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Birmingham, Sandwell, Solihull and environs APC Formulary
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 Formulary Chapter 4: Central nervous system - Full Chapter
04.06  Expand sub section  Drugs used in nausea and vertigo
Dexamethasone tablets
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Formulary
Green
  • for resistant nausea and vomitting
  • £££ 
  •    
    04.06  Expand sub section  Vomiting during pregnancy
    04.06  Expand sub section  Postoperative nausea and vomiting
    04.06  Expand sub section  Motion sickness
    04.06  Expand sub section  Other vestibular disorders to top
    04.06  Expand sub section  Cytotoxic chemotherapy
    04.06  Expand sub section  Palliative care
    Dexamethasone injection
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    Formulary
    Amber Recommended
    • palliative care only
     
       
    04.06  Expand sub section  Migraine
    04.06  Expand sub section  Antihistamines
    Cinnarizine tablets
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    Formulary
    Green
     
       
    Cyclizine
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    Formulary
    Green
  • tablets
  • injection- for palliative care  
  •    
    Promethazine Hydrochloride
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    Formulary
    Green
     
       
    04.06  Expand sub section  Phenothiazines and related drugs to top
    Levomepromazine
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    Formulary
    Green
  • palliative care only 
  •    
    Prochlorperazine
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    Formulary
    Green
  • tablets
  • buccal tablets
  • syrup
  • injection 
  • Link  SPS: Shortage of Stemetil (prochlorperazine) 5mg in 5ml oral syrup
       
    Chlorpromazine Hydrochloride
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    Formulary
    Red
  • nausea
  • hyperemesis in pregnancy (off label use) 
  •    
    04.06  Expand sub section  Domperidone and metoclopramide
    Domperidone
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    Formulary
    Green
  • tablets- short term use only
  • suppositories
  • SF suspension £££ - for patients with swallowing difficulties only 
  •    
    Metoclopramide
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    Formulary
    Green
  • tablets
  • SF solution- £££-for patients with swallowing difficulties only 
  •    
    Metoclopramide injection
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    Formulary Green Traffic Light  in palliative care


    Red Traffic Light  other indications
     

       
    04.06  Expand sub section  5HT3 antagonists
    Granisetron tablets
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    Formulary
    Red

     
       
    Granisetron transdermal patch (Sancuso®)
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    Formulary
    Red
  • for use in oncology patients only 
  •    
    Ondansetron
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    Formulary
    • tablets
    • melt tablets
    • suppositories
    • injection
    • SF syrup - swallowing difficulties only
       
         hyperemesis in pregnancy (off label)
       
         palliative care (off label)

      Red Traffic Light  Chemotherapy
     
       
    Palonosetron (Aloxi®)
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    Formulary
    Red
     
       
    04.06  Expand sub section  Neurokinin receptor antagonist
    Aprepitant (Emend®)
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    Formulary
    Red
  • for use with chemotherapy only 
  •    
    04.06  Expand sub section  Cannabinoid
    04.06  Expand sub section  Hyoscine to top
    Hyoscine Hydrobromide
    (300 microgram tablets)
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    Formulary
    Green
     
    Link  UKMI Q&A: Hypersalivation – can hyoscine hydrobromide be used to treat it?
    Link  UKMI Q&A: Hypersalivation treatment options
       
    Hyoscine Hydrobromide
    (patch)
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    Formulary
    Green
    £££ 
       
    04.06  Expand sub section  Other drugs for Ménière's disease
    Betahistine Dihydrochloride
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    Formulary
    Green
     
       
     ....
     Non Formulary Items
    Cinnarizine and Dimenhydrinate  (Arlevert®)

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    Non Formulary
     
    Dolasetron Mesilate  (Anzemet®)

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    Non Formulary
     
    Doxylamine/pyridoxine  (Xonvea®)

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    Non Formulary

    Non-formulary June 2019

    Link  NICE Evidence Summary [ES20] Doxylamine/pyridoxine (Xonvea) for treating nausea and vomiting of pregnancy
     
    Droperidol  (Xomolix®)

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    Non Formulary
     
    Fosaprepitant  (Ivemend®)

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    Non Formulary
     
    Nabilone

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    Non Formulary
     
    Perphenazine

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    Non Formulary
     
    Promethazine teoclate  (Avomine®)

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    Non Formulary
     
    Promethazine Teoclate  (Avomine®)

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    Non Formulary
     
    Tropisetron  (Navoban®)

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    Non Formulary
     
      
    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 children's BNF
    click to search medicines.org.uk
    Link to SPCs
    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

    Prescribing in children

    The APC notes that the informed use of unlicensed medicines or of licensed medicines for unlicensed applications (‘off-label’ use) is often necessary in paediatric practice.

    The APC advises GPs to consider specialist prescribing recommendations for Green and Amber medicines that are not subject to ESCAs or RICaDs in combination with the information provided in the BNFC which goes beyond that of marketing authorisations. The BNFC has been designed for rapid reference and the information presented has been carefully selected to aid decisions on prescribing.
      

    Green

    Medicines suitable for routine use within primary care. Initiation and maintenance of prescribing by Specialists, GPs and other qualified clinicians.   

    Amber Initiation

    Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry.  

    Amber Recommended

    Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist.  

    Amber SC

    Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry.  

    Red

    Medicines for initiation and maintenance prescribing by Specialists only.  

    Black

    Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use.  

    Grey

    Positive NICE TA and/or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information.  

    The term 'Specialist' refers to Consultants, General Practitioners and Independant Prescribers with a Specialist Interest.  

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