| Formulary Chapter 4: Central nervous system - Full Chapter
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| 04.10.01 |
Alcohol dependence |
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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Cancer Drugs Fund
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
| Status |
Description |
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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.
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Treatment can be initiated in primary care after a recommendation from an appropriate specialist |
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Specialist initiation followed by maintenance prescribing in primary care |
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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 |
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Specialist and non-specialist initiation |
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Not recommended for prescribing |
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Restricted
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
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
