04.08.01  Carbamazepine and Oxcarbazepine
Carbamazepine
(Oral)
View adult BNF View SPC online View childrens BNF
Formulary
Amber

100mg, 200mg Tablets
200mg & 400mg Sustained Release Tablets
100mg/5mL Suspension

WARNING: Prescribe by brand to ensure patient is maintained on a specific manufacturer's product.

L&D hospital: Tegretol is the brand stocked which most patients are on. Other brands can be ordered if needed.

 
   
Carbamazepine 125mg, 250mg
(Suppositories)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber

Where oral administration not possible.
When switching from oral formulations to suppositories the dosage should be increased by approximately 25% (the 125 and 250mg suppositories correspond to 100 and 200mg tablets respectively).
Where Suppositories are used the maximum daily dose is limited to 1000mg (250mg qid at 6 hour intervals).
N.B. Cost increase to £144 for 5 x 125mg, £168 x 5 x 250mg
Only prescribe for short-term use in epilepsy. Consider enteral tube administration if for longer than 2-3 days.

 
   
Oxcarbazepine
(Oral)
View adult BNF View SPC online View childrens BNF
Formulary
Amber
150mg, 300mg & 600mg Tablets
300mg/5mL Suspension

Prescribing generically or by brand is discretionary.

Restricted - to initiation by Neurology specialists, with continuation by GPs and to be used in accordance with NICE CG137 - see link above.(Replaces NICE TA76). 
   
04.08.01  Ethosuximide
Ethosuximide
View adult BNF View SPC online View childrens BNF
Formulary
Amber

50mg in 1mL Oral Solution

May be prescribed generically.

 
   
04.08.01  Gabapentin and pregabalin
Controlled Drug Gabapentin
(Capsules)
View adult BNF View SPC online View childrens BNF
Formulary
Amber

100mg, 300mg & 400mg Capsules

For enteral tube administration the capsules can be opened and dissolved in water immediately before administration

May be prescribed generically

 
Link  UKMI Q&A - Gabapentin and pregabalin—are they safe whilst breastfeeding?
   
Controlled Drug Gabapentin 250mg/5mL
(Oral solution)
View adult BNF View SPC online View childrens BNF
Formulary
Amber

For paediatric patients or adults with swallowing difficulties

For enteral tube administration the capsules can be opened and dissolved in water immediately before administration

May be prescribed generically

 
   
Controlled Drug Pregabalin
(Capsules)
View adult BNF View SPC online View childrens BNF
Formulary
Amber

May be prescribed generically. Several strengths available - refer to BNF.

 
   
04.08.01  Lacosamide to top
04.08.01  Lamotrigine
Lamotrigine
View adult BNF View SPC online View childrens BNF
Formulary
Amber

25mg, 50mg & 100mg Tablets
5mg, 25mg & 100mg Soluble Tablets

Prescribing generically or by brand is discretionary.

 
   
04.08.01  Levetiracetam
Levetiracetam
(Oral)
View adult BNF View SPC online View childrens BNF
Formulary
Amber

250mg, 500mg & 1g Tablets
100mg/1mL Solution - N.B. risk of medication errors (overdose) in children. Always prescribe dose in milligrams.

May be prescribed generically.

 
   
Levetiracetam
(Injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
100mg/1mL Injection

May be prescribed generically 
   
04.08.01  Perampanel
04.08.01  Phenobarbital and other barbiturates
Controlled Drug Phenobarbital 15mg, 30mg
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Amber

Must prescribe by brand name.

When prescribing this product on TTA's and outpatient prescriptions, the quantity to be supplied must be stated in words and figures and counter signed in order to fulfill the legal requirements of a controlled drug prescriptions. e.g. Please supply 30 (thirty) (signed).

 
   
Controlled Drug Phenobarbital 30mg, 60mg
(Injection)
View adult BNF View SPC online View childrens BNF
Formulary
Amber
 
   
Primidone
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Green
50mg & 250mg Tablets  
   
Controlled Drug Phenobarbital
(Oral Solution)
View adult BNF View SPC online View childrens BNF
Unlicensed Drug Unlicensed
Amber
50mg/5mL Oral Solution for paediatrics (alcohol free)

When prescribing this product on TTA's and outpatient prescriptions, the quantity to be supplied must be stated in words and figures and counter signed in order to fulfill the legal requirements of a controlled drug prescriptions. e.g. Please supply Fifty milliliters (50 mL) (signed). 
   
04.08.01  Phenytoin to top
Phenytoin
(Oral)
View adult BNF View SPC online View childrens BNF
Formulary
Amber

25mg, 50mg & 100mg Capsules
30mg/5mL Suspension

Preparations containing phenytoin sodium are not bioequivalent to those containing phenytoin base (such as Epanutin Infatabs® and Epanutin® suspension); 100 mg of phenytoin sodium is approximately equivalent in therapeutic effect to 92 mg phenytoin base.

WARNING: Prescribe by brand to ensure patient is maintained on a specific manufacturer's product.

 
   
04.08.01  Retigaine
04.08.01  Rufinamide
04.08.01  Rufinamide
04.08.01  Tiagabine
04.08.01  Topiramate to top
Topiramate
View adult BNF View SPC online View childrens BNF
Formulary
Amber
25mg, 50mg & 100mg Tablets

15mg & 25mg Sprinkle Capsules - may be swallowed whole or opened and sprinkled on a teaspoon of soft food (must be swallowed immediately and not chewed).

Prescribing generically or by brand is discretionary. 
   
04.08.01  Valproate
Sodium Valproate (Epilim®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber

200mg & 500mg Enteric Coated Tablets
100mg Crushable Tablets
200mg/5mL Sugar-free liquid

Prescribing generically or by brand is discretionary.

See bottom of section for latest MHRA guidance on pregnancy prevention programme (Sept 18) and patient information toolkit (May 2018).

 
Link  MHRA Drug Safety Update (January 2015) - Medicines related to valproate: risk of abnormal pregnancy outcomes
Link  MHRA Drug Safety Update April 18: Valproate medicines (Epilim▼, Depakote▼): contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met
Link  MHRA Drug Safety Update Sept 2018: Valproate Pregnancy Prevention Programme: actions required now from GPs, specialists, and dispensers
   
Sodium Valproate (Epilim® Chrono)
(Modified release tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Amber

200mg, 300mg & 500mg Controlled Release Tablets. May be given once or twice daily.

Prescribing generically or by brand is discretionary.

See bottom of section for latest MHRA guidance on pregnancy prevention programme (Sept 18) and patient information toolkit (May 2018).

 
Link  MHRA Drug Safety Update (January 2015) - Medicines related to valproate: risk of abnormal pregnancy outcomes
Link  MHRA Drug Safety Update April 18: Valproate medicines (Epilim▼, Depakote▼): contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met
Link  MHRA Drug Safety Update Sept 2018: Valproate Pregnancy Prevention Programme: actions required now from GPs, specialists, and dispensers
   
Sodium Valproate (Episenta®)
(Prolonged release capsules)
View adult BNF View SPC online View childrens BNF
Formulary
Amber

150mg & 300mg Prolonged Release Capsules

Prescribing generically or by brand is discretionary.

See bottom of section for latest MHRA guidance on pregnancy prevention programme (Sept 18) and patient information toolkit (May 2018).

 
Link  MHRA Drug Safety Update (January 2015) - Medicines related to valproate: risk of abnormal pregnancy outcomes
Link  MHRA Drug Safety Update April 18: Valproate medicines (Epilim▼, Depakote▼): contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met
Link  MHRA Drug Safety Update Sept 2018: Valproate Pregnancy Prevention Programme: actions required now from GPs, specialists, and dispensers
   
Sodium Valproate (Episenta®)
(Injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

300mg/3mL Injection

Oral and IV bioavailability similar. Patients already satisfactorily treated with oral sodium valproate may be continued at their current dosage. The total daily dose should be divided in three to four single slow intravenous injections or should be given by continuous or repeated infusion.

See bottom of section for latest MHRA guidance on pregnancy prevention programme (Sept 18) and patient information toolkit (May 2018).

 
Link  MHRA Drug Safety Update (January 2015) - Medicines related to valproate: risk of abnormal pregnancy outcomes
Link  MHRA Drug Safety Update April 18: Valproate medicines (Epilim▼, Depakote▼): contraindicated in women and girls of childbearing potential unless conditions of Pregnancy Prevention Programme are met
Link  MHRA Drug Safety Update Sept 2018: Valproate Pregnancy Prevention Programme: actions required now from GPs, specialists, and dispensers
   
04.08.01  Vigabatrin
Vigabatrin (Sabril®)
View adult BNF View SPC online View childrens BNF
Formulary
Amber
500mg Tablets
500mg Sachets

May be prescribed generically. 
   
04.08.01  Zonisamide
04.08.01  Benzodiazepines
Clobazam
View adult BNF View SPC online View childrens BNF
Formulary
Amber
10mg Tablets
 
   
Clobazam 5mg/ 5mL
(Oral Suspension)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber
For paediatric patients.
For enteral tube administration, tablets will disperse in 1 to 5 minutes. 
   
Clonazepam
View adult BNF View SPC online View childrens BNF
Formulary
Amber

500microgram & 2mg Tablets
2mg/5mL Oral Solution

 
   
04.08.01  Other Drugs to top
04.08.02  Drugs used in status epilepticus
Lorazepam
(Injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red

4mg/1mL injection

 
   
Diazepam 10mg/2mL
(Injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
Note: Diazepam injection comes in two forms - solution (IM or IV) and emulsion Diazemuls® (IV only). Emulsion is preferred for IV as it is less irritant to the vein. 
   
Controlled Drug Midazolam (Buccolam ®)
(Oromucosal solution, prefilled syringe)
View adult BNF View SPC online View childrens BNF
Formulary
Amber
Must be prescribed by brand name. Start all new patients on Buccolam (as licensed).

2.5mg/0.5ml, 5mg/1 ml, 7.5mg/1.5ml & 10mg/2ml Pre-filled oral syringe.

When prescribing this product on TTA's and outpatient prescriptions, the quantity to be supplied must be stated in words and figures and counter signed in order to fulfill the legal requirements of a controlled drug prescriptions. e.g. Please supply two (2) syringes (signed).  
Link  MHRA Drug Safety Update (August 2012) - Epistatus, Midazolam 10mg in 1ml Buccal Liquid x 5ml - packs containing new syringes to be distributed
   
Paraldehyde - Enema In Olive Oil
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
Paediatrics only  
   
Controlled Drug Phenobarbital
(Injection)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
30mg/1mL, 60mg/1mL & 200mg/1mL Injection
 
   
Phenytoin
(Injection)
View adult BNF View SPC online View childrens BNF
Formulary
Red
250mg/5mL Injection  
Link  Protocol for IV Phenytoin for Status Epilepticus in Adults
   
Controlled Drug Midazolam
(Injection)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
Restricted - intravenous route to be used on ITU only



 
Link  MHRA Drug Safety Update (August 2012) - Epistatus, Midazolam 10mg in 1ml Buccal Liquid x 5ml - packs containing new syringes to be distributed
   
Controlled Drug Midazolam (Epistatus®)
(Oromucosal solution, prefilled syringe)
View adult BNF View SPC online View childrens BNF
Unlicensed Drug Unlicensed
Amber
Must be prescribed by brand name

2.5mg/0.25mL, 5mg/0.5mL, 7.5mg/0.75mL & 10mg/1mL Oral pre-filled syringe
 
Link  MHRA Drug Safety Update (August 2012) - Epistatus, Midazolam 10mg in 1ml Buccal Liquid x 5ml - packs containing new syringes to be distributed
   
04.08.03  Febrile convulsions
04.09  Drugs used in parkinsonism and related disorders
04.09.01  Dopaminergic drugs used in Parkinsons disease
Opicapone 50mg
(Capsules)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber
Must be initiated by a Neurologist who specialises in Parkinson’s Disease and may be continued by the GP.

Only for patients who cannot tolerate entacapone as per JPC bulletin. 
Link  JPC Bulletin 262: Opicapone for Parkinson’s Disease (Dec 17)
   
04.09.01  Dopamine receptor agonists to top
Apomorphine
(Pre-filled syringes)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber SCG

Dacepton and APO-go brands

Dacepton ®

30mg/3mL pen cartridge

100mg/20mL solution for infusion

APO-go ®

30mg in 3ml pen

50mg/10mL prefilled syringe solution for infusion

  • initiation by consultant specialising in Parkinson's only inline with JPC shared care guideline (shared care guidline currently being updated)


 
Link  JPC shared care guideline for the use of apomorphine in treatment of Parkinson’s disease
Link  MHRA Drug Safety Update (April 2016) - Apomorphine with domperidone: minimising risk of cardiac side effects
   
Bromocriptine
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber
5mg & 10mg Capsule
Consultant initiation. Risk of fibrotic reactions so careful monitoring required. 
   
Pramipexole
View adult BNF View SPC online View childrens BNF
Formulary
Amber
88mmicrograms, 180micrograms, 350micrograms, 700micrograms

N.B. prolonged release formulation non-formulary. 
   
Ropinirole
View adult BNF View SPC online View childrens BNF
Formulary
Amber
500micrograms, 2mg tablets
2mg, 4mg & 8mg modified-release tablets 
   
Rotigotine (Neupro®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber

1mg, 2mg, 4mg, 6mg & 8mg Transdermal 24 hour patch

Restricted Item  Only for patients who are nil by mouth.

For conversion calculations from levodopa and dopamine agonists, refer to Trust Guideline 336 - The Management of Patients with Parkinson’s Disease In an Emergency and when Nil By Mouth. Also see attached protocol from these guidelines.

Please note doses are different when used for Restless Leg Syndrome - see BNF or SPC for further information

 
Link  GUIDELINES FOR TREATMENT OF PATIENTS WITH PARKINSON’S DISEASE (PD) IN AN EMERGENCY OR WHEN NIL‐BY‐MOUTH
Link  Parkinson’s UK: Emergency management of patients with Parkinson’s
   
04.09.01  Levodopa
Co-Beneldopa
View adult BNF View SPC online View childrens BNF
Formulary
Green

Ensure doses are prescribed at exact times as per patient's medication history using the 'free form' option on ePMA

62.5mg, 125mg & 250mg Capsules
62.5mg & 125mg Dispersible Tablets - for NBM patients only.
125mg Sustained Release Tablets 

Generic available. In hospital: contract brand will be supplied.

Primary care: Most cost effective brand to be advised via ScriptSwitch/ Optimise



If nil by mouth consult trust guidelines 336 - The Management of Patients with Parkinson’s Disease in an emergency and when Nil By Mouth.

 
Link  UKMI Q&A - How do you convert from co-beneldopa (Madopar®) prolonged-release capsules to dispersible tablets?
   
Co-Careldopa
View adult BNF View SPC online View childrens BNF
Formulary
Green

Ensure doses are prescribed at exact times as per patient's medication history using the 'free form' option on ePMA

Generic available. In hospital: contract brand will be supplied.

Primary care: Most cost effective brand to be advised via ScriptSwitch/ Optimise

Carbidopa / levodopa: 12.5/50mg, 10/100mg, 25/ 100mg & 25/250mg 
Carbidopa / levodopa: 25/100mg, 50/200mg Controlled Release tablets

L&D Hospital: If nil by mouth consult trust guidelines 336 - The Management of Patients with Parkinson’s Disease in an emergency and when Nil By Mouth.

 
   
Co-Careldopa and Entacapone (Levodopa/Carbidopa/Entacapone)
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Amber

Ensure doses are prescribed at exact times as per patient's medication history using the 'free form' option on ePMA

Levodopa 50mg/Carbidopa 12.5mg/Entacapone 200mg Tablets
Levodopa 75mg/Carbidopa 18.75mg/Entacapone 200mg Tablets
Levodopa 100mg/Carbidopa 20mg/Entacapone 200mg Tablets
Levodopa 125mg/Carbidopa 31.25mg/Entacapone 200mg Tablets
Levodopa 150mg/Carbidopa 37.5mg/Entacapone 200mg Tablets
Levodopa 200mg/Carbidopa 50mg/Entacapone 200mg Tablets

Secondary care: the current contract generic product will be supplied against any prescriptions. Generic brands include Sastravi and Stanek.

Primary care: Most cost effective brand to be advised via ScriptSwitch/ Optimise

 
   
04.09.01  Monoamine-oxidase-B inhibitors
Selegiline 5mg, 10mg
(Tablets)
View adult BNF View SPC online View childrens BNF
Formulary
Amber
 
   
04.09.01  Catachol-O-methyltransferase inhibitors
Entacapone
View adult BNF View SPC online View childrens BNF
Formulary
Amber
200mg Tablets 
   
04.09.01  Amantadine
Amantadine
View adult BNF View SPC online View childrens BNF
Formulary
Amber
100mg Capsules
Restricted Item 50mg/5mL Syrup - only to be prescribed for patients who cannot swallow capsules. 
   
04.09.02  Antimuscarinic drugs used in parkinsonism to top
Orphenadrine
View adult BNF View SPC online View childrens BNF
Formulary
Amber

50mg Tablets
50mg/5mL Oral Solution

 
   
Procyclidine
View adult BNF View SPC online View childrens BNF
Formulary
Amber

5mg Tablets
5mg/5mL Syrup

 
   
Trihexyphenidyl
View adult BNF View SPC online View childrens BNF
Formulary
Amber

2mg & 5mg Tablets
5mg/5mL Syrup

 
   
04.09.03  Drugs used in essential tremor, chorea, tics, and related disorders
Riluzole 50mg (Rilutek®)
(Tablets)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.
Restricted -prescribing by Consultant neurologists only in accordance with NICE TA20.

 
Link  NICE TA20: Motor neurone disease - riluzole
   
Tetrabenazine
View adult BNF View SPC online View childrens BNF
Formulary
Green
25mg Tablets  
   
Botulinum Toxin Type A (Xeomin®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
CCG

FOR ALL PRESCRIBING - Blueteq or High Cost Drug Form required - see link from Formulary Homepage.

Restricted prescribing in accordance with the following NICE TA:

 
Link  NICE TA 605 Xeomin (botulinum neurotoxin type A) for treating chronic sialorrhoea
   
04.09.03  Torsion dystonias and other involuntary movements
Botulinum Toxin Type A 100 units (Botox ®)
(Injection)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
High Cost Medicine
FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Restriction - for consultant initiation only
Must be prescribed by both GENERIC and BRAND name 
   
Botulinum Toxin Type A 300units, 500units (Dysport®)
(Injection)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Restriction - for consultant initiation only
Must be prescribed by both GENERIC and BRAND name 
   
04.10  Drugs used in substance dependence
04.10  Alcohol dependence
04.10  Cigarette smoking to top
04.10  Opioid dependence
04.10.01  Alcohol dependence
Acamprosate (Campral EC®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber SCG
Restricted - only to be initiated by a specialist in drug and alcohol problems or for continuing treatment in accordance with NICE guidance and JPC shared care guidelines. 
Link  JPC SHARED CARE GUIDELINES FOR USE OF ACAMPROSATE IN THE TREATMENT OF ALCOHOL DEPENDENCE
   
Disulfiram (Antabuse®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber
Restricted - only to be initiated by a specialist in drug and alcohol problems or for continuing treatment.

200mg Tablets  
Link  NICE CG115: Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence
   
Nalmefene
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber
18mg Tablets
Restricted - only to be initiated by a specialist in drug and alcohol problems or for continuing treatment in accordance with NICE TA325 
Link  NICE TA325: Nalmefene for reducing alcohol consumption in people with alcohol dependence
   
Naltrexone
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber SCG
50mg Tablets
Restricted - only to be initiated by a specialist in drug and alcohol problems or for continuing treatment in accordance with the JPC shared care guidance.



 
Link  JPC Shared Care Guideline - BEDFORDSHIRE & LUTON JOINT PRESCRIBING COMMITTEE SHARED CARE GUIDELINES FOR USE OF NALTREXONE IN THE TREATMENT OF ALCOHOL DEPENDENCE
Link  JPC Shared Care Guideline - BEDFORDSHIRE & LUTON JOINT PRESCRIBING COMMITTEE SHARED CARE GUIDELINES FOR USE OF NALTREXONE IN THE TREATMENT OF OPIOID DEPENDENCE
   
04.10.02  Nicotine dependence
Bupropion Hydrochloride (Zyban®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Green
For use in accordance with the Luton & Dunstable Hospital's Trust Guidelines.

Restricted - to be prescribed on the recommendation of a smoking cessation specialist. 
   
Nicotine Replacement Therapy
View adult BNF View SPC online View childrens BNF
Formulary
Green

7mg, 14mg & 21mg Patches (NiQuitin brand - releasing approx. 7mg, 14mg or 21mg over 24 hours). Leave on for 24 hours.

1.5mg, 4mg Mini Lozenges, mint (NiQuitin)

15mg Inhalator (Nicorette)

1mg per metered dose mouth spray - (Nicorette Quickmist)

2mg, 4mg gum (Nicorette)

N.B. Primary Care will only support the prescribing of monotherapy.

 
Link  UKMI Q&A - What is the evidence for nicotine replacement therapy for ulcerative colitis?
   
Varenicline (Champix®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Green
500mcg and 1mg Tablets

Restricted - to be used in accordance with Trust Guidelines, NICE TA123 and Public Health guidance, as second line therapy when NRT has failed.  
Link  NICE TA123: Varenicline
   
04.10.03  Opioid dependence
04.10.03  Opioid substitution therapy to top
Controlled Drug Buprenorphine 2mg, 8mg
(Sublingual tablets)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red

Restricted - prescribing by specialist dependency services according to NICE TA114.

Prescribe generically.

 
   
Controlled Drug Buprenorphine 2mg, 8mg (Espranor®)
(Orodispersible tablets)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red
Restricted - prescribing by specialist dependency services according to NICE TA114. N.B. Must ensure the correct formulation is prescribed as these are not interchangeable with the sublingual tablets. L&D:Listed on JAC as 'buprenorphine (Espranor) orodispersible tablets' 
   
Controlled Drug Buprenorphine / Naloxone
(Sublingual tablet)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red

Buprenorphine 2mg / naloxone 500micrograms
Buprenorphine 8mg / naloxone 2mg
Restricted - prescribing by specialist dependency services according to NICE TA114.

Prescribe generically

 
   
Controlled Drug Methadone 1mg/ 1mL
(Oral Solution)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red

Restricted for continuation of patients already on Methadone as part of their drug withdrawal scheme. For new patients refer to Drugs & Alcohol services.

This strength is only to be prescribed for addicts.

 
   
04.10.03  Adjunctive therapy and symptomatic treatment
Lofexidine
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber
200microgram Tablets

For continuing treatment only. To be initiated by the Mental Health Team. 
   
04.10.03  Opioid-receptor antagonists
Naltrexone
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber SCG
50mg Tablets
Restricted - only to be initiated by a specialist in drug and alcohol problems or for continuing treatment according to NICE TA115.
See JPC shared Care Guidelines for opioid dependence and alcohol dependence. 
Link  JPC SHARED CARE GUIDELINES FOR USE OF NALTREXONE IN THE TREATMENT OF ALCOHOL DEPENDENCE
Link  JPC SHARED CARE GUIDELINES FOR USE OF NALTREXONE IN THE TREATMENT OF OPIOID DEPENDENCE
Link  NICE TA115: Drug misuse - naltrexone
   
04.11  Drugs for dementia
Donepezil
View adult BNF View SPC online View childrens BNF
Formulary
Amber
5mg & 10mg Tablets
10mg Orodispersible Tablet

Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE TA217. 
   
Galantamine
View adult BNF View SPC online View childrens BNF
Formulary
Amber
8mg Tablets
8mg, 16mg & 24mg Modified release capsules

Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE TA217. 
   
Galantamine
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber
4mg/1mL oral solution.

Restricted - to patients who cannot swallow ordinary tablets AND
Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE TA217.

N.B. Much more expensive than tablets / capsules. 
   
Memantine
View adult BNF View SPC online View childrens BNF
Formulary
Amber
10mg & 20mg Tablets
10mg/1mL pump actuation oral solution

Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE TA217.  
   
Rivastigmine
(Patches)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Amber
4.6mg/24hours, 9.5mg/24hours

Restricted - to patients who are nil by mouth AND
Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE TA217.
 
Link  MHRA Drug safety Update (June 2010) - Rivastigmine (Exelon) transdermal patch: risk of medication errors
   
Rivastigmine
(Oral)
View adult BNF View SPC online View childrens BNF
Formulary
Amber
1.5mg & 6mg Capsules

Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE 217. 
   
 ....
 Non Formulary Items
Controlled Drug  Alfentanyl Sublingual Spray 5 mg in 5mL

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Almotriptan  (Almogran®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Amantadine  (Lysovir®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
AMANTADINE Injection 200 mg in 500mL

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Amitriptyline and perphenazine  (Triptafen®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Amitriptyline and perphenazine  (Triptafen-M®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Controlled Drug  Amobarbital (amylobarbitone) and secobarbital (quinalbarbitone)  (Tuinal®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Controlled Drug  Amobarbital (amylobrbitone)  (Sodium Amytal®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Analgesics  (Migraleve®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Aripiprazole  (Abilify Maintena®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Asenapine

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Aspirin  (Nu-Seals® Aspirin)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Aspirin and codeine  (Co-codaprin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Aspirin and metoclopramide  (MigraMax®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Aspirin and papaveretum  (Aspav®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Aspirin IV  (ASPEGIC®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Betahistine Dihydrochloride  (Serc®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Botulinum Toxin Type A  (Azzalure®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Botulinum Toxin Type A  (Vistabel®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Botulinum Toxin Type B 10,000units/2mL  (NeuroBloc®)
(Injection)

View adult BNF View SPC online View childrens BNF
Non Formulary
Link  JPC policy for Use of Botulinum Toxin B in patients with cervical dystonia
 
Buspirone Hydrochloride  (Buspar®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Controlled Drug  Butobarbital (butobarbitone)  (Soneryl®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cabergoline

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Capsaicin

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Carbamazepine

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Chloral Hydrate 300mg in 5mL

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Chlorpromazine Hydrochloride  (Largactil®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cinnarizine and Dimenhydrinate  (Arlevert®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Clomethiazole

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Clomipramine  (Anafranil® SR)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Cloral Betaine

View adult BNF View SPC online View childrens BNF
Non Formulary

Less suitable for prescribing, consider alternatives.

£140 for 30 tablets (June 2019).

 
Clozapine  (Zaponex®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Co-proxamol

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Controlled Drug  Dextromoramide

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Controlled Drug  Dipipanone

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
Now de-branded (from Diconal) and costs about £400 for 50.
 
Dolasetron Mesilate  (Anzemet®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Dosulepin

View adult BNF View SPC online View childrens BNF
Non Formulary

No longer recommended.

 
Doxepin

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Eletriptan  (Relpax®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ergotamine Tartrate

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Eslicarbazepine  (Zebinix®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ethosuximide  (Emeside®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Controlled Drug  Fentanyl  (Actiq®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Controlled Drug  Fentanyl  (Instanyl® nasal spray)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Controlled Drug  Fentanyl Buccal Film  (Breakyl)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Controlled Drug  Fentanyl Nasal Spray  (PecFent®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Flupentixol  (Depixol®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Flupentixol Decanoate

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Fluphenazine Decanoate 25mg/1mL, 100mg/1mL
(Injection (oily))

View adult BNF View SPC online View childrens BNF
Non Formulary

Discontinued 2019.

25mg/ml will expire August 2019

100mg/ml will expire August 2010.

Patients should be switched to an alternative.

 
Flurazepam  (Dalmane®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Fosaprepitant  (Ivemend®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Fosphenytoin Sodium  (Pro-Epanutin®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Granisetron transdermal patch  (Sancuso®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Haloperidol  (Dozic®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Haloperidol  (Haldol®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Haloperidol  (Serenace®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Haloperidol 1mg/ 5mL
(Liquid)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black

unlicensed unlicensed

 No longer manufactured.

 
Haloperidol 50mg/1mL, 100mg/1mL
(Injection (oily))

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Controlled Drug  Hydromorphone  (Palladone®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Controlled Drug  Hydromorphone Hydrochloride  (Palladone® SR)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Isometheptene Mucate  (Midrid®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Ketamine oral solution

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lacosamide  (Vimpat ® )

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lamotrigine

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lamotrigine  (Lamictal®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
LEVOMEPROMAZINE (METHOTRIMEPRAZINE)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lisuride

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Lithium Citrate  (Li-Liquid®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Melatonin

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Controlled Drug  Meprobamate

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Controlled Drug  Methadone 5mg
(Tablets)

View adult BNF View SPC online View childrens BNF
Non Formulary

Restricted - initiation by specialists with experience of using methadone.

 
Methysergide  (Deseril®)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Metoclopramide  (Maxolon® SR)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Metoclopramide Hydrochloride  (Maxolon® High Dose)

View adult BNF View SPC online View childrens BNF
Non Formulary
 
Mirtazapine 15mg/1mL
(Oral Solution)

View adult BNF View SPC online View childrens BNF
Non Formulary
Black
About 50 x more expensive than orodispersible tablets.
Use orodispersible tablets for patients with swallowing difficulties and for enteral tube administration.
 
Modafinil  (Provigil®)

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Non Formulary
 
Controlled Drug  Morphine and cyclizine  (Cyclimorph®)

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Non Formulary
 
Controlled Drug  Morphine suppositories

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Non Formulary
 
Nabilone

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Non Formulary
 
Naltrexone/ bupropion  (Mysimba®)

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Non Formulary
High Cost Medicine

Not recommended by NICE.

Link  NICE TA494: Naltrexone–bupropion for managing overweight and obesity
 
Nefopam

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Non Formulary
 
Nefopam  (Acupan®)

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Non Formulary
 
Netupitant and Palonosetron  (Akynzeo®)

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Non Formulary
 
Netupitant and Palonosetron  (Akynzeo®)

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Non Formulary
 
Nicotine  (Nicorette® Invisi patches)

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Non Formulary
 
Nicotine  (Nicotinell®)

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Non Formulary
 
Olanzapine Embonate  (ZypAdhera®)

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Non Formulary
 
Controlled Drug  Oxycodone/Naloxone  (Targinact®)
(Tablets)

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Non Formulary
Black
Trial period has expired. No good evidence to support this drug - do not prescribe. Not prescribable in Primary care.
 
Paliperidone  (Xeplion®)

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Non Formulary
 
Palonosetron  (Aloxi®)

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Non Formulary
 
Controlled Drug  Papaveretum

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Non Formulary
 
Paracetamol and codeine  (Co-codamol ®15/500)

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Non Formulary
 
Paracetamol and methionine  (Pardote®)

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Non Formulary
 
Paracetamol and metoclopramide  (Paramax®)

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Non Formulary
 
Controlled Drug  Pentazocine

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Non Formulary
 
Perampanel  (Fycompa®)

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Non Formulary
Link  NICE CG137: The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care
 
Pergolide

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Non Formulary
 
Pergolide  (Celance®)

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Non Formulary
 
Perphenazine

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Non Formulary
 
Perphenazine  (Fentazin®)

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Non Formulary
 
Controlled Drug  Pethidine Hydrochloride and promethazine  (Pamergan® P100)

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Non Formulary
 
Phenelzine  (Nardil®)

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Non Formulary
 
Pipotiazine Palmitate 50mg/1mL

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Non Formulary
 
Piracetam  (Nootropil®)

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Non Formulary
 
Pramipexole Prolonged Release  (Mirapexin®)
(Tablets)

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Non Formulary
 
Pregabalin

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Non Formulary
 
Prochlorperazine

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Non Formulary
 
Prochlorperazine  (Buccastem® (Bucal preparation))

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Non Formulary
 
Promazine

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Non Formulary
 
Promethazine Teoclate  (Avomine®)

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Non Formulary
 
Rasagiline

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Non Formulary
 
Retigabine

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Non Formulary
Amber
50mg & 100mg Tablets

N.B. Retigabine has been withdrawn from the market. All patients to be withdrawn by the end of June 2017.
Link  MHRA Drug Safety Update (July 2013) - Retigabine: indication restricted to last-line use and new monitoring requirements
Link  NICE TA232: Retigabine for the adjunctive treatment of adults with partial onset seizures in epilepsy with and without secondary generalisation
 
Rimonabant  (Acomplia®)

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Non Formulary
 
Risperidone  (Risperdal Consta®)

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Non Formulary
 
Rufinamide  (Inovelon®)

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Non Formulary
 
Safinamide

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Non Formulary
 
Controlled Drug  Secobarbital (quinalbarbitone)  (Seconal Sodium® )

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Non Formulary
 
Selegiline  (Zelapar®)
(Oral Lyophilisate)

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Non Formulary
 
Sertindole  (Serdolect®)

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Non Formulary
 
Controlled Drug  Sodium Oxybate  (Xyrem®)

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Non Formulary
High Cost Medicine
 
Sodium Valproate  (Convulex®)

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Non Formulary
 
Sufentanil  (Zalviso®)

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Non Formulary
 
Sulpiride

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Non Formulary
 
Sulpiride  (Dolmatil®)

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Non Formulary
 
Controlled Drug  Tapentadol  (Palexia®)

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Non Formulary
 
Tasimelteon  (Hetlioz®)

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Non Formulary
 
Tasimelteon  (Hetlioz®)

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Non Formulary
 
Tiagabine  (Gabitril®)

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Non Formulary

Must be initiated in a tertiary centre

 
Tolcapone  (Tasmar®)

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Non Formulary
 
Tolfenamic Acid  (Clotam®)

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Non Formulary
 
Tramadol Hydrochloride  (Dromadol®SR)
(Sustained Release Tablets)

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Non Formulary
 
Tramadol Hydrochloride  (Larapam® SR)
(Sustained Release Tablets)

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Non Formulary
 
Tramadol Hydrochloride  (Zamadol® SR)
(Sustained Release Tablets)

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Non Formulary
 
Controlled Drug  Tramadol Hydrochloride and paracetamol  (Tramacet®)

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Non Formulary
 
Controlled Drug  Tramadol MR  (Marol MR® and Tramulief SR®)
(Sustained Release Tablets)

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Non Formulary
 
Controlled Drug  Tramadol oral drops

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Non Formulary
 
Tranylcypromine

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Non Formulary
 
Trazodone

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Non Formulary
 
Trazodone Hydrochloride  (Molipaxin®)

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Non Formulary
 
Triclofos Sodium  (Triclofos® oral Solution BP (Triclofos Elixir))

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Non Formulary
 
Trifluoperazine  (Stelazine®)

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Non Formulary
 
Trimipramine  (Surmontil®)

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Non Formulary
 
Tropisetron  (Navoban®)

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Non Formulary
 
Tryptophan

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Non Formulary
 
Trytophan  (Optimax®)

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Non Formulary
 
Zaleplon  (Sonata®)

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Non Formulary
 
Ziprasidone  (Zeldox®)

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Non Formulary
 
Zonisamide  (Zonegran®)

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Non Formulary
 
Zotepine  (Zoleptil®)

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Non Formulary
 
Zuclopenthixol Acetate  (Clopixol Acuphase®)

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Non Formulary
 
Zuclopenthixol Decanoate 500mg/1mL  (Clopixol Conc.®)
(Injection (oily))

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Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF