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 Formulary Chapter 4: Central nervous system - Full Chapter
04.03.01  Expand sub section  Tricyclic and related antidepressant drugs
04.03.01  Expand sub section  Tricyclic antidepressants
Amitriptyline
(tablet/liquid)
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First Choice
Green

May also be used off-label for hypersalivation

 
Imipramine
(tablet)
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Second Choice
Amber Recommended

note May be considered as a potential second line alternative when amitriptyline is not suitable/not tolerated

 
   
Clomipramine
(capsule)
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Formulary
Amber Recommended
 
   
Lofepramine
(tablet/liquid)
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Formulary
Amber Recommended
 
   
04.03.01  Expand sub section  Related antidepressants
Trazodone
(capsule/liquid)
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Formulary
Amber Recommended

For agitation in older people with dementia

 
   
 ....
 Non Formulary Items
Dosulepin
(capsules/tablets)

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Non Formulary
Black

Red Triangle Not recommended nationally due to significant safety concerns (see NICE CG90)

 
Mianserin

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Non Formulary
 
Nortriptyline
(tablets)

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Non Formulary
Black

Red Triangle Not recommended for use locally.

Consider alternatives according to indication.

For neuropathic pain refer to NICE CG173

For depression refer to NICE CG90

For insomnia refer to NICE CKS

 
Trimipramine
(tablets/capsules)

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Non Formulary
Black

Red Triangle Not recommended for use nationally.

Consider alternatives according to indication.

For neuropathic pain refer to NICE CG173

For depression refer to NICE CG90

For insomnia refer to NICE CKS

 
  
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

Traffic Light Status Information

Status Description

Green

Suitable for prescribing by all in both primary and secondary care.  

Amber Recommended

Specialist recommended but suitable for continuation in primary care.  

Amber Initiation

Specialist initiated but suitable for continuation in primary care.  

Amber SCG

Specialist initiated and for continuation in primary care under a locally approved shared care guideline.  

Red

Suitable for prescribing in specialist settings (secondary care) only.   

Red Specialist Centre

Secondary care medicines to be used under specialised commissioning arrangements only.  

Blue

For primary care, either via FP10 or supplied through specialist services. These products may be stocked by hospital pharmacies only for supply to primary care units/wards or for continuing supplies for patients admitted on therapy.  

Black

Not recommended for use.  

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