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 Formulary Chapter 4: Central nervous system - Full Chapter
04.07.04  Expand sub section  Antimigraine drugs
04.07.04.01  Expand sub section  Treatment of the acute migraine attack
04.07.04.01  Expand sub section  Analgesics
 note 

First line option -  Paracetamol or aspirin (preferably in a soluble or dispersible form) +/- metoclopramide

Aspirin
(tablet/soluble tablet/suppositories)
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Formulary
Green

Soluble or dispersible form preferred +/- metoclopramide

 
   
Paracetamol
(tablet/soluble tablet/liquid/suppositories)
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Formulary
Green

Soluble or dispersible form preferred +/- metoclopramide

 
   
04.07.04.01  Expand sub section  5HT1 agonists
Sumatriptan
(tablet/injection/nasal spray)
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First Choice
Green

50mg tablet - first line oral triptan

Injection for migraine, if oral or nasal preparations fail, or cluster headache

 
Almotriptan
(tablet)
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Second Choice
Green

Second line oral triptan

 
   
Zolmitriptan
(nasal spray)
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Second Choice
Green

Useful if patients vomit

 
   
04.07.04.02  Expand sub section  Prophylaxis of migraine to top
Amitriptyline
(tablet/liquid)
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Formulary
Green

Off label use

 
   
Botulinum Toxin Type A
(injection)
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Formulary
Red
High Cost Medicine

Specify brand

 
Link  DPC Agreed Indications Botulinum Toxin (September 2013)
Link  NICE TA260: Botulinum toxin type A for the prevention of headaches in adults with chronic migraine
   
Pizotifen
(tablet)
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Formulary
Green
 
   
Propranolol
(tablet/liquid)
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Formulary
Green
 
   
Topiramate (migraine prophylaxis)
(tablet/sprinkle capsule)
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Formulary
Green
 
   
 ....
 Non Formulary Items
Eletriptan  (Relpax)

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Non Formulary
 
Flunarizine
(tabs/caps)

Non Formulary

unlicensed unlicensed

Link  NICE ESUOM33: Migraine prophylaxis: flunarizine Sept 2014
 
Frovatriptan

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Non Formulary
 
Methysergide  (Deseril)

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Non Formulary
 
Naratriptan  (Naramig)

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Non Formulary
 
Rizatriptan  (Maxalt®)

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Non Formulary
 
Tolfenamic Acid  (Clotam®)

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Non Formulary
 
  
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

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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