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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...
04.07.03  Expand sub section  Neuropathic pain
Amitriptyline
View adult BNF View SPC online
First Choice Tablets: 10 mg, 25 mg, 50 mg
Oral solution: 25 mg/5 mL, 50 mg/5 mL
 
Duloxetine
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Alternatives Capsules: 30mg, 60mg 
   
Gabapentin
View adult BNF View SPC online
Alternatives Capsules: 100mg, 300mg, 400mg
Tablets: 600mg, 800mg
Oral solution: 250mg/5ml 
   
Nortriptyline
View adult BNF View SPC online
Alternatives Tablets: 10 mg, 25 mg
For use after trialling other options as detailed above
 
   
Pregabalin
View adult BNF View SPC online
Alternatives Capsules: 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, 300 mg
Liquid: 20mg/mL

For use after trialling other options as detailed above
 
   
Capsaicin (Axsain)
(Topical preparation)
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Alternatives Cream: 0.075% 
   
Lidocaine (Versatis)
(Topical preparation)
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Alternatives
Green +
Plasters: 5% (700mg/medicated plaster) 
   
04.07.03  Expand sub section  Trigeminal neuralgia
Carbamazepine
View adult BNF View SPC online
First Choice Tablets: 100 mg, 200 mg, 400 mg
SR Tablets: 200 mg, 400 mg
Liquid: 100 mg/5 mL

Indicated in trigeminal neuralgia and compression neuralgia 
Oxcarbazepine
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Second Choice
Green +
Tablets: 150mg, 300mg, 600mg
Indicated in for trigeminal neuralgia and compression neuralgia after trialling carbamazepine 
   
04.07.03  Expand sub section  Postherpetic neuralgia
04.07.03  Expand sub section  Chronic facial pain
 ....
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
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Link to adult BNF
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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. In some cases there may be a further restriction for use outlined - these will be defined in each case.  

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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