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Sunderland Joint Formulary
NHS Sunderland Clinical Commissioning Group
South Tyneside and 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...
04.01  Hypnotics and anxiolytics
04.01.01  Hypnotics
 note 

Hypnotics should not be prescribed for more than 10 nights without being reviewed.

Use in the elderly is discouraged.

Nitrazepam is no longer included in the formulary for use as a hypnotic

Benzodiazepines should not be used as an anxiolytic for more than 4 weeks without being reviewed.  Use in the elderly is discouraged.
Melatonin
View adult BNF View SPC online
First Choice

MR tablets (Circadin ®): 2 mg – 1st line
MR tablets (Circadin ®): 2 mg (crushed) – 2nd line
MR tablets (Slenyto ®): 1mg, 5 mg (as per licensed indications)

RAG status depends on indication:


Amber Traffic Light  For the management of sleep-wake disorders in children and young people under the age of 18


Green+ Traffic Light For the management of sleep-wake disorders in people over the age of 18 and over (note; check BNF for licensing information)


Green+ Traffic Light  Not currently approved by NTW for use in licensed indication, but approved for use in some other sleep disorders


Please refer to information sheet for up to date information regarding approved indications

 
Melatonin
View adult BNF View SPC online
Third Choice Solution: 1mg/1ml

RAG status depends on indication:


Amber Traffic Light  For the management of sleep-wake disorders in children and young people


Green+ Traffic Light For the management of sleep-wake disorders in people over the age of 18 and over (note; check BNF for licensing information)


Green+ Traffic Light  Not currently approved by NTW for use in licensed indication, but approved for use in some other sleep disorders


Please refer to information sheet for up to date information regarding approved indications
 
   
04.01.01  Benzodiazepines
Controlled Drug Temazepam
View adult BNF View SPC online
First Choice Tablets: 10mg, 20mg
Oral solution: 10mg/5ml 
04.01.01  Zaleplon, Zolpidem and Zopiclone
Zopiclone
View adult BNF View SPC online
Alternatives Tablets: 3.75mg, 7.5mg 
   
04.01.01  Chloral and derivatives to top
Chloral Hydrate
View adult BNF View SPC online
Alternatives Mixture: 500mg/5ml 
   
Chloral Hydrate
View adult BNF View SPC online
Alternatives
Red

Liquid: 1g/5ml
This strength is to be prescribed in paediatric patients (NPPG and RCPCH recommendation)

 
   
04.01.01  Clomethiazole (Chlormethiazole)
Clomethiazole
View adult BNF View SPC online
Alternatives Capsules: 192mg
Oral solution: 157.5mg/5ml

Chlordiazepoxide is preferred in the management of alcohol withdrawal.
Heminevrin syrup has been discontinued. 
   
04.01.01  Antihistamines
Promethazine Hydrochloride
View adult BNF View SPC online
Alternatives Tablets: 10mg, 25mg
Elixir: 5mg/5ml
Injection: 25mg/1ml 
   
04.01.01  Alcohol
04.01.01  Sodium oxybate
04.01.02  Anxiolytics to top
04.01.02  Benzodiazepines
Diazepam
View adult BNF View SPC online
First Choice Tablets: 2mg, 5mg
2mg tablets are the preferred strength in primary care. 10mg diazepam tablets should no longer be used

Oral solution: 2mg/5ml
Injection: 10mg/2ml - for use in epilepsy
Rectal tubes: 2.5mg/1.25ml, 5mg/2.5ml, 10mg/2.5ml 
Chlordiazepoxide
View adult BNF View SPC online
Alternatives Capsules: 5mg, 10mg 
   
Lorazepam
View adult BNF View SPC online
Alternatives Tablets: 1mg, 2.5mg
Injection: 4mg/1ml
Oral solution: 1mg/5ml 
   
04.01.02  Buspirone
Buspirone Hydrochloride
View adult BNF View SPC online
Formulary
Green +
Tablets: 5mg 
   
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
(Preferred)
View adult BNF View SPC online
Formulary Tablets: 10mg, 25mg, 50mg, 100mg
Oral solution: 25mg/5ml, 100mg/5ml
Injection: 50mg/2ml 
   
Haloperidol
(Preferred)
View adult BNF View SPC online
Formulary Capsules: 500 microgram
Tablets: 1.5mg, 5mg, 10mg
Oral liquid: 1mg/1ml, 2mg/1ml
Injection: 5mg/1ml, 20mg/2ml 
   
Perphenazine
(Preferred)
View adult BNF View SPC online
Formulary Tablets: 2mg, 4mg 
   
Sulpiride
(Preferred)
View adult BNF View SPC online
Formulary Tablets: 200mg, 400mg
Oral solution (sugar-free): 200mg/5ml 
   
Flupentixol
(Alternative)
View adult BNF View SPC online
Alternatives Tablets: 500 microgram, 1mg, 3mg 
   
Levomepromazine
(Alternative)
View adult BNF View SPC online
Alternatives Tablets: 25mg
Injection: 25mg/1ml - for use in palliative care 
   
Trifluoperazine
(Alternative)
View adult BNF View SPC online
Alternatives Tablets: 1mg, 5mg
Syrup: 1mg/5ml
Oral sugar-free solution: 5mg/5ml 
   
Levomepromazine
(Alternative)
View adult BNF View SPC online
Unlicensed Drug Unlicensed Tablets: 6mg 
   
04.02.01  First-Generation Antipsychotic Drugs
04.02.01  Second-Generation Antipsychotic Drugs
Risperidone
View adult BNF View SPC online
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
View adult BNF View SPC online
Second Choice
Green +
Tablets: 50mg, 200mg
Oral solution: 100mg/1ml 
   
Aripiprazole
View adult BNF View SPC online
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 TA 213: Aripiprazole for the treatment of schizophrenia in people aged 15 -17 years
Link  NICE TA 292: Bipolar disorder (children) - aripiprazole
   
Aripiprazole
View adult BNF View SPC online
Alternatives
Red
IM Injection: 7.5mg/ml
- approved for use in rapid tranquilisation in patients with acute psychosis. NTW use only 
   
Clozapine
View adult BNF View SPC online
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
View adult BNF View SPC online
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
View adult BNF View SPC online
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)

 
   
04.02.02  Antipsychotic depot injections to top
Zuclopenthixol Decanoate
View adult BNF View SPC online
First Choice
Green +
Injection: 200mg/1ml, 500mg/1ml 
Aripiprazole
View adult BNF View SPC online
Alternatives
Green +
Injection: 400mg long acting injection
-NTAG approved for the treatment of schizophrenia as per its licensed indication and as outlined in the Guidance on the Use of Antipsychotic Long-Acting Injections in the North of England 
   
Flupentixol Decanoate
View adult BNF View SPC online
Alternatives
Green +
Injection: 20mg/1ml, 40mg/2ml, 50mg/0.5ml, 100mg/1ml, 200mg/1ml 
   
Haloperidol decanoate
View adult BNF View SPC online
Alternatives
Green +
Injection: 50mg/1ml, 100mg/1ml 
   
Paliperidone
View adult BNF View SPC online
Alternatives
Green +
Pre-filled syringe: 50mg, 100mg, 150mg
-NTAG approved for the treatment of schizophrenia as per its licensed indication and as outlined in the Guidance on the Use of Antipsychotic Long-Acting Injections in the North of England 
   
Pipotiazine Palmitate
View adult BNF View SPC online
Alternatives
Green +
Injection: 50 mg/1 mL, 100 mg/2 mL
- specialist initiation only
 
   
Risperidone
View adult BNF View SPC online
Alternatives
Green +
Long acting injection: 25 mg, 37.5 mg, 50 mg 
   
Zuclopenthixol acetate
View adult BNF View SPC online
Alternatives
Red
Injection: 50 mg/1 mL
- For short-term use by NTW specialists only
 
   
04.02.03  Drugs used for mania and hypomania
 note 

Other anticonvulsant drugs are used in the management of bipolar disorders e.g. lamotrigine for the depressive phase.  Such use is ‘off-licence’.


04.02.03  Benzodiazepines
04.02.03  Antipsychotic drugs
04.02.03  Carbamazepine
Carbamazepine
View adult BNF View SPC online
Formulary Tablets: 100mg, 200mg, 400mg
Sugar-free liquid: 100mg/5mL
- see section 4.8 for other formulations

 
   
04.02.03  Valproic acid to top
Sodium valproate
View adult BNF View SPC online
Formulary M/R Tablets: 200mg, 300mg & 500mg
- used for the prevention and treatment of manic episodes associated with bipolar disorder (unlicensed indication). May be useful in patients unresponsive to lithium. See section 4.8.1 for other sodium valproate formulations.
 
Link  Toolkit on the risks of valproate medicines in female patients
Link  Valproate medicines: Pregnancy prevention programme materials online
   
Valproic Acid (as semisodium valproate)
View adult BNF View SPC online
Formulary Tablets: 250 mg, 500 mg
- licensed alternative to sodium valproate m/r tablets
 
Link  Toolkit on the risks of valproate medicines in female patients
Link  Valproate medicines: Pregnancy prevention programme materials online
   
04.02.03  Lithium
Lithium Carbonate
View adult BNF View SPC online
Formulary
Amber
Tablets: 250mg (6.8mmol Li+)
MR Tablets: 200mg & 400mg (5.4 & 10.8 mmol Li+)
- lithium should be prescribed by brand name
 
   
Lithium Citrate
View adult BNF View SPC online
Formulary
Amber
Liquid: 509mg/5mL (5.4 mmol Li+/5mL), 1,018mg/5mL (10.8 mmol Li+/5mL)
M/R Tablets: 564mg (6 mmol Li+)
- lithium should be prescribed by brand name
 
   
04.03  Antidepressant drugs
04.03.01  Tricyclic and related antidepressant drugs
04.03.01  Tricyclic and related antidepressant drugs
 note 
Trazodone
(1st line for antidepressant indication)
View adult BNF View SPC online
First Choice Capsules: 50 mg, 100 mg
Tablets: 150 mg
Liquid (sugar-free): 50 mg/5 mL
- Trazodone is widely used off-licence for night sedation and behavioural symptoms of dementia – see section 4.1
 
Amitriptyline
(1st line for other indications (N.B. unlicensed use))
View adult BNF View SPC online
First Choice Tablets: 10 mg, 25 mg, 50 mg
Sugar-free oral solution: 25 mg/5 mL
 
Clomipramine
View adult BNF View SPC online
Alternatives Capsules: 10 mg, 25 mg, 50 mg 
   
Imipramine
View adult BNF View SPC online
Alternatives Tablets: 10 mg, 25 mg
Syrup: 25 mg/5 mL

 
   
Lofepramine
View adult BNF View SPC online
Alternatives Tablets: 70 mg
Sugar-free oral suspension: 70 mg/5 mL
- Safer than amitriptyline in overdosage, but not as effective.
 
   
Dosulepin
View adult BNF View SPC online
Alternatives Capsules*: 25mg
Tablets*: 75mg
*For existing patients only - no new patients 
   
04.03.01  Related antidepressants to top
04.03.02  Monoamine-oxidase inhibitors
Phenelzine
View adult BNF View SPC online
Formulary
Green +

Tablets: 15mg
- For use on advice from psychiatrists only

 
   
04.03.02  Reverible MAOIs
Moclobemide
View adult BNF View SPC online
Formulary
Green +

Tablets: 150 mg, 300 mg

 
   
04.03.03  Selective serotonin re-uptake inhibitors
Citalopram
View adult BNF View SPC online
Formulary Tablets: 10 mg, 20 mg, 40 mg
Oral drops (sugar-free): 40 mg/1 mL
4 drops (8mg) is therapeutically equivalent to a 10 mg tablet
 
   
Fluoxetine
View adult BNF View SPC online
Formulary Fluoxetine
Capsules: 20 mg
Dispersible tablets: 20mg - 1st choice in patients unable to use the capsules
Liquid: 20 mg/5 mL
 
   
Paroxetine
View adult BNF View SPC online
Formulary Tablets: 10 mg, 20 mg, 30 mg
Liquid (sugar-free): 10 mg/5 mL
 
   
Sertraline
View adult BNF View SPC online
Formulary Tablets: 50 mg, 100 mg
Liquid: 50mg/5ml 
   
Vortioxetine
View adult BNF View SPC online
Formulary Tablets: 5mg, 10mg, 20mg

- approved for the treatment of major depressive episodes in adults whose condition has responded inadequately to 2 antidepressants within the current episode in line with NICE 
Link  NICE TA 367: Vortioxetine for treating major depressive episodes
   
04.03.04  Other antidepressant drugs
 note 

These drugs are for use in patients not responding adequately to first-line treatments


Venlafaxine
(N.B. RAG status is GREEN+ for doses of 300mg or more)
View adult BNF View SPC online
Formulary

Tablets: 37.5 mg, 75 mg
Solution: 75mg/5ml*
MR tablets: 75 mg, 150 mg
- Patients who are deemed stable on doses of up to 225mg daily of MR Venlafaxine should be switched to the equivalent dose of immediate-release venlafaxine
- MR preparations are only to be used in patients currently prescribed doses of 300mg and over and for whom there is no suitable alternative, those who have experienced discontinuation reactions (at any dose), and for patients who need to take the once daily formulation in order to facilitate care visits.
(preferred brand of Venlafaxine XL in primary care is Vencarm XL)
*Hospital use only

 
   
Mirtazapine
View adult BNF View SPC online
Formulary Tablets: 15mg, 30mg, 45mg
Orodispersible tablets: 15mg, 30mg, 45mg
- Orodispersible tablets should only be prescribed for use when other formulations are unsuitable 
   
Reboxetine
View adult BNF View SPC online
Formulary Tablets: 4mg
- not licensed for use in the elderly
 
   
Duloxetine
View adult BNF View SPC online
Formulary Capsules: 30mg, 60mg
- For use on advice of psychiatrists as a 3rd line antidepressant but only for use in patients who cannot tolerate high dose (>150mg daily) venlafaxine, or patients with hypertension, established CHD or other cardiovascular risk factors which would make the use of high dose venlafaxine undesirable.  
   
Agomelatine
View adult BNF View SPC online
Formulary
Green +
Tablets: 25mg
- NETAG approved for the treatment of depression only following an adequate trial of at least three alternative antidepressant drugs at maximally tolerated doses (as described by NICE and as stated in the BNF). Prescribing and monitoring should be initiated by specialist mental health physicians. After a minimum of 12 weeks, prescribing may be transferred to primary care.
 
   
04.04  CNS stimulants and other drugs used for attention deficit hyperactivity disorder to top
Controlled Drug Methylphenidate
View adult BNF View SPC online
First Choice
Amber
 

Tablets: 5mg, 10mg

MR Tablets: 18mg, 27mg, 36mg, 54mg (Xaggitin XL® or Concerta XL®)

MR Capsules: 5mg, 10mg, 20mg, 30mg, 40mg (Medikinet XL®)

MR Capsules: 10mg, 20mg, 30mg (Equasym XL®)

NOTE

- Concerta XL is also approved for the treatment of narcolepsy in patients

 
Controlled Drug Dexamfetamine
View adult BNF View SPC online
Second Choice
Amber

Tablets: 5mg

ADHD in children and adults : AMBER -  see shared care guideline.

Narcolepsy: Doses up to 30mg GREEN +, doses over 30mg RED

 
   
Controlled Drug Lisdexamfetamine (Elvanse®)
View adult BNF View SPC online
Third Choice
Amber

Capsules: 20mg, 30mg, 40mg, 50mg, 60mg, 70mg (Elvanse®)
- For 3rd line use after an inadequate response to methylphenidate.
- For specialist initiation and only transferred to GPs after at least 6 month stable symptoms control.

 
   
Atomoxetine
View adult BNF View SPC online
Formulary
Amber
Capsules: 10mg, 18mg, 25mg, 40mg, 60mg, 80mg 
   
Guanfacine (Intuniv®)
View adult BNF View SPC online
Formulary
Amber
Prolonged release tablets: 1mg, 2mg, 3mg, 4mg 
   
Solriamfetol (Sunosi®)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine

Tablets: 75 mg and 150 mg

Approved for the treatment of narcolepsy woth or without cataplexy in adults as an alternative to pitolisant in those who would have otherwise received pitolisant in line with NTAG guidance.

 
   
Modafinil
View adult BNF View SPC online
Formulary
Green +
Tablets: 100 mg
- Only approved for limited use in the treatment of patients with narcolepsy
 
   
Pitolisant
View adult BNF View SPC online
Formulary
Red
Tablets: 20mg
- approved for use in patients with narcolepsy who experience psychomotor side effects with modafinil and dexamfetamine. 
   
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
View adult BNF View SPC online
Formulary Tablets: 120mg 
   
04.05.02  Centrally acting appetite suppressants
04.06  Drugs used in nausea and vertigo to top
Netupitant and Palonosetron (Akynzeo®)
View adult BNF View SPC online
Formulary
Red

Capsules: 300mg/0.5mg

 
   
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
View adult BNF View SPC online
Formulary Tablets: 15mg 
   
Cyclizine
View adult BNF View SPC online
Formulary Tablets: 50 mg
Injection: 50 mg/1 mL
Suspension*: 50mg/5ml
*For paediatric use only
 
   
Promethazine Hydrochloride
View adult BNF View SPC online
Formulary Tablets: 10 mg, 25 mg
Liquid: 5 mg/5 mL
Injection: 25 mg/1 mL
 
   
04.06  Phenothiazines and related drugs
Prochlorperazine
View adult BNF View SPC online
Formulary Tablets: 5 mg
Syrup: 5 mg/5 mL
Injection: 12.5 mg/1 mL
Buccal tablets: 3 mg – for the treatment of nausea associated with migraine when the oral route cannot be used due to vomiting
 
   
04.06  Domperidone and metoclopramide to top
Domperidone
View adult BNF View SPC online
Formulary Tablets: 10 mg
Liquid: 5 mg/5 mL
Suppository: 30 mg
 
   
Metoclopramide
View adult BNF View SPC online
Formulary Tablets: 10 mg
Liquid: 5 mg/5 mL
 
   
Metoclopramide
View adult BNF View SPC online
Formulary
Red
Injection: 10 mg/2 mL

RAG status is RED unless prescribing in end of life care 
   
04.06  5HT3 antagonists
Ondansetron
View adult BNF View SPC online
Formulary Tablets: 4 mg, 8 mg
Orodispersible films: 4 mg, 8 mg
Oral solution: 4 mg/5 mL
Suppositories: 16mg 
   
Ondansetron
View adult BNF View SPC online
Formulary
Red
Injection: 4 mg/2 mL, 8 mg/4 mL

RAG status is RED unless prescribing in end of life care 
   
Palonosetron
View adult BNF View SPC online
Formulary
Red
Injection: 250 micrograms/5 mL 
   
04.06  Neurokinin receptor antagonist
Aprepitant
View adult BNF View SPC online
Formulary
Red

Capsules: 80mg, 125mg

 
   
Fosaprepitant (Ivemend®)
View adult BNF View SPC online
Formulary
Red

150mg powder for infusion vials

Approved for second-line use when oral aprepitant is not tolerated

 
   
04.06  Cannabinoid
Controlled Drug Cannabidiol  (Epidyolex®)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
NHS England

Oral solution: 100mg/1mL

Approved for use according to criteria in NICE TA614 and TA615

 
Link  NICE TA 614: Cannabidiol with clobazam for treating seizures associated with Dravet syndrome
Link  NICE TA 615: Cannabidiol with clobazam for treating seizures associated with Lennox–Gastaut syndrome
   
Nabilone
View adult BNF View SPC online
Alternatives
Red
Capsules*: 1mg
*Hospital use and existing patients only. No new patients 
   
04.06  Hyoscine
Hyoscine Hydrobromide
View adult BNF View SPC online
Formulary Tablets: 300mcg
Transdermal patch: 1mg/72hrs
 
   
Hyoscine Hydrobromide
View adult BNF View SPC online
Formulary
Green +
Tablets: 150mcg*
Ampoules: 400mcg/1ml**
*For paediatric use only
**For palliative care use only
 
   
Glycopyrronium 2mg/5ml SF suspension
View adult BNF View SPC online
Formulary
Green +

Suspension*: 2mg/5ml
*Only for use in patients with excessive secretions

 
   
04.06  Other drugs for Ménière's disease to top
Betahistine Dihydrochloride
View adult BNF View SPC online
First Choice Tablets: 8mg, 16mg 
04.07  Analgesics
04.07.01  Non-opioid analgesics and compound analgesic preparations
04.07.01  Compound analgesic preparations
Paracetamol
View adult BNF View SPC online
Formulary Tablets: 500 mg
Soluble Tablets: 500 mg
Suspension: 120 mg/5 mL, 250 mg/5 mL
Suppository: 60 mg, 125 mg, 250 mg, 500 mg
Injection: 500 mg/50 mL, 1g/100 mL
 
   
Paracetamol and codeine (Co-codamol 8/500)
View adult BNF View SPC online
Formulary

Tablets: 8/500

 
   
04.07.02  Opioid analgesics
Codeine
(1st line weak opiate)
View adult BNF View SPC online
First Choice

Codeine phosphate
Tablets: 15 mg, 30 mg, 60 mg
Syrup: 25 mg/5 mL

Injection 60mg/ml - hospital only

 
Controlled Drug Morphine Sulphate
(1st line strong opiate)
View adult BNF View SPC online
First Choice IR tablets: 10 mg, 20 mg, 50 mg
MR capsules for twice daily administration (Zomorph®): 10 mg, 30 mg, 60 mg, 100 mg, 200 mg
MR tablets: 5 mg, 15 mg
MR suspension sachets: 20 mg, 30 mg, 60 mg, 100 mg, 200 mg
N.B. the MR suspension sachets are only for use when other formulations are unsuitable
Oral solution: 10 mg/5 mL, 20 mg/1 mL
Injection: 10 mg/1 mL, 15 mg/1 mL, 20 mg/1 mL, 30 mg/1 mL
Suppositories: 10 mg, 15 mg, 20 mg, 30 mg
 
Dihydrocodeine
View adult BNF View SPC online
Alternatives

Tablets: 30mg

 

Not recommended for regular use. Codeine is the first line weak opioid.

 
   
Dihydrocodeine
View adult BNF View SPC online
Alternatives
Green +

SR Tablets: 60mg, 90mg, 120mg
SR formulation only to be used on advice of pain specialists

Not recommended for regular use. Codeine is the first line weak opioid.

 
   
Controlled Drug Tramadol
View adult BNF View SPC online
Alternatives Capsules: 50 mg
Soluble Tablets: 50 mg

 
   
Controlled Drug Tramadol
View adult BNF View SPC online
Alternatives
Green +

MR: 50mg, 100mg, 150mg, 200mg, 300mg, 400mg
MR formulation only to be used on advice of pain specialists

 
   
Controlled Drug Buprenorphine
View adult BNF View SPC online
Alternatives

Transdermal patches: 5mcg, 10mcg, 15mcg, 20mcg/hour over 7 days*
Transdermal patches: Transtec® 35mcg, 52.5mcg, 70mcg/hour over 96 hours

*Sevodyne preferred brand in primary care

 

 

Red Sublingual tablets: 200micrograms

* For treatment of post-operative pain only*

 
   
Controlled Drug Fentanyl
View adult BNF View SPC online
Alternatives Transdermal patches: 12, 25, 50, 75 and 100 micrograms/hour 
   
Controlled Drug Oxycodone
View adult BNF View SPC online
Alternatives IR capsules: 5 mg, 10 mg, 20 mg
Liquid: 5 mg/5 mL, 10 mg/1 mL
Injection: 10 mg/1 mL, 20 mg/2 mL, 50 mg/1 mL
MR tablets: 5 mg, 10 mg, 20 mg, 40 mg, 80 mg
 
   
Controlled Drug Alfentanil
View adult BNF View SPC online
Alternatives
Green +

Injection: 500 micrograms/1 mL, 5 mg/1 mL

Specialist initiation only - consult pain team or palliative care before use.

 
   
Controlled Drug Diamorphine
View adult BNF View SPC online
Alternatives
Green +

Injection: 5 mg, 10 mg, 30 mg, 100 mg, 500 mg
N.B. 10mg strength also used in maternity

Specialist initiation only - consult pain team or palliative care before use.

 
   
Controlled Drug Fentanyl Lozenges
View adult BNF View SPC online
Alternatives
Green +

Lozenges*: 200mcg, 400mcg

*Existing chronic or palliative care patients only

 
   
Controlled Drug Fentanyl Nasal Spray (PecFent®)
View adult BNF View SPC online
Alternatives
Green +

Nasal spray (PecFent): 100 micrograms/metered spray, 400 micrograms/metered spray

N.B. For short term use in palliative care only.

Specialist initiation only - consult pain team or palliative care before use.

 
   
Controlled Drug Fentanyl sublingual tablets (Abstral®)
View adult BNF View SPC online
Alternatives
Green +

Sublingual tablets (Abstral): 100 micrograms, 200 micrograms, 300 micrograms, 400 micrograms, 600 micrograms, 800 micrograms

N.B. For short term use in palliative care only.

Specialist initiation only - consult pain team or palliative care before use.

 
   
Controlled Drug Hydromorphone
View adult BNF View SPC online
Alternatives
Green +
Ampoules*: 10mg/ml

*For palliative care use only 
   
Controlled Drug Hydromorphone
View adult BNF View SPC online
Alternatives

IR capsules 1.3 mg, 2.6 mg
SR capsules : 2 mg, 4 mg, 8 mg, 16 mg, 24 mg

Specialist initiation only - consult pain team or palliative care before use.

 
   
Controlled Drug Methadone
View adult BNF View SPC online
Alternatives
Green +

Tablets: 5 mg
Linctus: 2 mg/5 mL
Oral Concentrate: 10mg/mL
Injection: 10 mg/1 mL

 

Specialist initiation only - consult pain team or palliative care before use as an analgesic.

(Red when used for addiction)

 
   
Controlled Drug Pethidine
View adult BNF View SPC online
Alternatives
Red

Injection: 50 mg/1 mL, 100 mg/2 mL, 50 mg/5 mL, 100 mg/10 mL

 

Only for use by midwives or in palliative care.

 
   
Controlled Drug Tapentadol (Palexia®)
View adult BNF View SPC online
Alternatives
Green +

Palexia® MR Tablets: 50 mg, 100 mg, 150 mg, 200 mg, 250 mg
Use only after trial with other strong opiates

Specialist initiation only - consult pain team or palliative care before use.

 
   
Ketamine
View adult BNF View SPC online
Unlicensed Drug Unlicensed
Red

Injection: 10 mg/1 mL, 50 mg/1 mL, 100 mg/1 mL
Oral solution: 50mg/5mL

 
   
04.07.03  Neuropathic pain to top
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
View adult BNF View SPC online
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)
View adult BNF View SPC online
Alternatives Cream: 0.075% 
   
Lidocaine (Versatis®)
(Topical preparation)
View adult BNF View SPC online
Alternatives
Green +

Plasters: 5% (700mg/medicated plaster)

To be initiated by the pain and palliative care teams only

 
   
04.07.03  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
View adult BNF View SPC online
Second Choice
Green +
Tablets: 150mg, 300mg, 600mg
Indicated in for trigeminal neuralgia and compression neuralgia after trialling carbamazepine 
   
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
Aspirin
View adult BNF View SPC online
Formulary Soluble Tablets: 300 mg 
   
Ibuprofen
View adult BNF View SPC online
Formulary Tablets: 200 mg, 400 mg
Suspension: 100 mg/5 mL
 
   
Naproxen
View adult BNF View SPC online
Formulary Tablets: 250mg, 500mg 
   
Paracetamol
View adult BNF View SPC online
Formulary Soluble Tablets: 500 mg 
   
04.07.04.01  5HT1 agonists
Sumatriptan
View adult BNF View SPC online
Formulary

Tablets: 50 mg, 100 mg
Nasal spray: 10 mg/0.1 mL actuation, 20 mg/0.1 mL actuation
Injection (pre-filled syringe): 3 mg/0.5 mL and 6 mg/0.5 mL

 
   
04.07.04.01  Anti-emetics
04.07.04.01  Other drugs for migrane
04.07.04.02  Prophylaxis of migraine to top
Amitriptyline
View adult BNF View SPC online
Formulary Tablets: 10 mg, 25 mg, 50 mg
Liquid: 25 mg/5 mL, 50 mg/5 mL
 
   
Fremanezumab (Ajovy® )
View adult BNF View SPC online
Formulary
Red
High Cost Medicine

Solution for injection: pre-filled syringes 225mg/1.5mL

Recommended for use according to NICE criteria (TA631)

 
Link  NICE TA 631: Fremanezumab for preventing migraine
   
Galcanezumab (Emgality®)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine

Solution for injection: Pre-filled pen 120 mg/1 mL

Recommended for use according to NICE criteria (TA659)

 
Link  NICE TA 659: Galcanezumab for preventing migraine
   
Pizotifen
View adult BNF View SPC online
Formulary Tablets: 500 micrograms, 1.5 mg 
   
Propranolol
View adult BNF View SPC online
Formulary Tablets: 10mg*, 40 mg, 80 mg
Solution: 10mg/5ml**, 40 mg/5 mL

*10mg tablets may also be used for anxiety
**Hospital use for paediatrics only
 
   
Clonidine Hydrochloride
View adult BNF View SPC online
Formulary
Red
Suspension*: 50mcg/5ml
*Hospital use only 
   
04.07.04.03  Cluster headache
04.08  Antiepileptics
04.08.01  Control of epilepsy
Brivaracetam
View adult BNF View SPC online
Formulary
Green +
Tablets: 25mg, 50mg
Oral solution: 10mg/ml
Solution for injection/infusion: 10mg/ml 
   
04.08.01  Partial seizures with or without secondary generalisation
04.08.01  Generalised seizures to top
04.08.01  Carbamazepine and Oxcarbazepine
Carbamazepine
View adult BNF View SPC online
Formulary
Green +
Tablets: 100 mg, 200 mg, 400 mg
SR Tablets: 200 mg, 400 mg
Liquid: 100 mg/5 mL
Suppositories: 125 mg, 250 mg

CHM advise brand specific prescribing 
   
Oxcarbazepine
View adult BNF View SPC online
Formulary
Green +
Tablets: 150 mg, 300 mg, 600 mg
Liquid (sugar-free): 300 mg/5 mL
 
   
04.08.01  Ethosuximide
Ethosuximide
View adult BNF View SPC online
Formulary
Green +
Capsules: 250 mg
Liquid: 250 mg/5 mL
 
   
04.08.01  Gabapentin and pregabalin
Gabapentin
View adult BNF View SPC online
Formulary
Green +
Capsules: 100 mg, 300 mg, 400 mg
Tablets: 600 mg, 800 mg
Oral solution: 50mg/mL
 
   
Pregabalin
View adult BNF View SPC online
Formulary
Green +
Capsules: 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, 300 mg
Oral solution: 20 mg/1 mL
 
   
04.08.01  Lacosamide
Lacosamide
View adult BNF View SPC online
Formulary
Green +
Tablets: 50 mg, 100 mg, 150 mg, 200 mg
Syrup (sugar-free): 50 mg/5 mL
 
   
04.08.01  Lamotrigine to top
Lamotrigine
View adult BNF View SPC online
Formulary
Green +
Tablets: 25 mg, 50 mg, 100 mg, 200 mg
Dispersible Tablets: 2 mg, 5 mg, 25 mg, 100 mg
 
   
04.08.01  Levetiracetam
Levetiracetam
View adult BNF View SPC online
Formulary
Green +
Tablets: 250 mg, 500 mg, 750 mg, 1 g
Oral solution: 100 mg/1 mL
Granules: 250 mg/sachet, 500 mg/sachet, 1 g/sachet

 
   
Levetiracetam
View adult BNF View SPC online
Formulary
Green +

Vials: 500mg/5ml*


*Green + for palliative indication only; otherwise hospital only

 
   
04.08.01  Perampanel
04.08.01  Phenobarbital and other barbiturates
Controlled Drug Phenobarbital
View adult BNF View SPC online
Formulary
Green +
Tablets: 15 mg, 30 mg, 60 mg
Elixir: 15mg/5 mL

CHM advise brand specific prescribing
(Alcohol-free elixir available from Rosemont Pharmaceuticals - unlicensed)
 
   
Controlled Drug Phenobarbital
View adult BNF View SPC online
Formulary
Red
Alcohol free Solution: 50mg/5ml* (Unlicensed from Rosemont)
*For paediatric use only 
   
Primidone
View adult BNF View SPC online
Formulary
Green +

Tablets: 50mg, 250 mg

CHM advise brand specific prescribing

 
   
Primidone
View adult BNF View SPC online
Unlicensed Drug Unlicensed
Green +
Suspension: 50 mg/5 mL, 250 mg/5 mL (available from Rosemont Pharmaceuticals)

CHM advise brand specific prescribing
 
   
04.08.01  Phenytoin
Phenytoin
View adult BNF View SPC online
Formulary
Green +
Chewable Tablets (as Phenytoin base): (Infatabs®): 50 mg
Capsules (as phenytoin sodium): 25 mg, 50 mg, 100 mg, 300 mg
Suspension (as Phenytoin base) (Epanutin®): 30 mg/5 mL

CHM advise brand specific prescribing
 
   
04.08.01  Retigaine to top
04.08.01  Rufinamide
04.08.01  Rufinamide
04.08.01  Tiagabine
04.08.01  Topiramate
Topiramate
View adult BNF View SPC online
Formulary
Green +
Tablets: 25 mg, 50 mg, 100 mg, 200 mg
Capsules: 15 mg, 25 mg, 50 mg
 
   
04.08.01  Valproate to top
Sodium Valproate
View adult BNF View SPC online
Formulary
Green +

Tablets, crushable: 100 mg
Tablets (e/c): 200 mg, 500 mg
MR Tablets: 200 mg, 300 mg, 500 mg
MR Granules: 50 mg, 100 mg, 250 mg, 500 mg, 750 mg, 1g
Liquid (sugar-free available): 200 mg/5 mL

 
Link  Toolkit on the risks of valproate medicines in female patients
Link  Valproate medicines: Pregnancy prevention programme materials online
   
Sodium Valproate
View adult BNF View SPC online
Formulary
Red
Injection: 400mg
 
Link  Toolkit on the risks of valproate medicines in female patients
Link  Valproate medicines: Pregnancy prevention programme materials online
   
Sodium Valproate
View adult BNF View SPC online
Unlicensed Drug Unlicensed Suppositories: 300 mg (unlicensed in the UK)
 
Link  Toolkit on the risks of valproate medicines in female patients
Link  Valproate medicines: Pregnancy prevention programme materials online
   
04.08.01  Vigabatrin
Vigabatrin
View adult BNF View SPC online
Formulary
Green +
Tablets: 500 mg
Powder: (sugar-free): 500 mg/sachet

 
   
04.08.01  Zonisamide
Zonisamide
View adult BNF View SPC online
Formulary
Green +
Capsules: 25 mg, 50 mg, 100 mg 
   
04.08.01  Benzodiazepines
Clobazam
View adult BNF View SPC online
Formulary
Green +
Tablets: 10 mg
Oral Suspension: 5mg/5 mL - licensed product, Tapclob®, now available
Should only be prescribed on the NHS to patients for the treatment of epilepsy under SLS regulations. Prescriptions should be endorsed “SLS”.
 
   
Clonazepam
View adult BNF View SPC online
Formulary
Green +
Tablets: 500 micrograms, 2 mg
Oral solution (contains alcohol): 500 micrograms/5 mL, 2 mg/5 mL
Oral solution contains 100mg ethanol per 5mL (Rosemont Pharmaceuticals)
 
   
04.08.01  Other Drugs
Perampanel
View adult BNF View SPC online
Formulary
Green +
Tablets: 2mg, 4mg, 8mg 
Link  NICE CG 137: The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care
   
04.08.02  Drugs used in status epilepticus to top
Diazepam
View adult BNF View SPC online
Formulary Injection: 5 mg/1 mL
Rectal solution: 2.5 mg, 5 mg, 10 mg
 
   
Lorazepam
View adult BNF View SPC online
Formulary
Green +
Injection: 4 mg/1 mL 
   
Controlled Drug Midazolam
View adult BNF View SPC online
Formulary
Green +

Oromucosal solution (Buccolam®): 2.5 mg/0.5 mL, 5 mg/1 mL, 7.5 mg/1.5 mL, 10 mg/2 mL

Liquid: 10mg/5mL

 
   
Controlled Drug Phenobarbital
View adult BNF View SPC online
Formulary
Green +
Injection: 15mg/1 mL, 30 mg/1 mL, 60 mg/1 mL, 200 mg/1 mL 
   
Phenytoin
View adult BNF View SPC online
Formulary
Green +
Injection: 250 mg/5 mL 
   
Paraldehyde in olive oil
View adult BNF View SPC online
Unlicensed Drug Unlicensed
Red
Injection: 50 mg/50 mL 
   
04.08.03  Febrile convulsions
04.09  Drugs used in parkinsonism and related disorders
04.09.01  Dopaminergic drugs used in Parkinsons disease
SafinamideBlack Triangle (Xadago)
View adult BNF View SPC online
Formulary
Green +
High Cost Medicine

Tablets: 50mg, 100mg.

Green Plus information leaflet: Click here.

 
Link  Safinamide patient information leaflet
   
04.09.01  Dopamine receptor agonists
Apomorphine
View adult BNF View SPC online
Formulary
Amber
Injection: 20 mg/2 mL, 50 mg/5 mL
Pre-filled multiple dose pen injection device: 30 mg/3 mL
Pre-filled syringe: 50 mg/10 mL
 
   
Pramipexole
(as base)
View adult BNF View SPC online
Formulary
Green +
Tablets: 88 micrograms, 180 micrograms, 350 micrograms, 700 micrograms
MR tablets: 260 micrograms, 520 micrograms, 1.05 mg, 1.57 mg, 2.1 mg, 2.62 mg, 3.15 mg
 
   
Ropinirole
View adult BNF View SPC online
Formulary
Green +

Tablets: 250 micrograms, 500 micrograms, 1 mg, 2 mg, 5 mg
MR tablets: 2 mg, 4 mg, 8 mg


(preferred brand in primary care is Repinex XL)

 
   
Rotigotine
View adult BNF View SPC online
Formulary
Green +
Transdermal patches: 2 mg/24 hrs, 4 mg/24 hrs, 6 mg/24 hrs, 8 mg/24 hrs 
   
04.09.01  Levodopa to top
Co-Beneldopa
(benserazide + levodpoa)
View adult BNF View SPC online
Formulary Capsules: 12.5/50, 25/100, 50/200
Dispersible Tablets: 12.5/50, 25/100
CR capsules: 25/100
 
   
Co-Careldopa
(carbidopa + levedopa)
View adult BNF View SPC online
Formulary Tablets: 12.5/50, 10/100, 25/100, 25/250
MR Tablets: 25/100, 50/200
 
   
Co-Careldopa and Entacapone
View adult BNF View SPC online
Formulary
Green +
Stalevo® and Sastravi® and Stanek® brands available in the following strengths
  • 50 mg/12.5 mg/200 mg Tablets: levodopa 50 mg, carbidopa 12.5 mg, entacapone 200 mg
  • 75 mg/18.75 mg/200 mg Tablets: levodopa 75 mg, carbidopa 18.75 mg, entacapone 200 mg
  • 100 mg/25 mg/200 mg Tablets: levodopa 100 mg, carbidopa 25 mg, entacapone 200 mg
  • 125 mg/31.25 mg/200 mg Tablets: levodopa 125 mg, carbidopa 31.25 mg, entacapone 200 mg
  • 150 mg/37.5 mg/200 mg Tablets: levodopa 150 mg, carbidopa 37.5 mg, entacapone 200 mg
  • 175 mg/43.75 mg/200 mg Tablets: levodopa 175 mg, carbidopa 43.75 mg, entacapone 200 mg
  • 200 mg/50 mg/200 mg Tablets: levodopa 200 mg, carbidopa 50 mg, entacapone 200 mg
     
  •    
    04.09.01  Monoamine-oxidase-B inhibitors
    Rasagiline
    View adult BNF View SPC online
    Formulary
    Green +
    Tablets: 1 mg 
       
    Selegiline Hydrochloride
    View adult BNF View SPC online
    Formulary Tablets: 5 mg 
       
    04.09.01  Catachol-O-methyltransferase inhibitors
    Entacapone
    View adult BNF View SPC online
    Formulary
    Green +
    Tablets: 200 mg 
       
    Opicapone
    View adult BNF View SPC online
    Formulary
    Green +
    50mg capsules

    Adjunct to co-beneldopa or co-careldopa in Parkinson's disease 
       
    Tolcapone
    View adult BNF View SPC online
    Formulary
    Red

    Tablets: 100mg

     
       
    04.09.01  Amantadine
     note  Amantadine
    Amantadine
    View adult BNF View SPC online
    Formulary
    Green +
    Capsules: 100mg
    Syrup: 50mg/5ml 
       
    04.09.02  Antimuscarinic drugs used in parkinsonism
    Procyclidine
    View adult BNF View SPC online
    Formulary Tablets: 5 mg
    Syrup (sugar-free): 2.5 mg/5 mL, 5 mg/5 mL
     
       
    Orphenadrine
    View adult BNF View SPC online
    Formulary
    Green +
    Tablets: 50mg
    Syrup: 50mg/5ml 
       
    Procyclidine
    View adult BNF View SPC online
    Formulary
    Red
    Injection: 10 mg/2 mL
     
       
    04.09.03  Drugs used in essential tremor, chorea, tics, and related disorders to top
    Riluzole
    View adult BNF View SPC online
    Formulary
    Red
    High Cost Medicine
    Tablets: 50 mg 
    Link  NICE TA 20: Motor neurone disease - riluzole
       
    Tetrabenazine
    View adult BNF View SPC online
    Formulary
    Green +
    Tablets: 25 mg 
       
    04.09.03  Torsion dystonias and other involuntary movements
    Botulinum Toxin Type A
    View adult BNF View SPC online
    Formulary
    Red

    Botox®: 50 units, 100 units, 200 units
    Dysport®: 300 units, 500 units
    Xeomin ®: 50units, 100 units, 200 units

     

    N.B. Botox® is also licensed for the prophylaxis of headache in adults with chronic migraine (NICE TA260)

     
    Link  Botulinum toxin type A for the prevention of headaches in adults with chronic migraine
       
    04.10  Drugs used in substance dependence
    04.10  Alcohol dependence
    04.10  Cigarette smoking
    04.10  Opioid dependence to top
    04.10.01  Alcohol dependence
    Acamprosate
    View adult BNF View SPC online
    Formulary
    Green +
    Tablets: 333mg 
       
    Disulfiram
    View adult BNF View SPC online
    Formulary Tablets: 200 mg 
       
    Nalmefene
    View adult BNF View SPC online
    Formulary Tablets: 18mg 
    Link  NICE TA 325: Nalmefene for reducing alcohol consumption in people with alcohol dependence
       
    04.10.02  Nicotine dependence
    Bupropion Hydrochloride
    (Nicotine dependence – to be routinely prescribed through stop smoking voucher scheme)
    View adult BNF View SPC online
    Formulary

    MR Tablets: 150 mg

     
       
    Nicotine
    View adult BNF View SPC online
    Formulary Nicorette®
    Microtab (sublingual): 2 mg
    Chewing gum: 2 mg, 4 mg
    Patches (Invisi or non-Invisi): ‘5 mg' patch (releasing approx. 5 mg/16 hours), ‘10 mg' patch (releasing approx. 10 mg/16 hours), ‘15 mg' patch (releasing approx. 15 mg/16 hours)
    Oral spray: 1 mg/metered dose
    Nasal spray: 500 micrograms/metered spray
    Inhalator: 10 mg/cartridge, 15 mg/cartridge

    Nicotinell®
    Lozenge: 1 mg, 2 mg
    Patches: TTS 10 patch (releasing approx. 7 mg/24 hours), TTS 20 patch (releasing approx. 14 mg/24 hours), TTS 30 patch (releasing approx. 21 mg/24 hours)
     
       
    Varenicline
    View adult BNF View SPC online
    Formulary Tablets: 500 micrograms, 1 mg
    Starter pack available
     
    Link  NICE TA 123: Varenicline
       
    04.10.03  Opioid dependence
    04.10.03  Opioid substitution therapy
    Controlled Drug Buprenorphine
    View adult BNF View SPC online
    Formulary
    Red

    Sublingual Tablets: 400 micrograms, 2 mg, 8 mg

    RED when used to treat substance misuse, where initiation by specialist includes specialist substance misuse services

     
       
    Controlled Drug Methadone
    View adult BNF View SPC online
    Formulary
    Red

    Oral solution (sugar-free available, must be specified): 1 mg/1 mL
    Injection: 50 mg/2 mL, 50 mg/1 mL

     

    RED when used to treat substance misuse, where initiation by specialist includes specialist substance misuse services

     
       
    Controlled Drug Buprenorphine and Naloxone (Suboxone®)
    View adult BNF View SPC online
    Alternatives
    Red

    Sublingual tablets: 8mg/2mg

    RED when used to treat substance misuse, where initiation by specialist includes specialist substance misuse services

     
       
    04.10.03  Adjunctive therapy and symptomatic treatment to top
    Lofexidine
    View adult BNF View SPC online
    Formulary
    Green +
    Tablets: 200 micrograms 
       
    04.10.03  Opioid-receptor antagonists
    Naltrexone
    View adult BNF View SPC online
    Formulary
    Red

    Tablets: 50 mg

    For use under drug misuse specialist 

     
    Link  NICE TA 115: Drug misuse - naltrexone
       
    04.11  Drugs for dementia
    Donepezil
    View adult BNF View SPC online
    First Choice
    Green +
    Tablets: 5 mg, 10 mg
    Orodispersible tablets: 5mg, 10mg
     
    Galantamine
    View adult BNF View SPC online
    Alternatives
    Green +

    Tablets: 8 mg, 12 mg
    MR capsules: 8mg, 16mg, 24mg
    Oral solution (sugar-free): 4 mg/1 mL
    (preferred brand in primary care is Luventa XL)

     
       
    Memantine
    View adult BNF View SPC online
    Alternatives
    Green +
    Tablet: 10 mg, 20 mg
    Oral solution: 5 mg/actuation (10 mg/1 mL)
     
       
    Rivastigmine
    View adult BNF View SPC online
    Alternatives
    Green +
    Capsules: 1.5 mg, 3 mg, 4.5 mg, 6 mg
    Oral solution: 2 mg/1 mL
    Patches: 4.6 mg/24 hours, 9.5 mg/24 hours, 13.3mg/24hours
     
       
     ....
     Non Formulary Items
    Acetazolamide

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

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

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

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

    View adult BNF View SPC online
    Non Formulary
     
    Asenapine

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

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

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

    View adult BNF View SPC online
    Non Formulary
     
    Benperidol  (Anquil®)

    View adult BNF View SPC online
    Non Formulary
     
    Benzatropine

    View adult BNF View SPC online
    Non Formulary
     
    Bromocriptine

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

    View adult BNF View SPC online
    Non Formulary
     
    Cabergoline

    View adult BNF View SPC online
    Non Formulary
     
    Cabergoline  (Cabaser®)

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

    View adult BNF View SPC online
    Non Formulary
     
    Cloral Betaine  (Welldorm®)

    View adult BNF View SPC online
    Non Formulary
     
    Co-proxamol

    View adult BNF View SPC online
    Non Formulary
     
    Controlled Drug  Dextromoramide

    View adult BNF View SPC online
    Non Formulary
     
    Controlled Drug  Dipipanone  (Diconal®)

    View adult BNF View SPC online
    Non Formulary
     
    Dolasetron Mesilate  (Anzemet®)

    View adult BNF View SPC online
    Non Formulary
     
    Doxepin  (Sinepin®)

    View adult BNF View SPC online
    Non Formulary
     
    Droperidol  (Xomolix®)

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

    View adult BNF View SPC online
    Non Formulary
     
    Escitalopram  (Cipralex®)

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

    View adult BNF View SPC online
    Non Formulary
     
    Fluphenazine Decanoate

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    Non Formulary
    Green +

    Injection: 12.5mg/0.5ml, 25mg/1ml, 50mg/0.5ml, 100mg/1ml

     
    Fluphenazine Hydrochloride  (Moditen®)

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    Non Formulary
     
    Flurazepam  (Dalmane®)

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    Non Formulary
     
    Fluvoxamine Maleate  (Fluvoxamine®)

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    Non Formulary
     
    Fosphenytoin Sodium  (Pro-Epanutin®)

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    Non Formulary
     
    Frovatriptan

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    Non Formulary
     
    Granisetron

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    Non Formulary
     
    Granisetron transdermal patch  (Sancuso®)

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    Non Formulary
     
    Isocarboxazid

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    Non Formulary
     
    Isometheptene Mucate  (Midrid®)

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    Non Formulary
     
    Levodopa

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    Non Formulary
     
    Lisuride

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    Non Formulary
     
    Loprazolam

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    Non Formulary
     
    lormetazepam

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    Non Formulary
     
    Lurasidone  (Latuda®)

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    Non Formulary
     
    Controlled Drug  Meprobamate

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    Non Formulary
     
    Meptazinol  (Meptid®)

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    Non Formulary
     
    Methysergide  (Deseril®)

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    Non Formulary
     
    Mianserin

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    Non Formulary
     
    Controlled Drug  Morphine and cyclizine  (Cyclimorph®)

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    Non Formulary
     
    Naltrexone/ bupropion  (Mysimba®)

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    Non Formulary
     
    Naratriptan  (Naramig®)

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    Non Formulary
     
    Nefopam  (Acupan®)

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    Non Formulary
     
    Nitrazepam

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    Non Formulary
     
    Olanzapine Embonate  (ZypAdhera®)

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    Non Formulary
     
    Opicapone

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    Non Formulary
     
    Opicapone

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    Non Formulary
     
    Controlled Drug  Papaveretum

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    Non Formulary
     
    Paracetamol and dihydrocodeine  (Co-dydramol®)

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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
     
    Paraldehyde

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    Non Formulary
     
    Controlled Drug  Pentazocine

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    Non Formulary
     
    Pergolide

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    Non Formulary
     
    Pergolide  (Celance®)

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    Non Formulary
     
    Pericyazine  (Neilactil®)

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

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    Non Formulary
     
    Phenytoin Sodium  (Epanutin® Ready Mixed Parenteral)

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    Non Formulary
     
    Pimozide  (Orap®)

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    Non Formulary
     
    Piracetam  (Nootropil®)

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    Non Formulary
     
    Promazine Hydrochloride  (Promazine®)

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    Non Formulary
     
    Promethazine teoclate  (Avomine®)

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    Non Formulary
     
    Rimonabant  (Acomplia®)

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    Non Formulary
     
    Rizatriptan  (Maxalt®)

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    Non Formulary
     
    Rufinamide  (Inovelon®)

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

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    Non Formulary
     
    Sertindole  (Serdolect®)

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    Non Formulary
     
    Sibutramine Hydrochloride  (Reductil®)

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    Non Formulary
     
    Controlled Drug  Sodium Oxybate  (Xyrem®)

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    Non Formulary
    High Cost Medicine
     
    Sufentanil  (Zalviso®)

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

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

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    Non Formulary
     
    Tasimelteon  (Hetlioz®)

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    Non Formulary
     
    Tiagabine  (Gabitril®)

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    Non Formulary
     
    Tolfenamic Acid  (Clotam®)

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

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    Non Formulary
     
    Controlled Drug  Tramadol oral drops

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    Non Formulary
     
    Tranylcypromine

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

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    Non Formulary
     
    Trihexyphenidyl

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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
     
    Zaleplon  (Sonata®)

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    Non Formulary
     
    Ziprasidone  (Zeldox®)

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    Non Formulary
     
    Zolmitriptan

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    Non Formulary
     
    Zolpidem

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    Non Formulary
    Link  NICE TA77: Zaleplon, zolpidem and zopiclone for the management of insomnia
     
    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. 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.   

    netFormulary