Inpatient use and prison settings only

Oct 2018: supply issues with injection

• For rapid tranquilisation

• £££
• Supported by ESCA, see link below.

• £££
• Supported by ESCA, see link below.

The APC's view is that, on clinical grounds, the status of antipsychotic depot injections should be amber with a framework in place in Primary Care before transfer.
HOWEVER, until the commissioning arrangements have been agreed to allow safe transfer of patient care, the status will remain RED.

The APC's view is that, on clinical grounds, the status of antipsychotic depot injections should be amber with a framework in place in Primary Care before transfer.
HOWEVER, until the commissioning arrangements have been agreed to allow safe transfer of patient care, the status will remain RED.

• Discontinued by manufacturer by the end of 2018.

Contraindicated in women of childbearing potential unless part of the Pregnancy Prevention Programme.  See MHRA guidance

• Capsules

• Not recommended routinely due to QT prolongation risk

• Not recommended routinely due to QT prolongation risk

• for generalised anxiety disorder
• ££

Schedule 3 Controlled Drug as of 01/04/2019

APC preferred brands

• 1st choice: Vensir XL capsules (suggest switching generic prescriptions to this agent)
• 2nd choice: Venlalic XL tablets

Please note that commissioning discussion is underway. However the present status is as follows:-
Birmingham CrossCity CCG, Birmingham South Central CCG, Sandwell & West Birmingham CCG

Supported with an ESCA- Solihull CCG (to be developed)
  

• for narcolepsy

Orlistat 60mg capsules - Over the counter preparation suitable for self-care/purchase if appropriate

  other indications
 

• Use with caution in patients aged over 65
• Contraindicated in children below the age of 12

• for specialist initiation: specialist pain clinics, palliative care and for patients with swallowing difficulties
  
  Patches should be prescribed by BRAND

• tablets
• 25mg/5ml syrup
• Use with caution in patients aged over 65
• Contraindicated in children below the age of 12

• Third line after morphine and codeine

• Third line after morphine and codeine
• For patients with swallowing difficulties
• £££

• 2nd line
• please be aware of the abuse potential associated with this class of agent

Schedule 3 Controlled Drug as of 01/04/2019

• 4th line after duloxetine
• on advice of specialist if duloxetine is unsuitable
• please be aware of the abuse potential associated with this class of agent
• From 17th July 2017, clinicians can now return to normal practice when prescribing pregabalin and no longer need to specify a brand name when prescribing for neuropathic pain.

Schedule 3 Controlled Drug as of 01/04/2019

Approved only in patients who have been treated in line with NICE CG173 Neuropathic pain in adults: pharmacological management in non-specialist settings but are still experiencing neuropathic pain associated with previous herpes zoster infection (post-herpetic neuralgia)

• Amber specialist recommendation

Unlicensed medicine

• Supported by an ESCA

• Capsules
• Tablets £££
  
  MHRA Advice
  It is usually unnecessary to ensure that patients are maintained on a specific manufacturer’s product unless there are specific reasons such as patient anxiety and risk of confusion or dosing errors

Schedule 3 Controlled Drug as of 01/04/2019

• Capsules
  
  MHRA Advice
  For patients being treated for epilepsy, it is usually unnecessary to ensure that patients are maintained on a specific manufacturer’s product unless there are specific reasons such as patient anxiety and risk of confusion or dosing errors.

Schedule 3 Controlled Drug as of 01/04/2019

• E/C tablets
• M/R tablets
• Crushable tablets
• SF liquid
• M/R granules see Episenta^®
  MHRA Advice
  Care should be taken when switching between oral formulations. The need for continued supply of a particular manufacturer’s product should be based on clinical judgement and consultation with patient and/or carer, taking into account factors such as seizure frequency and treatment history.

Contraindicated in women of childbearing potential unless part of the Pregnancy Prevention Programme.  See MHRA guidance

• Paediatrician initiation.
• For patients with epilepsy aged up to and including 16 years of age unable to swallow tablets and who require a modified release formulation in whom other formulations are more expensive or not appropriate.
  MHRA Advice
  Care should be taken when switching between oral formulations. The need for continued supply of a particular manufacturer’s product should be based on clinical judgement and consultation with patient and/or carer, taking into account factors such as seizure frequency and treatment history.

Contraindicated in women of childbearing potential unless part of the Pregnancy Prevention Programme.  See MHRA guidance

• Initiation by Tertiary Epilepsy Specialist only.
• For adjunctive therapy in the treatment of partial-onset seizures with or without secondary generalisation in adult and adolescent patients from 16 years of age with severe refractory epilepsy warranting tertiary specialist input for patients who have tried three or more AEDs. The patient has used levetiracetam and has documentation of intolerance and patient is using a third line agent (perampanel, zonisamide, lacosamide, eslicarbazepine) which would be replaced by brivaracetam.
• Supported by an ESCA
  

• For use in Restless Legs - Supported by an ESCA, see link below.

• Tablets

• Tablets

• Tablets
• Oral lyophilisate reserved for patients with swallowing difficulties in Parkinson's disease

• Tablets

Specialist use only for neurological conditions

Specialist use only for neurological conditions

Specialist use only for neurological conditions

Specialist use only for neurological conditions

Specialist use only for neurological conditions