netFormulary South East London Joint Medicines Formulary NHS
Guy's and St Thomas' NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Lewisham and Greenwich NHS Trust
 
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 Formulary Chapter 4: Central nervous system - Full Chapter
Notes:
In this section "SPECIALISTS" refer to medical prescribers specialising in Mental Health unless otherwise stated. At Guy's and St Thomas' and Lewisham Hospitals this would refer to SLAM employed consultants
 Details...
04.01.01  Expand sub section  Hypnotics
Melatonin m/r tabs (sleep disorders in children - off-label)
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Restricted Drug Restricted
Amber 3

SPECIALIST INITIATION ONLY

Sleep disorders in children (off-label)

 
Link  SE London APC Shared Care Guidancance for Melatonin for the treatment of Sleep disorders in Children and Adolescents (age 1 - 17 years)
   
Melatonin m/r tabs, liquid (adult sleep clinic use - off-label)
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Restricted Drug Restricted
Amber 3

SLEEP DISORDER CENTRE USE ONLY

  • REM sleep behaviour disorder (off-label)
  • Delayed sleep phase disorder (off-label)
  • Free running disorder (off-label)
  • The liquid (unlicensed preparation) is restricted to use in swallowing difficulties, or in patients on a specific dose that is not practical to be given from the 2mg m/r tabs
 
   
Venlafaxine m/r tabs (adult sleep clinic use - off-label)
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Restricted Drug Restricted

SLEEP DISORDER CENTRE USE ONLY

Cataplexy (off-label)

 
   
Melatonin tabs (Bio-melatonin brand) (adult sleep clinic use)
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Unlicensed Drug Unlicensed
Red
SLEEP DISORDER CENTRE USE ONLY
  • Restricted to use in adult circadian rhythm disorders where a more sedative and immediate acting melatonin is required  
  •    
    04.01.01  Expand sub section  Benzodiazepines
    Nitrazepam tabs, oral suspension
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    Formulary  
       
    Controlled Drug Temazepam tabs, oral solution
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    Formulary  
       
    Loprazolam tabs
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    Formulary  
       
    Clonazepam tabs (Parasomnias and REM sleep disorder - off-label)
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    Restricted Drug Restricted
    Amber 2

    SLEEP DISORDER CENTRE USE ONLY

    • Parasomnias (off-label)
    • REM sleep behaviour disorder (off-label)
     
       
    04.01.01  Expand sub section  Zaleplon, Zolpidem and Zopiclone
    Zolpidem tabs (insomnia)
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    Formulary  
       
    Zopiclone tabs (insomnia)
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    Formulary  
       
    04.01.01  Expand sub section  Chloral and derivatives
    Chloral hydrate liquid
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    Restricted Drug Restricted INITIATION BY SPECIALIST ONLY 
       
    04.01.01  Expand sub section  Clomethiazole (Chlormethiazole) to top
    Clomethiazole caps
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    Formulary  
       
    04.01.01  Expand sub section  Sodium oxybate
    Controlled Drug Sodium oxybate oral solution
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    Restricted Drug Restricted
    Amber 2
    High Cost Medicine

    RESTRICTED USE – NAMED SPECIALIST CONSULTANTS AT GSTFT ONLY

    For disabling cataplexy in patients objectively diagnosed with narcolepsy and suffering from cataplexy of severity similar to the entry criteria for the positive US clinical trial.

     
       
     ....
    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 SPCs
    SMC
    Scottish Medicines Consortium
    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

    Red

    Specialist or hospital prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist or hospital. In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.   

    Amber 1

    Treatment can be initiated in primary care after a recommendation from an appropriate specialist  

    Amber 2

    Specialist initiation followed by maintenance prescribing in primary care  

    Amber 3

    Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation  

    Green

    Specialist and non-specialist initiation  

    Grey

    Not recommended for prescribing  

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