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NHS Sunderland Clinical Commissioning Group
City Hospitals Sunderland NHS Foundation Trust
 
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 Formulary Chapter 4: Central nervous system - Full Chapter
Notes:

As psychiatric services are provided by Northumberland, Tyne and Wear NHS Foundation Trust (NTW) the drugs available for Sections 4.1, 4.2, 4.3 and 4.4 are those listed in the Formulary used by NTW which is the North of Tyne Formulary

 Details...
04.02.01  Expand sub section  Antipsychotic Drugs
04.02.01  Expand sub section  First-Generation Antipsychotic Drugs
04.02.01  Expand sub section  Second-Generation Antipsychotic Drugs
Risperidone
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First Choice
Green +
Tablets: 500 microgram, 1mg, 2mg, 3mg, 4mg, 6mg
Oral liquid: 1mg/1ml
Orodispersible tablets: 500 microgram, 1mg, 2mg (Quicklets )
N.B. The dispersible tablets should only be used in situations where the plain tablets are unsuitable
 
Amisulpride
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Second Choice
Green +
Tablets: 50mg, 200mg
Oral solution: 100mg/1ml 
   
Aripiprazole
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Alternatives
Green +
Tablets: 5mg, 10mg, 15mg, 30mg

Orodispersible tablets: 10mg, 15mg
- for doses over 5 mg for those patients who have difficulty swallowing

Oral solutions: 1mg/1ml
- only for doses of 5 mg or less, or when titrating patients on doses of increments of less than 5 mg, in patients who have difficulty swallowing tablets 
Link  NICE TA213: Aripiprazole for the treatment of schizophrenia in people aged 15 -17 years
Link  NICE TA292: Bipolar disorder (children) - aripiprazole
   
Aripiprazole
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Alternatives
Red
IM Injection: 7.5mg/ml
- approved for use in rapid tranquilisation in patients with acute psychosis. NTW use only 
   
Clozapine
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Alternatives
Red
Tablets: 25mg, 100mg
First choice in patients with treatment-resistant schizophrenia
Contact NTW pharmacy department for continued supplies of clozapine during admission and on discharge 
   
Olanzapine
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Alternatives
Green +
Tablets: 2.5mg, 5mg, 7.5mg, 10mg, 15mg, 20mg
Orodispersible tablets: 5mg, 10mg, 15mg
N.B. The orodispersible tablets should only be used in situations where the plain tablets are unsuitable

10mg injection
- For rapid control of agitation and disturbed behaviours in patients with schizophrenia or manic episode, when oral therapy is not appropriate.
- The orodispersible tablets and injection are also approved for 2nd/3rd line use in the management of delirium in critical care patients unlicensed indication.
 
   
Quetiapine
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Alternatives
Green +

Tablets: 25mg, 100mg, 150mg, 200mg, 300mg
Prolonged release tablets: 50mg, 150mg, 200mg, 300mg, 400mg
– this formulation is only approved for use in patients who require an outside carer to administer their medicines, and for short term use when rapid dose titration is considered important e.g. where its use might avoid the need to admit the patient to hospital


 


(note: preferred brand of quetiapine XL in primary care is Biquelle XL)

 
   
 ....
 Non Formulary Items
Lurasidone  (Latuda)

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Non Formulary
 
Sertindole  (Serdolect)

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Non Formulary
 
Ziprasidone  (Zeldox)

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Non Formulary
 
Zotepine  (Zoleptil®)

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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 SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red

Drugs for hospital use or use by a specialist within specialist centre only. Initiation and monitoring of treatment should remain under the total responsibility of the appropriate hospital clinician or specialist. These drugs should only be prescribed under the direct supervision of that clinician or specialist and are not suitable for shared care arrangements. The drug should be supplied via the hospital or specialist centre for the duration of treatment.   

Amber

These are specialist drugs which must be initiated by secondary care specialist prescribers, but with the potential to transfer prescribing to primary care within written and agreed shared care protocols and according to the agreed process for transfer of care. For these drugs, in order to ensure patient safety, some aspects of care must remain with the specialist due to their complexity e.g. monitoring of disease or drug response. Other more routine aspects can be transferred to the GP e.g. monitoring of adverse effects and supply of the medicine. The specific responsibilities of the specialist and GP are defined in the shared care agreement for each drug. Shared care agreements are still under development for some amber drugs. Until these are available, it would be expected that any shared care request from secondary care to a GP would be accompanied by written information which defines prescribing and monitoring responsibilities. The hospital specialist should also provide the GP with enough information and support to allow the safe transfer and ongoing management of prescribing into primary care.   

Green +

Drugs which should usually be initiated in secondary care, or by a specialist clinician, but can be safely maintained in primary care with very little or no monitoring required. An information leaflet may be provided in order to facilitate ongoing prescribing in primary care.   

Green

These are defined as new and established drugs, which may be prescribed, initiated, changed or maintained on FP10 by the GP and, if appropriate, discontinued without recourse to secondary care. N.B. DRUGS NOT IDENTIFIED IN THE FORMULARY BY A RED, AMBER OR GREEN+ SYMBOL ARE CLASSIFIED AS GREEN.   

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