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Birmingham, Sandwell, Solihull and environs APC Formulary
Maintained by Midlands and Lancashire Commissioning Support Unit
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 Formulary Chapter 4: Central nervous system - Full Chapter
04.08.01  Expand sub section  Control of epilepsy
 note 

Category

Antiepileptic drugs

MHRA Advice

1

phenytoin, carbamazepine, phenobarbital, primidone

For these drugs, doctors are advised to ensure that their patient is maintained on a specific manufacturer’s product

2

valproate, lamotrigine, perampanel, retigabine, rufinamide, clobazam, clonazepam, oxcarbazepine, eslicarbazepine, zonisamide, topiramate

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

3

levetiracetam, lacosamide, tiagabine, gabapentin, pregabalin, ethosuximide, vigabatrin  

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

04.08.01  Expand sub section  Partial seizures with or without secondary generalisation
04.08.01  Expand sub section  Generalised seizures
04.08.01  Expand sub section  Carbamazepine and Oxcarbazepine
04.08.01  Expand sub section  Ethosuximide to top
04.08.01  Expand sub section  Gabapentin and pregabalin
04.08.01  Expand sub section  Lacosamide
Lacosamide
View adult BNF View SPC online View childrens BNF
Formulary
Amber SC
  • Tablets
  • Syrup
  • Supported by an ESCA, see link below.
 
Link  ESCA: Lacosamide.
   
04.08.01  Expand sub section  Lamotrigine
04.08.01  Expand sub section  Levetiracetam
04.08.01  Expand sub section  Perampanel to top
04.08.01  Expand sub section  Phenobarbital and other barbiturates
04.08.01  Expand sub section  Phenytoin
04.08.01  Expand sub section  Retigabine
04.08.01  Expand sub section  Rufinamide
04.08.01  Expand sub section  Tiagabine to top
04.08.01  Expand sub section  Topiramate
04.08.01  Expand sub section  Valproate
04.08.01  Expand sub section  Vigabatrin
04.08.01  Expand sub section  Zonisamide
04.08.01  Expand sub section  Benzodiazepines to top
04.08.01  Expand sub section  Other Drugs
 ....
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
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

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.
  

Green

Medicines suitable for routine use within primary care. Initiation and maintenance of prescribing by Specialists, GPs and other qualified clinicians.   

Amber Initiation

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 Recommended

Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.  

Amber SC

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.  

Red

Medicines for initiation and maintenance prescribing by Specialists only.  

Black

Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use.  

Grey

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

The term 'Specialist' refers to Consultants, General Practitioners and Independant Prescribers with a Specialist Interest.  

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