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Birmingham, Sandwell, Solihull and environs APC Formulary
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 Formulary Chapter 4: Central nervous system - Full Chapter
04.10.01  Expand sub section  Alcohol dependence
Acamprosate (Campral EC®)
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Formulary
Amber Recommended
 
   
Chlordiazepoxide
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Formulary
Green
  • Adjunct in acute alcohol withdrawal 
  •    
    Diazepam
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    Formulary
    Green
     
       
    Disulfiram (Antabuse®)
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    Formulary
    Amber Recommended
     
       
    Nalmefene
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    Restricted Drug Restricted
    Red
    Restricted to Specialist Substance Misuse Services only
  • Reach Out Recovery (CRI) in Birmingham. Single point of contact 24/7 Tel: 0121 227 5890 Link Reach Out Recovery website
  • Swanswell in Sandwell Tel: 0121 553 1333 Link to Swanswell website
  • SIAS in Solihull Tel:0121 301 3600 Link to SIAS website


    The Nalmefene for reducing alcohol consumption technology appraisal (TA325) recommends this drug as a possible treatment for people with alcohol dependence who:
    • are still drinking more than 7.5 units per day (for men) and more than 5 units per day (for women) 2 weeks after an initial assessment and
    • do not have physical withdrawal symptoms and
    • do not need to either stop drinking straight away or stop drinking completely
    The guidance also recommends that nalmefene should only be prescribed in conjunction with continuous psychosocial support focused on treatment adherence and reducing alcohol consumption.
     
  • Link  NICE TA 325: Nalmefene for reducing alcohol consumption in people with alcohol dependence
       
    Naltrexone
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    Formulary
    Amber Recommended
    • Useful as an adjunct in the treatment of alcohol dependence after a successful withdrawal.
     
       
     ....
    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
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    Link to adult BNF
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    Link to children's BNF
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    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.  

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