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...
04.10  Expand sub section  Drugs used in substance dependence
04.10.01  Expand sub section  Alcohol dependence
Acamprosate tabs
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Formulary
Amber 3
 
   
Disulfiram tabs
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Amber 2
SPECIALIST INITIATION ONLY 
   
Nalmefene tabs
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Restricted Drug Restricted
Red

INITIATION BY SUBSTANCE MISUSE SPECIALISTS ONLY

Use in accordance with NICE guidance for reducing alcohol consumption in people with alcohol dependence.

Nalmefene should only be prescribed in conjunction with continuous psychosocial support focused on treatment adherence and reducing alcohol consumption.

Patients requiring treatment with nalmefene should be referred to their local drug and alcohol services

 
Link  NICE TA325: Nalmefene for reducing alcohol consumption in people with alcohol dependence
   
Alcohol infusion
Restricted Drug Restricted
Red

RESTRICTED USE

Acute alcohol withdrawal in patients unable to take chlordiazepoxide.

Dose = 30 mL of 90% alcohol injection in 500 mL 5% dextrose solution, over a 24 hour period

 
   
04.10.02  Expand sub section  Nicotine dependence
Nicotine Replacement Therapy
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Formulary

Products available:

  • Nicotinell® patches
  • Nicorette® invisi patches
  • Sublingual tablet
  • Orodispersible film
  • Lozenge
  • Medicated chewing gum
  • Spray
  • Inhalator

Follow local guidelines for nicotine replacement therapy

 
   
Varenicline tabs
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Formulary  
Link  NICE TA123: Varenicline
   
04.10.03  Expand sub section  Opioid dependence
04.10.03  Expand sub section  Opioid substitution therapy to top
Controlled Drug Buprenorphine and Naloxone sublingual tabs
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Restricted Drug Restricted SLAM ONLY 
   
Controlled Drug Buprenorphine sublingual tabs
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Formulary  
   
Controlled Drug Methadone hydrochloride oral solution
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Formulary  
   
04.10.03  Expand sub section  Adjunctive therapy and symptomatic treatment
Lofexidine tabs
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Formulary
Red
 
   
04.10.03  Expand sub section  Opioid-receptor antagonists
Naltrexone tabs
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Link  NICE TA115: Naltrexone for the management of opioid dependence
   
 ....
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
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Link to adult BNF
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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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