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:

Where a formulary entry does not detail a medicine’s indications for use, the medicine can be assumed to be approved for all licensed indications.

Formulary approved "off-label" use is detailed separately.

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...
04.10.01  Expand sub section  Alcohol dependence
Acamprosate tabs
View adult BNF View SPC online 		Formulary
Amber 3 		 
   
Disulfiram tabs
View adult BNF View SPC online 		Formulary
Amber 2 		SPECIALIST INITIATION ONLY 
   
Nalmefene tabs
View adult BNF View SPC online 		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

 
   
 link Link    NICE CG100: Alcohol-use disorders: diagnosis and management of physical complications
 link Link    NICE CG115: Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol 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
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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