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
 
 Search
 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...
04.09.01  Expand sub section  Dopaminergic drugs used in Parkinsons disease
04.09.01  Expand sub section  Dopamine receptor agonists
Apomorphine injection, infusion

View adult BNF  View SPC online
Formulary
Amber 3
SPECIALIST INITIATION ONLY

Link  SE London APC Shared Care Agreement: Apomorphine for Parkinson’s Disease    
Bromocriptine tabs

View adult BNF  View SPC online
Formulary
   
Cabergoline tabs

View adult BNF  View SPC online
Formulary
Amber 2
SPECIALIST INITIATION ONLY
   
Pergolide tabs

View adult BNF  View SPC online
Formulary Red Traffic Light
For all new patients

Amber Traffic Light
For existing patients managed in primary care
   
Pramipexole tabs, m/r tabs (Parkinson's disease)

View adult BNF  View SPC online
Formulary
Amber 2
   
Ropinirole tabs, m/r tabs (Parkinson's disease)

View adult BNF  View SPC online
Formulary
Amber 2

Link  SE London APC Recommendation: Ropinirole MR tabs for Parkinson’s Disease    
Rotigotine patches

View adult BNF  View SPC online
Formulary
Amber 2
SPECIALIST INITIATION ONLY
Treatment of the signs and symptoms of early-stage idiopathic Parkinson’s disease as monotherapy (i.e. without levodopa) or in combination with levodopa (i.e.
over the course of the disease) through to late stages when the effect of levodopa wears off or becomes inconsistent and fluctuations of the therapeutic effect
occur.

RESTRICTED TO CONSULTANTS SPECIALISING IN THE TREATMENT OF RESTLESS LEG SYNDROME (RLS):
Treatment of moderate to severe idiopathic RLS (maximum Dose = 3 mg/24 hours) in adult patients who:
• Are having distressing symptoms at rest and/or during the day
• Have not achieved meaningful benefit on previous dopamine agonist
• Have demonstrated augmentation of symptoms due to previous agonist treatment

Refer to RLS pathway below
   
04.09.01  Expand sub section  Levodopa
Co-beneldopa caps, disp tabs, m/r caps

View adult BNF  View SPC online
Formulary
   
Co-careldopa and Entacapone tabs

View adult BNF  View SPC online
Formulary
Amber 2
   
Co-careldopa intestinal gel (Duodopa®)

View adult BNF  View SPC online
Formulary
High Cost Medicine
Red
RESTRICTED USE - ALL REFERRALS FOR PRESCRIBING SHOULD BE MADE TO
PROFESSOR RAY CHAUDHURI AT KCH

Treatment of advanced levodopa responsive Parkinson’s disease in patients with severe motor fluctuations and hyper-/dyskinesia when available combinations of Parkinson medicinal products have not given satisfactory results.

Refer to NHSE commissioning criteria

Blueteq prior approval required

Link  NHS England Commissioning position on levodopa/carbidopa intestinal gel (DO4/P/e) (July 2015)    
Co-careldopa tabs, m/r tabs

View adult BNF  View SPC online
Formulary
   
04.09.01  Expand sub section  Monoamine-oxidase-B inhibitors
Rasagiline tabs

View adult BNF  View SPC online
Formulary
Amber 2
INITIATION BY SPECIALIST ONLY
Treatment for early Parkinson’s disease. To be used as monotherapy and gradually withdrawn when more symptomatic treatments are required. Not to be used in combination with levodopa
   
Selegiline hydrochloride tabs, liquid

View adult BNF  View SPC online
Formulary
Amber 2
SPECIALIST INITIATION ONLY
   
04.09.01  Expand sub section  Catachol-O-methyltransferase inhibitors to top
Entacapone tabs

View adult BNF  View SPC online
Formulary
Amber 2
   
04.09.01  Expand sub section  Amantadine
Amantadine caps, syrup

View adult BNF  View SPC online
Formulary
Amber 2
Approved for use in:
  • Parkinson's Disease
  • Fatigue in Multiple Sclerosis (off-label) as per NICE Clinical Guideline 186. Dose as per licensed use.

    Not approved for use in influenza
    (see NICE TA168)

  • Link  NICE CG186: Multiple sclerosis in adults: management    
    04.09.01  Expand sub section  Mild to moderate dementia in Parkinsons disease
     ....
    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
    click to search medicines.org.uk
    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  

    netFormulary