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 Formulary Chapter 4: Central nervous system - Full Chapter
04.08  Expand sub section  Antiepileptics
04.08.01  Expand sub section  Control of epilepsy
04.08.01  Expand sub section  Carbamazepine and Oxcarbazepine
Carbamazepine
(tablet/MR tablet/liquid/suppositories)
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Formulary
Green

For partial seizures and secondary generalised tonic-clonic seizures

 
   
Eslicarbazepine (Zebinix®)
(tablet)
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Formulary
Amber Recommended
 
   
Oxcarbazepine
(tablet/liquid)
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Amber Recommended
 
   
04.08.01  Expand sub section  Ethosuximide
Ethosuximide
(capsule/liquid)
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Formulary
Green
 
   
04.08.01  Expand sub section  Gabapentin and pregabalin to top
Controlled Drug Gabapentin
(capsule)
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Formulary
Green
 
   
Controlled Drug Pregabalin
(capsule)
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Formulary

Amber Recommended Amber for epilepsy (not a first line choice)

Green Green for generalised anxiety disorder

Also green for neuropathic pain (see section 4.7.3)                                                      

 

 
   
04.08.01  Expand sub section  Lacosamide
Lacosamide  (Vimpat ® )
(tablet/liquid/injection)
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Formulary

For refractory partial epilepsy

Amber Tablet/liquid

Red Injection is red on formulary for those NBM

 
   
04.08.01  Expand sub section  Lamotrigine
Lamotrigine
(tablet/dispersible tablet)
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Formulary
Green

For primary generalised epilepsy (including absences and myoclonus), partial seizures, secondary generalised tonic-clonic seizures.

 
   
04.08.01  Expand sub section  Levetiracetam
Levetiracetam
(tablet/liquid)
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Formulary
Amber Recommended
 
   
Levetiracetam
(injection)
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Formulary
Red
 
   
04.08.01  Expand sub section  Perampanel
Perampanel (Fycompa®)
(tablet)
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Formulary
Amber Initiation

Restricted Item  Treatment initiated and patients stabilised by neurology specialists

 
   
04.08.01  Expand sub section  Phenobarbital and other barbiturates to top
Controlled Drug Phenobarbital
(tablet/liquid/injection)
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Formulary
Red

Restricted Item Child Health and existing patients only

 
   
Controlled Drug Phenobarbital elixir
(liquid)
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Formulary
Red

unlicensed unlicensed

Restricted Item Specialist use only

 
   
Primidone
(tablet)
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Formulary
Green

Existing patients only

 
   
04.08.01  Expand sub section  Phenytoin
Phenytoin
(tablet/capsule/liquid/injection)
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Formulary
Green

Preparations containing phenytoin sodium are not bioequivalent to those containing phenytoin base. 

 
   
04.08.01  Expand sub section  Rufinamide
Rufinamide (Inovelon®)
(tablet)
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Formulary
Amber Initiation

Restricted Item Initiated by Paediatric Neurologists for Lennox Gastaut syndrome

 
   
04.08.01  Expand sub section  Tiagabine
Tiagabine (Gabitril®)
(tablet)
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Formulary
Amber Recommended
 
   
04.08.01  Expand sub section  Topiramate
Topiramate (epilepsy)
(tablet/sprinkle capsule)
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Formulary
Amber Recommended
 
   
04.08.01  Expand sub section  Valproate to top
Sodium ValproateBlack Triangle
(tablet/MR tablet/liquid/injection)
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Formulary
Green

For primary generalised epilepsy (including absences and myoclonus), partial seizures, secondary generalised tonic-clonic seizures

 
Link  MHRA Drug Safety Update May 2018: Valproate medicines: Pregnancy Prevention Programme materials online
   
04.08.01  Expand sub section  Vigabatrin
Vigabatrin (Sabril®)
(tablet/sachet)
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Formulary
Green
 
   
04.08.01  Expand sub section  Zonisamide
Zonisamide (Zonegran®)
(capsule)
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Formulary
Amber Recommended
 
   
04.08.01  Expand sub section  Benzodiazepines
Clobazam
(tablet/liquid)
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Formulary
Green
 
   
Clonazepam
(tablet)
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Formulary
Green
 
   
04.08.01  Expand sub section  Other Drugs
Brivaracetam (Briviact®)
(tablet/liquid/injection)
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Formulary
Amber Initiation

Restricted Item For specialist initiation. Use restricted to selected patients. (e.g. inadequate seizure control or where other antiepileptic drugs are contraindicated, not tolerated or inappropriate)

 
   
Controlled Drug Cannabidiol (Epidyolex®)
(oral solution)
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Formulary
Red
NHS England

Restricted Item Registered specialist only. See NICE NG144 (section 1.5) for details on who should prescribe.

 
Link  NICE NG144: Cannabis-based medicinal products
Link  NICE TA614: Cannabidiol with clobazam for treating seizures associated with Dravet syndrome
Link  NICE TA615: Cannabidiol with clobazam for treating seizures associated with Lennox–Gastaut syndrome
   
Stiripentol (Diacomit®)
(capsule/sachet)
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Formulary

Restricted Item Specialist initiation only.

Amber Initiation Amber Initiation - for the treatment of severe myoclonic epilepsy.

Amber SCG Amber Shared Care Guidelines - for Dravet syndrome in children aged 3 years or older, adolescents and adults, in accordance with NICE guidelines CG137.

 
Link  DPC Shared Care Guideline for Stiripentol Feb 2020
Link  NICE CG137: Epilepsies: diagnosis and management Jan 2012
   
04.08.02  Expand sub section  Drugs used in status epilepticus to top
Clonazepam
(injection)
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Formulary
Green

unlicensed unlicensed

 
   
Diazepam (epilepsy)
(rectal liquid/injection/emulsion injection)
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Formulary
Green
 
   
Lorazepam (epilepsy)
(injection)
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Formulary
Green
 
   
Controlled Drug Midazolam buccal liquid (seizures)
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Formulary
Amber Initiation

unlicensed unlicensed

Child Health only

 
   
Controlled Drug Midazolam oromucosal solution (seizures)
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Formulary
Amber Recommended

Amber for children with a seizure disorder

 
   
Paraldehyde and olive oil enema
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Formulary
Red

unlicensed unlicensed

 
   
Controlled Drug Phenobarbital
(injection)
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Formulary
Red
 
   
Phenytoin
(injection)
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Formulary
Red
 
   
Pyridoxine
(injection)
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Formulary
Red

unlicensed unlicensed

Restricted Item Child Health only.

 
   
04.08.03  Expand sub section  Febrile convulsions
 ....
 Non Formulary Items
Valproic acid  (Convulex®)

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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
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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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