• 200mg in 20ml (10mg/ml), 500mg in 10ml (50mg/ml) & 1g in 10ml (100mg/ml) injections
• 50mg in 5ml oral solution unlicensed

• Often used as an analgesic in the management of neuropathic pain by specialist pain teams 

• 99.9% inhalation vapour
  • Approved for use in trauma related pain in Emergency Departments, in adults only
  • Approved for procedural analgesia in procedures such as VAC dressing change/stent change/brachytherapy rod change, in adults only

50% nitrous oxide and 50% oxygen mixture used for analgesia

• 1mg in 5ml and 3mg in 30ml injections in prefilled syringes used in cardiac resuscitation.

• 200 microgram in 1ml
• 600 microgram in 3ml injections
•  for EoL use in line with NENC Palliative and End of Life Care Symptom Control Guidelines

• 2mg, 5mg tablets – 10mg tablets should no longer be used.
• 2mg in 5ml oral solution.
• 10mg in 2ml injection (plain & emulsion) .
  
  • For use in epilepsy see section 4.8.2 and use in anxiety see
    section 4.1.2.
  
  

• See section 04.01.02.

• 5mg in 5ml, 10mg in 2ml injections
• 50mg in 50ml prefilled syringes - ITU use only 
• Intranasal midazolam 40mg/ml + lidocaine 20mg/ml 
  
  • approved for use prior to cannulation for adult patients with
    special needs receiving dental treatment under IV sedation.

• Miprosed® 5mg in 1ml (7.5ml) oral solution is approved for use as a sedative and pre-medication in children 

Palliative care

• 10mg/2ml injection 

• see section 04.01.01

• 30mg/5ml syrup.
  
  • see section 03.04.01 for other formulations.

• Mainly for use in post-operative analgesia - see section 10.01.01 for other formulations

• For peri-operative use only.

• 10mg/1ml & 30mg/1ml injection
  
  • the use of this is no longer recommended, other parenteral analgesics are now preferred
  
  

• All non-palliative care indications

• 500micrograms in 1ml [ST&S], 1mg in 2ml, 5mg in 10ml & 5mg in 1ml injection ampouless - approved for initiation by specialists in palliative care

• 100 microgram in 2ml & 500 microgram in 10ml injections 
• 2.5mg in 50ml (50 micrograms/ml) syringe unlicensed 

• 2 micrograms/ml with levobupivacaine 0.1% in sodium chloride 0.9% infusion, 100ml, 250ml & 500ml unlicensed
• 4 micrograms/ml with levobupivacaine 0.125% in sodium chloride 0.9% infusion, 500ml (RVI) unlicensed

• 1mg, 2mg & 5mg injections.

• 100 micrograms in 1ml injection approved for use in patients:
  
  
  
  
  • with traumatic brain injury, have no respiratory problems but require prolonged ventilatory support due to severe agitation, confusion and requirement for propofol/midazolam; and
  
  
  • who are difficult to sedate e.g. with overdose of MDMA/PMA/”legal highs” or who have pre-existing drug or alcohol dependence or who have failed conventional methods of treatment.
  
  
  • Paediatric patients undergoing cardiac surgery with a high risk of post-operative Junctional Ectopic Tachyarrhythmia (JET) or those suitable for fast-track surgery.
  
  
  
  


• 100 micgrograms in 1ml injection (intranasal) unlicensed route
  
  
  
  
  • approved for pre-operative sedation in anxious children at risk of respiratory depression in whom midazolam is contraindicated or those who have failed pre-operative sedation with other agents.
  
  
  
  

• 100mg/2ml injection

• 25mg in 2.5ml
• 50mg in 5ml  
• 250mg in 25ml injection

• 20mg in 10ml (2mg/ml) injection
• 150mg in 30ml (5mg/ml) injection

• 10mg in 5ml injection
• 20mg in 10ml injection

• 4mg in 2ml injection

• 30mg/2ml injection unlicensed

• 50mg in 5ml injection

• 10mg in 5ml injection

• 10mg in 1ml injection

• 2.5mg in 1ml injection

• Glycopyrronium 500 microgram & neostigmine 2.5mg in 1ml injection (Robinul – neostigmine)

• 1mg in 1ml injection unlicensed

• 200mg in 2ml & 500mg in 5ml injections
  
  • Approved for the emergency reversal of blockade in cases of failed intubation in patients who are undergoing rapid sequence induction anaesthesia with rocuronium because of contra-indications to suxamethonium.
  • Approved for the reversal of rocuronium blockade in obstetric general anaesthesia for caesarean sections.
  
  

• 100mg in 5ml injection
• 2mg/ml 500ml intravenous infusion in glucose 5%
  see section 03.05.01

• 500 microgram in 5ml injection

• 400 microgram in 1ml injection (ampoules).
• 2mg/2ml pre-filled syringes (as per ACMD guidance).

• 20mg injection

•  0.3 molar peppermint falvoured solution.

• 0.25% & 0.5% injection 10ml
• 0.25% & 0.5% + adrenaline 1 in 200,000 inj. 10ml
• 0.5% in glucose 8% injection (Marcain Heavy)
• 0.1% & 0.125% unlicensed in sodium chloride 0.9% infusions

• 133mg/10ml & 266mg/20ml prolonged-release dispersion for injection.
• Alternative to local anaesthetic infusion via an indwelling brachial plexus nerve catheter for major shoulder/upper limb surgery.
• Audit of outcomes to be presented to trust Drug and therapeutic Committee's and Formulary Working Group within 12 months (from April 2024).

• 0.25%, 25mg in 10ml & 0.5%, 50mg in 10ml & 0.75%, 75mg in 10ml injections 
• 0.625mg/ml & 1.25mg/ml infusion bags 
  - for local infiltration in hip and knee replacement surgery.

• Injections (plain)
• 0.5% 10ml
• 1% 2ml, 5ml, & 10ml (10mg/ml)
  
  • approved for use in post-operative pain management subject to local protocols with a review of adverse events to be submitted by October 2018
• 2% 2ml, 5ml & 20ml injection (20mg/ml)
• 5% 2ml Heavy injection (50mg/ml)
• 5% 10ml injection (50mg/ml) unlicensed
• Topical preparations
• 1% & 2% gel with chlorhexidine 0.25%
• 4% topical solution (some packs unlicensed)
• 5% ointment
• 2% spray unlicensed
• 100mg lollipops unlicensed
• Lidocaine 4%, adrenaline 0.1% & tetracaine 0.5% (LAT gel®) unlicensed
  - approved for use in anaesthetising lacerations particularly in the paediatric population – not to be used in children
  weighing under 15kg.

• 5% lidocaine & 0.5% phenylephrine solution with
  applicator

• Metered dose spray (10mg/spray)

• 0.5% 10ml injection unlicensed, 1% 20ml injection.

• 4% 2ml injection (cartridges).

• 2% 5ml injection (cartridges) 
  
  

• Only to be used in patients undergoing spinal anaesthesia for day surgery where the procedure is anticipated to last less than 90 minutes.

• 3% & felypressin injection (cartridges).

• 50mg/5ml ampoules & 400mg/20ml vials.
  
  
  
  • Approved for spinal nerve and peripheral blocks. To be reviewed in April 2022.
  
  
  
  

• 0.2% (200mL) infusion 
  
  
  
  • approved for peripheral nerve block infusions for post-operative pain
  
  
  
  


• 0.75% (10mL)
  
  
  
  • approved for use in setting of conversion from labour epidural analgesia to surgical analgesia for emergency caesarean section
  
  
  
  


• 0.2% (10mL) solution for injection
  
  
  
  • approved as an option for ambulatory day case hand surgery
  
  
  
  

• 4% gel

• Articaine 4% & adrenaline 1 in 100,000 injection
• approved for mandibular procedures in patients in whom nerve blocks are contraindicated.

• 4% nasal solution (drops) unlicensed
  25% paste (1g syringe pack) unlicensed

• 4% solution with adrenaline unlicensed

• 3% 2.2 ml cartridges