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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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)

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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 Parkinson’s Disease    
Rotigotine patches

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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.

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
04.09.01  Expand sub section  Monoamine-oxidase-B inhibitors
04.09.01  Expand sub section  Catachol-O-methyltransferase inhibitors to top
04.09.01  Expand sub section  Amantadine
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
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Link to SPCs
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Link to adult BNF
Track Changes
Display tracking information
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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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