| Formulary Chapter 4: Central nervous system - Full Chapter
|
|
| Chapter Links... |
 Administration of depot antipsychotic injections during COVID-19 in stable adult patients |
| Details... |
| 04.01 |
Hypnotics and anxiolytics |
|
|
|
|
|
|
|
|
| 04.01.01 |
Hypnotics |
|
|
Melatonin MR (Circadin ®)
|
Formulary
|
 Sandwell & West Birmingham CCG for patients seen by the Black Country ADHD Services.
REM sleep behaviour disorder and circadian rhythm sleep-wake disorder in adults in line with ESCA
 For all other indications
|
|
|
Melatonin 3mg tablets
|
Formulary
|
REM sleep behaviour disorder and circadian rhythm sleep-wake disorder in adults in line with ESCA
For all other indications
|
|
|
Melatonin
(Capsules)
|
 Unlicensed
|
|
|
|
|
|
| 04.01.01 |
Benzodiazepines |
|
|
Temazepam
(SF solution)
|
Formulary
|
From Monday 1st June 2015, prescriptions for temazepam will be required to meet full prescription requirements for Schedule 3 controlled drugs (CDs)
Legislative changes to prescription writing requirements for temazepam
|
|
|
Temazepam
(Tablets)
|
Formulary
|
£££££
From Monday 1st June 2015, prescriptions for temazepam will be required to meet full prescription requirements for Schedule 3 controlled drugs (CDs)
Legislative changes to prescription writing requirements for temazepam
|
|
|
Diazepam liquid
|
Formulary
|
Inpatient use and prison settings only
|
|
|
| 04.01.01 |
Zaleplon, Zolpidem and Zopiclone |
|
|
Zopiclone
|
First Choice
|
Licensed for short-term use only (4 weeks).
|
NICE TA77: Zaleplon, zolpidem and zopiclone for the management of insomnia
|
Zolpidem
|
Formulary
|
|
NICE TA77: Zaleplon, zolpidem and zopiclone for the management of insomnia
|
| 04.01.01 |
Chloral and derivatives |
|
|
Chloral Hydrate 500mg in 5mL
|
Formulary
|
For hospital use only.
Unlicensed special.
|
|
|
| 04.01.01 |
Antihistamines |
|
|
Promethazine Hydrochloride
|
Formulary
|
|
|
|
| 04.01.01 |
Pitolisant |
|
|
| 04.01.02 |
Anxiolytics |
|
|
|
|
| 04.01.02 |
Benzodiazepines |
|
|
Diazepam
(Liquid)
|
Formulary
|
Inpatient use and prison settings only
|
|
|
Diazepam
(tablets)
|
Formulary
|
|
|
|
Oxazepam
(Tablets)
|
Formulary
|
|
|
|
Chlordiazepoxide
|
Formulary
|
Adjunct in acute alcohol withdrawal
|
|
|
Lorazepam
(tablets)
|
Formulary
|
|
|
|
Diazepam
(Injection)
|
Formulary
|
|
|
|
Lorazepam
(Injection)
|
Formulary
|
|
|
|
| 04.01.02 |
Buspirone |
|
|
Buspirone Hydrochloride
(Tablets)
|
Formulary
|
£££££
Second line
|
|
|
| 04.01.03 |
Barbiturates |
|
|
| .... |
| Non Formulary Items |
Almotriptan (Almogran®)
|
Non Formulary
|
|
|
|
Alprazolam
|
Non Formulary
|
|
|
|
Alprazolam (Xanax®)
|
Non Formulary
|
|
|
|
Amobarbital (amylobarbitone) and secobarbital (quinalbarbitone) (Tuinal®)
|
Non Formulary
|
|
|
|
Amobarbital (amylobrbitone) (Sodium Amytal®)
|
Non Formulary
|
|
|
|
Aspirin and metoclopramide (MigraMax®)
|
Non Formulary
|
|
|
|
Buspirone Hydrochloride (Buspar®)
|
Non Formulary
|
|
|
|
Butobarbital (butobarbitone) (Soneryl®)
|
Non Formulary
|
|
|
|
Chloral Hydrate 300mg in 5mL
|
Non Formulary
|
|
|
|
Clomethiazole (Heminevrin®)
|
Non Formulary
|
|
|
|
Cloral Betaine
|
Non Formulary
|
|
|
|
Eletriptan (Relpax®)
|
Non Formulary
|
|
|
|
Ergotamine Tartrate (Cafergot®, Migril®)
|
Non Formulary
|
|
|
|
Flurazepam (Dalmane®)
|
Non Formulary
|
|
|
|
Frovatriptan
|
Non Formulary
|
|
|
|
Loprazolam
|
Non Formulary
|
|
|
|
Meprobamate
|
Non Formulary
|
|
|
|
Naratriptan
|
Non Formulary
|
Removed from formulary May 2017 following 6-fold price increase. More cost-effective options available on formulary. |
|
|
Nitrazepam (Tablets, Suspension)
|
Non Formulary
|
|
|
|
Paracetamol and metoclopramide (Paramax®)
|
Non Formulary
|
|
|
|
Secobarbital (quinalbarbitone) (Seconal Sodium®)
|
Non Formulary
|
|
|
|
Sodium Oxybate (Xyrem®)
|
Non Formulary
|
|
|
|
Sumatriptan (Imigran® Radis)
|
Non Formulary
|
|
|
|
Tolfenamic Acid (Clotam®)
|
Non Formulary
|
|
|
|
Triclofos Sodium (Triclofos® oral solution BP)
(Triclofos Elixir)
|
Non Formulary
|
|
|
|
Zaleplon (Sonata®)
|
Non Formulary
|
|
|
|
| |
Key |
 |
Restricted Drug |
|
Unlicensed |
|
|
Link to adult BNF
|
|
|
Link to children's BNF
|
|
|
Link to SPCs
|
|
Cytotoxic Drug |
|
Controlled Drug |
|
|
High Cost Medicine |
|
Cancer Drugs Fund |
|
NHS England |
|
Homecare |
|
ICB |
|
Low carbon footprint |
|
Medium carbon footprint |
|
High carbon footprint |
|
| Status |
Description |
|
All Settings
Suitable for initiation, ongoing prescribing, and discontinuation in both primary and secondary care settings. They are generally familiar, frequently used therapies that can be started within their licensed indications without specialist oversight. |
|
Specialist only
Designated for initiation, ongoing prescribing, monitoring, exclusively by a specialists either in a hospital or as part of a specialist service (to note this could be in a non-hospital setting). Primary care should neither start nor continue these treatments except as part of a specialist service. A specialist could be either a medical or non-medical prescriber. |
|
Specialist advice
Prescribers in primary care should seek advice and a recommendation from a specialists prior to initiating a medicine. Once agreed with a specialist, medicines can be initiated, prescribed and monitored in primary care without a formal shared-care agreement. |
|
Specialist initiation
Medicines in this category require a specialist to start therapy, titrate dosage, and assess initial efficacy or tolerability. Once stabilised, prescribing responsibility may transfer to primary care without the need for a formal shared-care agreement. |
|
Shared care agreement
Prescribing responsibility can be shared across health settings and between specialists and GPs only when formal shared care arrangement has been made. For example, there may be extensive and complex monitoring requirements or significant safety concerns (note would need a national policy on this to define the criteria for requiring a formal SCA), this will be produced once nationally. |
|
Do not prescribe
Not approved for routine prescribing in primary or secondary care. For example, because they are agents classified in the BNF as “not NHS” or “Drugs of Low Clinical Value”, or they are products on NICE’s “do not do” list or NHS England’s “should not routinely prescribe” list. |
|
Self Care
Not for routine prescribed in primary or secondary care unless as part of care for a long term condition. Instead, patients should be encouraged to self care with support from community pharmacy. |
|
Medicines which are suitable for initiation and maintenance prescribing by primary and secondary care clinicians. These medicines should be initiated and prescribed within their licensed indications |
|
Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry. |
|
Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry. |
|
Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a specialist. |
|
Medicines for initiation and maintenance prescribing by Specialists (hospital or GPs with Special Interest) only |
|
Positive NICE TA and /or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information. |
|
Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use. |
|
|
|
