Formulary Chapter 4: Central nervous system - Full Chapter
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04.08.01 |
Control of epilepsy |
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Category
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Antiepileptic drugs
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MHRA Advice
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1
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phenytoin, carbamazepine, phenobarbital, primidone
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For these drugs, doctors are advised to ensure that their patient is maintained on a specific manufacturer’s product
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2
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valproate, lamotrigine, perampanel, retigabine, rufinamide, clobazam, clonazepam, oxcarbazepine, eslicarbazepine, zonisamide, topiramate
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For these drugs, the need for continued supply of a particular manufacturer’s product should be based on clinical judgement and consultation with patient and/or carer, taking into account factors such as seizure frequency and treatment history
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3
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levetiracetam, lacosamide, tiagabine, gabapentin, pregabalin, ethosuximide, vigabatrin
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For these drugs, it is usually unnecessary to ensure that patients are maintained on a specific manufacturer’s product unless there are specific reasons such as patient anxiety and risk of confusion or dosing errors
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04.08.01 |
Partial seizures with or without secondary generalisation |
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04.08.01 |
Generalised seizures |
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04.08.01 |
Carbamazepine and Oxcarbazepine |
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04.08.01 |
Gabapentin and pregabalin |
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04.08.01 |
Phenobarbital and other barbiturates |
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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Cancer Drugs Fund
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
Status |
Description |

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Prescribing in children
The APC notes that the informed use of unlicensed medicines or of licensed medicines for unlicensed applications (‘off-label’ use) is often necessary in paediatric practice.
The APC advises GPs to consider specialist prescribing recommendations for Green and Amber medicines that are not subject to ESCAs or RICaDs in combination with the information provided in the BNFC which goes beyond that of marketing authorisations. The BNFC has been designed for rapid reference and the information presented has been carefully selected to aid decisions on prescribing.
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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. |

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Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate, or initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.
Some amber medicines require agreement with the local (internal) medicines committee prior to initiation; others may require a framework to support safe transfer and maintenance of care such as a RICaD or ESCA. The Formulary will be annotated to reflect these requirements. |

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Medicines for initiation and maintenance prescribing by Specialists only |

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Non-formulary medicines- medicines not recommended for routine primary care prescribing. |

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Positive NICE TA and /or awaiting local clarification on place in therapy ; Please contact your Medicines Optimisation team for more information. |
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