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...
04.09.01  Expand sub section  Dopaminergic drugs used in Parkinsons disease
04.09.01  Expand sub section  Dopamine receptor agonists
Apomorphine injection, infusion
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Amber 3
SPECIALIST INITIATION ONLY 
Link  SE London APC Shared Care Agreement: Apomorphine for Parkinson’s Disease
   
Bromocriptine tabs
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Cabergoline tabs
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Amber 2
SPECIALIST INITIATION ONLY 
   
Pergolide tabs
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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)
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Amber 2
 
   
Ropinirole tabs, m/r tabs (Parkinson's disease)
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Amber 2
 
Link  SE London APC Recommendation: Ropinirole MR tabs for Parkinsonís Disease
   
Rotigotine patches (Parkinson's disease)
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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.

 
   
04.09.01  Expand sub section  Levodopa
Co-beneldopa caps, disp tabs, m/r caps
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Co-careldopa and Entacapone tabs
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Amber 2
 
   
Co-careldopa intestinal gel (Duodopaģ)
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Red
High Cost Medicine
BlueTeq

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

 
Link  NHS England Commissioning position on levodopa/carbidopa intestinal gel (DO4/P/e) (July 2015)
   
Co-careldopa tabs, m/r tabs
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04.09.01  Expand sub section  Monoamine-oxidase-B inhibitors
Rasagiline tabs
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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
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Amber 2
SPECIALIST INITIATION ONLY 
   
04.09.01  Expand sub section  Catachol-O-methyltransferase inhibitors to top
Entacapone tabs
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Amber 2
 
   
04.09.01  Expand sub section  Amantadine
Amantadine caps, syrup
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Amber 2

Approved for use in:

 
Link  NICE CG186: Multiple sclerosis in adults: management
   
04.09.01  Expand sub section  Mild to moderate dementia in Parkinsons disease
 ....
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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