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 Formulary Chapter 4: Central nervous system - Full Chapter
04.04  Expand sub section  CNS stimulants and other drugs used for attention deficit hyperactivity disorder
 note 

Drugs for ADHD should only be initiated by specialists, but can be continued by GPs

Atomoxetine (Strattera)
(capsule)
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Amber Initiation
 
   
Controlled Drug Dexamfetamine
(tablet)
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Amber Initiation
 
   
Guanfacine (Intuniv)
(Prolonged release tablets)
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Amber Initiation

Specialist initiation only

In accordance with Shared Care Guidelines 

 
   
Controlled Drug Lisdexamfetamine (Elvanse)
(capsule)
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Amber Initiation

For use according to licence.

 
   
Controlled Drug Methylphenidate
(tablet/MR tablet/MR capsule)
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Amber Initiation
 
   
04.04  Expand sub section  Narcolepsy medicines
Modafinil
(tablets)
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Amber Initiation

Restricted Item Restricted use. For treatment of excessive sleepiness associated with narcolepsy only. Prescribing to be initiated by sleep specialist/neurologist.

Caution: prescribers should be aware of abuse risk (Modafinil: Be Smart) when considering quantities on prescriptions.

Modafinil is not supported for use (off-label) in any other indications in accordance with MHRA safety alert 2011.

 

 
Link  European Medicines Agency review of safety and effectiveness of modafinil Nov 2010
Link  MHRA Safety Update Mar 2011: Modafinil now restricted to narcolepsy
Link  PrescQIPP Bulletin 250: Modafinil Oct 2019
   
Pitolisant (Wakix)
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Red
High Cost Medicine

Restricted Item Restricted use. For specialist sleep clinic use for treatment of narcolepsy in patients aged ≥18 years, only when conventional stimulants have failed/not tolerated, and sodium oxybate is not suitable/not tolerated as per DPC recommendations.

 
   
Controlled Drug Sodium Oxybate (Xyrem)
(liquid)
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Red Specialist Centre
High Cost Medicine

Restricted Item As per NHS England clinical commissioning criteria for use in children (≤18 years).

Adult use (≥19 years) requires IFR submission to CCG.

 
Link  NHS England Clinical Commissioning Policy: Sodium oxybate for symptom control of narcolepsy with cataplexy (children) Dec 2016
Link  RMOC: Sodium oxybate in adult patients Oct 2019
   
 ....
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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