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...
04.04  Expand sub section  CNS stimulants and other drugs used for attention deficit hyperactivity disorder
Atomoxetine caps, oral solution

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Restricted Drug Restricted
Amber 3
INITIATION BY SPECIALIST ONLY
Treatment of ADHD in children and adults

Refer to links in this section for ADHD shared care documentation
   
Controlled Drug  Dexamfetamine tabs

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Restricted Drug Restricted
Amber 3
INITIATION BY SPECIALIST ONLY
Treatment of ADHD in children
Treatment of ADHD in adults (off-label)

Refer to links in this section for ADHD shared care documentation

Link  SEL APC recommendation - Dexamfetamine for the treatment of ADHD in adults    
Guanfacine m/r tabs

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Restricted Drug Restricted
Red
SPECIALIST PRESCRIBING ONLY
Restricted to use in ADHD in children where methyphenidate and atomoxetine are not suitable, not tolerated or have been ineffective

Link  SEL APC Recommendation: Guanfacine for ADHD in children    
Controlled Drug  Lisdexamfetamine caps

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Restricted Drug Restricted
Amber 3
INITIATION BY SPECIALIST ONLY
Treatment of ADHD in children and adults

Refer to links in this section for ADHD shared care documentation

Link  SEL APC Recommendation - Lisdexamfetamine for the treatment of ADHD in adults
Link  SEL APC Recommendation - Lisdexamfetamine for the treatment of ADHD in children aged 6 years and over    
Controlled Drug  Methylphenidate tabs, m/r tabs, m/r caps

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Restricted Drug Restricted
Amber 3
INITIATION BY SPECIALIST ONLY
Treatment of ADHD in children
Treatment of ADHD in adults (off-label)

Refer to links in this section for ADHD shared care documentation

Extended release formulations to be prescribed by brand, as different formulations are not bioequivalent. Brands available:
  • Concerta
  • Xenidate
  • Matoride
  • Equasym
  • Medikinet
  •    
    Controlled Drug  Dexamfetamine tabs

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    Restricted Drug Restricted
    Red
    SLEEP CENTRE USE ONLY
    Narcolepsy and idiopathic hypersomnia (off-label)

    Restricted to patients who have not responded to modafinil, or where modafinil is contra-indicated

    Link  SEL APC Recommendation: Dexamfetamine for narcolepsy
    Link  SEL APC Recommendation: Methylphenidate and dexamfetamine for idiopathic hypersomnia in adults    
    Controlled Drug  Methylphenidate tabs, m/r tabs, m/r caps

    View adult BNF  View SPC online
    Restricted Drug Restricted
    Red
    SLEEP CENTRE USE ONLY
    Narcolepsy and idiopathic hypersomnia (off-label)

    Restricted to patients who have not responded to modafinil, or where modafinil is contra-indicated

    Refer to APC recommendations for detailed information
    Extended release formulations to be prescribed by brand, as different formulations are not bioequivalent. Brands available:
  • Concerta
  • Xenidate
  • Matoride
  • Equasym
  • Medikinet

  • Link  SE London APC Recommendation: Methylphenidate and dexamfetamine idiopathic hypersomnia in adults    
    Modafinil tabs

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    Restricted Drug Restricted
    Amber 3
    INITIATION BY SPECIALIST ONLY
    Symptomatic relief of excessive sleepiness associated with narcolepsy

    Approved off-label indication:
    Idiopathic hypersomnia: Dose = 200 400 mg daily.
    Subject to production of a shared care agreement and patient information leaflet
       
    Mazindol tabs

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    Restricted Drug Unlicensed
    Red
    SLEEP CENTRE USE ONLY
    Narcolepsy and idiopathic hypersomnia after failure or intolerance to modafinil and amphetamines. Dose: 14mg daily.
    Subject to production of a shared care agreement and patient information leaflet
       
     ....
    Key
    note Notes First Choice Item First Choice item
    Section Title Section Title (top level) Non Formulary Item Non Formulary section
    Section Title Section Title (sub level)
    Cytotoxic Drug
    Cytotoxic Drug
    Restricted Drug
    Restricted Drug
    CD
    Controlled Drug
    Unlicensed Drug
    Unlicensed
    High Cost Medicine
    High Cost Medicine
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    Link to SPCs
    click to search medicines.org.uk
    Link to adult BNF
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Cancer Drugs Fund
    Cancer Drugs Fund
       

     

    Traffic Light Status Information

    Status Description
      Red   Specialist Prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist. 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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