netFormulary Central Lancashire Formulary NHS
Lancashire Teaching Hospitals NHS Foundation Trust
Chorley and South Ribble CCG
Greater Preston CCG
 
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 Formulary Chapter 4: Central nervous system - Full Chapter
04.01  Hypnotics and anxiolytics
04.01.01  Hypnotics
04.01.01  Benzodiazepines
Controlled Drug Temazepam
(hypnotic)
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Green
 
   
04.01.01  Zaleplon, Zolpidem and Zopiclone
Zolpidem
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Green
 
Link  NICE TA77: Zaleplon, zolpidem and zopiclone for the management of insomnia
   
Zopiclone
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Restricted Drug Restricted
Green
 
Link  NICE TA77: Zaleplon, zolpidem and zopiclone for the management of insomnia
   
04.01.01  Chloral and derivatives to top
04.01.01  Clomethiazole (Chlormethiazole)
04.01.01  Antihistamines
04.01.01  Alcohol
04.01.01  Sodium oxybate
04.01.02  Anxiolytics to top
04.01.02  Benzodiazepines
Diazepam
(anxiety)
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Formulary
Green
 
   
Lorazepam
(tablets )
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Green

anxiety

 

 
   
Lorazepam
(injection)
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Red
 
   
04.01.02  Buspirone
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
Zuclopenthixol
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Amber
 
   
Trifluoperazine
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Amber
 
   
Zuclopenthixol Acetate
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Formulary
Red

LCFT ONLY

Clopixol Acuphase®

 

 
   
04.02.01  First-Generation Antipsychotic Drugs
Chlorpromazine
(tablets/liquids)
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Formulary
Green
 
   
Haloperidol
(tablets/liquid)
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Formulary
Green
 
   
Promazine Hydrochloride (Promazine®)
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Green
 
   
Fluphenazine Hydrochloride
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Formulary
Amber
 
   
Haloperidol decanoate injection
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Amber
 
   
Levomepromazine (Nozinan®)
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Formulary
Amber

existing patients

Black (RAG) rating for new patients

 
   
Haloperidol injection
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Red
 
   
04.02.01  Second-Generation Antipsychotic Drugs
Olanzapine tablets
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Formulary
Amber 1

LCFT INITIATION ONLY

 
   
Quetiapine
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Formulary
Amber 1

LCFT INITIATION ONLY

tablets and XL tablets

 
   
Risperidone
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Formulary
Amber 1

LCFT INITIATION ONLY

 
   
Amisulpride
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Formulary
Amber 1

LCFT INITIATION ONLY

 
   
Aripiprazole
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Formulary
Amber 1

LCFT INITIATION ONLY

 
Link  NICE TA213: Aripiprazole for the treatment of schizophrenia in people aged 15 -17 years
Link  NICE TA292: Bipolar disorder (children) - aripiprazole
   
Clozapine
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Formulary
Red

LCFT ONLY

 
   
Lurasidone (Latuda®)
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Formulary
Red

LCFT ONLY

 
   
Olanzapine injection
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Formulary
Red

LCFT ONLY

 

 
   
Paliperidone (Invega®)
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Formulary
Red

LCFT ONLY

 
   
04.02.02  Antipsychotic depot injections to top
Flupentixol Decanoate
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Formulary
Amber

LCFT INITIATION ONLY

Depixol®

 
   
Zuclopenthixol Decanoate
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Formulary
Amber

LCFT INITIATION  ONLY

 
   
Aripiprazole
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Formulary
Red

LCFT ONLY

Abilify Maintena®

 
   
Paliperidone palmitate
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Formulary
Red

LCFT ONLY

Xeplion®

 
   
Risperidone
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Formulary
Red

LCFT ONLY

Risperdal Consta®

 
   
04.02.03  Drugs used for mania and hypomania
04.02.03  Benzodiazepines
04.02.03  Antipsychotic drugs
04.02.03  Carbamazepine
04.02.03  Valproic acid to top
Valproic Acid
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Amber

Depakote®

 
   
Sodium valproate
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Unlicensed Drug Unlicensed
Amber
 
   
04.02.03  Lithium
Lithium Carbonate
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Formulary
Amber 1

Priadel®

 
   
Lithium Citrate
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Amber 1

Priadel® Liquid

 
   
04.03  Antidepressant drugs
04.03.01  Tricyclic and related antidepressant drugs
04.03.01  Tricyclic antidepressants
Amitriptyline
(antidepressant)
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Green
 
   
Clomipramine
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Green
 
   
Imipramine
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Green
 
   
Lofepramine
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Green
 
   
Doxepin
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Amber
 
   
04.03.01  Related antidepressants to top
Trazodone
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Green
 
   
Mianserin
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Amber
 
   
04.03.02  Monoamine-oxidase inhibitors
Phenelzine
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Formulary
Amber

Nardil®

 
   
04.03.02  Reverible MAOIs
Moclobemide
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Amber
 
   
04.03.03  Selective serotonin re-uptake inhibitors
Citalopram
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Green
 
   
Escitalopram
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Restricted Drug Restricted
Green

Major depressive illness only

 
   
Fluoxetine
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Green
 
   
Paroxetine
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Green
 
   
Sertraline
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Green
 
   
Vortioxetine
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Green
 
Link  NICE TA367 - Vortioxetine for treating major depressive episodes
   
04.03.04  Other antidepressant drugs
Mirtazapine
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Green
 
   
Venlafaxine
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Green
 
   
Duloxetine
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Amber
 
   
Reboxetine
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Amber

Edronex®

 
   
04.04  CNS stimulants and other drugs used for attention deficit hyperactivity disorder to top
Controlled Drug Methylphenidate
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Formulary
Amber 1
 
   
Controlled Drug Methylphenidate Hydrochloride MR
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Formulary
Amber 1

Equasym®

Medikinet®

Concerta®

 

 
   
Atomoxetine
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Formulary
Amber 1

Strattera®

 
   
Controlled Drug Dexamfetamine
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Formulary
Amber 1
 
   
Guanfacine
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Formulary
Amber 1

Intuniv®

 
   
Controlled Drug Lisdexamfetamine
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Formulary
Red

AMBER 1 for ADHD in adults

RED for ADHD in children and young adults

Elvanse®

 
   
Modafinil (Provigil®)
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Formulary
Amber
 
   
04.04  Cocaine
04.05  Drugs used in the treatment of obesity
04.05.01  Anti-obesity drugs acting on the gastro-intestinal tract
Orlistat
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Restricted Drug Restricted
Green
 
   
04.05.02  Centrally acting appetite suppressants
04.06  Drugs used in nausea and vertigo to top
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
Cyclizine
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Green
 
   
Haloperidol
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Green
 
   
Levomepromazine
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Formulary
Green
 
   
04.06  Migraine
04.06  Antihistamines
Cinnarizine
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Green
 
   
Cyclizine
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Green
 
   
04.06  Phenothiazines and related drugs
Prochlorperazine
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Green
 
   
04.06  Domperidone and metoclopramide to top
Metoclopramide
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Formulary
Green
 
   
Domperidone
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Formulary
Amber 1
 
   
04.06  5HT3 antagonists
Granisetron
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Formulary
Red
 
   
Ondansetron
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Restricted Drug Restricted
Green

NB off licence use as only licensed for post chemo/post operative use

 
   
04.06  Neurokinin receptor antagonist
Aprepitant
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Formulary
Red

Emend®

 
   
Fosaprepitant
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Formulary
Red

Ivemend®

 
   
04.06  Cannabinoid
Cannabidiol 2.5mg/dose (Sativex oromucosal spray®)
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Formulary
Red
 
   
04.06  Hyoscine
Hyoscine Hydrobromide
(tablets/patches)
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Formulary
Green
 
   
04.06  Other drugs for Ménière's disease to top
Betahistine Dihydrochloride
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Green
 
   
04.07  Analgesics
04.07.01  Non-opioid analgesics and compound analgesic preparations
Paracetamol
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Formulary
Purple

Drug included within CCG low priority prescribing policy. EXEMPTIONS EXIST FOR CERTAIN INDICATIONS. Please consult attached policy for list of excepted indications for prescribing of this drug.

 
   
04.07.01  Compound analgesic preparations
Co-Codamol 30/500
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Green

NOT for INPATIENT USE - use seperate components

Hospital - Emergency Department only

 
   
04.07.02  Opioid analgesics
Dihydrocodeine
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Green
 
   
Codeine
(analgesia)
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Formulary
Green
 
Controlled Drug Injection Only
   
Controlled Drug Diamorphine
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Formulary
Green
 
   
Controlled Drug Fentanyl
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Formulary
Green
 
   
Controlled Drug Morphine
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Formulary
Green
 
   
Controlled Drug Oxycodone
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Formulary
Green
 
   
Controlled Drug Pethidine
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Formulary
Green
 
   
04.07.03  Neuropathic pain to top
Amitriptyline
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Formulary
Green
 
   
Capsaicin
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Formulary
Green

0.025% - Unlicensed in Neuropathic Pain

0.075% - Licensed for post-herpetic neuralgia after open skin lesions have healed and painful diabetic peripheral polyneuropathy

 

 
   
Duloxetine
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Formulary
Green
 
   
Gabapentin
(Neuropathic pain)
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Formulary
Green
 
   
Lidocaine 5% patches
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Formulary
Red
 
Link  LMMG Recommendation - Neuropathic Pain
Link  LMMG Recommendation - Post Herpetic Neuralgia
   
Pregabalin
(Neuropathic pain)
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Formulary
Green
 
   
04.07.03  Trigeminal neuralgia
Carbamazepine
(Trigeminal neuralgia)
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Formulary
Green
 
   
04.07.03  Postherpetic neuralgia
04.07.03  Chronic facial pain
04.07.04  Antimigraine drugs
Botulinum Toxin Type A
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Formulary
Red
BlueTeq
 
   
04.07.04.01  Treatment of the acute migraine attack to top
04.07.04.01  Analgesics
04.07.04.01  5HT1 agonists
Rizatriptan (Maxalt®)
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Formulary
Green
 
   
Sumatriptan
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Formulary
Green

tablets/injection

 
   
Zolmitriptan
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Formulary
Green
 
   
04.07.04.01  Ergot alkaloids
04.07.04.01  Anti-emetics
04.07.04.01  Other drugs for migrane to top
04.07.04.02  Prophylaxis of migraine
Topiramate
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Formulary
Green

migraine prophylaxis

 
   
04.07.04.03  Cluster headache
04.08  Antiepileptics
04.08.01  Control of epilepsy
Brivaracetam (Briviact®)
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Formulary
Amber
 
   
04.08.01  Partial seizures with or without secondary generalisation to top
04.08.01  Generalised seizures
04.08.01  Carbamazepine and Oxcarbazepine
Carbamazepine
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Formulary
Amber
 
   
Eslicarbazepine (Zebinix®)
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Formulary
Amber
 
   
Oxcarbazepine (Trileptal®)
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Formulary
Amber
 
   
04.08.01  Ethosuximide
Ethosuximide
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Formulary
Amber
 
   
04.08.01  Gabapentin and pregabalin
Gabapentin
(Epilepsy)
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Formulary
Amber
 
   
Pregabalin
(Epilepsy)
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Formulary
Amber
 
   
04.08.01  Lacosamide to top
Lacosamide  (Vimpat ® )
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Formulary
Amber
 
   
04.08.01  Lamotrigine
Lamotrigine
(epilepsy)
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Formulary
Amber

Unlicensed use as a mood stabiliser

 
   
04.08.01  Levetiracetam
Levetiracetam
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Amber

RED for Levetiracetam infusion

 
   
04.08.01  Perampanel
04.08.01  Phenobarbital and other barbiturates
Controlled Drug Phenobarbital
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Amber
 
   
Primidone
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Amber
 
   
04.08.01  Phenytoin to top
Phenytoin
(Oral)
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Formulary
Amber
 
   
04.08.01  Retigaine
04.08.01  Rufinamide
Rufinamide (Inovelon®)
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Formulary
Amber 1
 
   
04.08.01  Rufinamide
04.08.01  Tiagabine
04.08.01  Topiramate to top
Topiramate
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Formulary
Amber
 
   
04.08.01  Valproate
Sodium Valproate (Epilim®Epilim Chrono®)
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Formulary
Amber
 
Link  Guideline: Sodium Valproate in women of child-bearing potential
   
04.08.01  Vigabatrin
Vigabatrin (Sabril®)
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Formulary
Amber
 
   
04.08.01  Zonisamide
Zonisamide (Zonegran®)
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Formulary
Amber
 
   
04.08.01  Benzodiazepines
Clobazam
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Formulary
Amber
 
   
Clonazepam
(epilepsy/mood disorders)
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Formulary
Amber

GREEN unlicensed anxiety

 
   
04.08.01  Other Drugs to top
Perampanel (Fycompa®)
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Formulary
Amber
 
Link  NICE CG137: The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care
   
Retigabine
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Formulary
Amber
 
Link  NICE TA232: Retigabine for the adjunctive treatment of adults with partial onset seizures in epilepsy with and without secondary generalisation
   
04.08.02  Drugs used in status epilepticus
Diazepam (epilepsy)
(rectal)
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Formulary
Amber
 
   
Lorazepam
(injection - epilepsy)
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Formulary
Red
 
   
Controlled Drug Midazolam (Buccolam®)
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Formulary
Amber
 
   
Phenytoin
(IV)
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Formulary
Red
 
   
04.08.03  Febrile convulsions
04.09  Drugs used in parkinsonism and related disorders
04.09.01  Dopaminergic drugs used in Parkinsons disease
04.09.01  Dopamine receptor agonists to top
Apomorphine
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Formulary
Amber 1
 
   
Cabergoline
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Formulary
Amber
 
   
Pramipexole
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Formulary
Amber
 
   
Ropinirole
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Amber
 
   
Rotigotine
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Formulary
Amber
 
   
04.09.01  Levodopa
Co-Beneldopa (Madopar®)
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Formulary
Amber
 
   
Co-Beneldopa (Madopar®CR)
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Formulary
Amber
 
   
Co-Careldopa (Sinemet®)
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Formulary
Amber
 
   
Co-Careldopa and Entacapone (Stalevo ®)
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Formulary
Amber
 
   
Levodopa
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Formulary
Amber
 
   
04.09.01  Monoamine-oxidase-B inhibitors
Rasagiline
(Parkinsons disease)
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Formulary
Amber

BLACK unlicensed MS

 
   
Selegiline Hydrochloride
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Formulary
Amber
 
   
04.09.01  Catachol-O-methyltransferase inhibitors
Entacapone (Comtess®)
(Adjunct to co-beneldopa or co-careldopa in Parkinson's disease)
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Formulary
Amber
 
   
04.09.01  Amantadine
Amantadine
(Parkinson's)
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Formulary
Amber
 
   
04.09.02  Antimuscarinic drugs used in parkinsonism to top
Procyclidine
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Formulary
Green
 
   
Trihexyphenidyl
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Formulary
Green
 
   
04.09.03  Drugs used in essential tremor, chorea, tics, and related disorders
Botulinum Toxin Type A
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Formulary
Red

Xeomin®; Dysport®; Botox®

 
   
Piracetam (Nootropil®)
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Formulary
Amber
 
   
Riluzole (Rilutek®)
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Formulary
Amber 1
High Cost Medicine
BlueTeq
 
Link  NICE TA20: Motor neurone disease - riluzole
   
Tetrabenazine (Xenazine® 25)
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Formulary
Amber
 
   
04.09.03  Torsion dystonias and other involuntary movements
Botulinum Toxin Type A
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Formulary
Red

Xeomin®; Dysport®; Botox®

 
   
04.09.04  Restless leg syndrome
Pramipexole
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First Choice
Green
 
Ropinirole
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Formulary
Green
 
   
Rotigotine
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Formulary
Green
 
   
Gabapentin
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Unlicensed Drug Unlicensed
Green
 
   
Pregabalin
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Unlicensed Drug Unlicensed
Green
 
   
04.10  Drugs used in substance dependence
Thiamine
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Formulary
Purple

Drug included within CCG low priority prescribing policy. EXEMPTIONS EXIST FOR CERTAIN INDICATIONS. Please consult attached policy for list of excepted indications for prescribing of this drug.

 
   
Vitamin B substances with ascorbic acid (Pabrinex®)
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Formulary
Red
 
   
04.10  Alcohol dependence to top
Chlordiazepoxide
(substance dependence)
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Formulary
Amber
 
   
04.10  Cigarette smoking
Nicotine (Nicorette® Invisi patches)
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Restricted Drug Restricted
Green
 
   
04.10  Opioid dependence
04.10.01  Alcohol dependence
04.10.02  Nicotine dependence
04.10.03  Opioid dependence to top
04.10.03  Opioid substitution therapy
Controlled Drug Buprenorphine (Subutex®)
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Formulary
Amber 2
 
   
Controlled Drug Methadone
(Dependance )
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Formulary
Amber 2
 
   
04.10.03  Adjunctive therapy and symptomatic treatment
04.10.03  Opioid-receptor antagonists
Naltrexone (Nalorex®)
(opioid dependence)
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Formulary
Amber
 
Link  NICE TA115: Drug misuse - naltrexone
   
04.11  Drugs for dementia
Donepezil
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First Choice
Amber

Tablet, Orodispersible Tablet, Oral Solution

 
Rivastigmine
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Formulary
Amber

Capsule, Oral Solution, Transdermal Patch

 
   
Galantamine
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Formulary
Amber

Tablet, Modified Release Capsule, Oral Solution

 
   
Memantine
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Formulary
Amber

Tablet, Orodispersible Tablet, Oral Solution

 
   
 ....
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 children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
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

Amber

Suitable for prescribing in primary care following recommendation or initiation by a specialist. Little or no specific monitoring required. Patient may need a regular review, but this would not exceed that required for other medicines routinely prescribed in primary care. Brief prescribing document or information sheet may be required.  

Amber 1

Suitable for prescribing in primary care following recommendation or initiation by a specialist. Minimal monitoring required. Patient may need a regular review, but this would not exceed that required for other medicines routinely prescribed in primary care. Full prior agreement about patient’s on-going care must be reached under the shared care agreement.  

Amber 2

Initiated by specialist and transferred to primary care following a successful initiation period. Significant monitoring required on an on-going basis. Full prior agreement about patient’s on-going care must be reached under the shared care agreement. Suitable for enhanced service.  

Black

NOT recommended for use by the NHS in Lancashire. Includes medicines that NICE has not recommended for use and terminated technology appraisals, unless there is a local need.  

Blue

Products shown as blue have different Traffic Light List classifications dependent on indication. See the accompanying text next to the product for further information  

Green

Appropriate for initiation and ongoing prescribing in both primary and secondary care. Generally, little or no routine drug monitoring is required.  

Purple

Low Priority for Prescribing - see Low Priority for Prescribing Policy  

Red

Medicine is supplied by the hospital for the duration of the treatment course. Primary care initiation or continuation of treatment is not recommended unless exceptional circumstances such as specialist GP.  

Red Specialist Centre

Prescribing restricted to Specialist Centres only  

netFormulary