MHRA Alert (Feb 2015): Drugs and driving: blood concentration limits set for certain drugs
Please refer to NICE guidelines NICE TA77
CSM Advice:
MR Tabs - 2mg
Capsules - 1mg, 2mg, 2.5mg, 3mg, 5mg, 10mg
Orodispersible Tabs - 2mg, 3mg
Liquid - 1mg/ml
MR tabs licensed only for adults over 55years. Classed as Amber for children and young adults and prescribed off label. All other products are available from UK specials manufacturers and classed as Amber drugs. Shared care protocol available.
Refer to NICE guidance for schizophrenia CG 178
See also: NICE NG11 - Challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges
The choice of antipsychotic should take into account the relative side-effect profile and the views of the user.
Tabs - 500microgram, 1.5mg, 5mg, 10mg, 20mg
Oral Liquid - 2mg/ml
See NICE NG10 - Violence and aggression: short-term management in mental health, health and community settings
Tabs - 1mg, 5mg
Oral Solution - 5mg/5ml
For initiation by specialists only
Tabs - 5mg, 10mg, 15mg, 30mg
Orodispersible Tabs - 10mg, 15mg
Oral Solution - 1mg/ml
Orodispersible tablets should only be prescribed for patients who are unable to swallow solid dose forms
Tabs - 2.5mg, 5mg, 7.5mg, 10mg, 15mg, 20mg
Orodispersible Tabs - 5mg, 10mg, 20mg
Orodispersible tablets should only be prescribed for patients who are unable to swallow solid dose forms
Tabs - 25mg, 100mg, 150mg, 200mg, 300mg
M/R Tabs - 50mg, 150mg, 200mg, 300mg, 400mg
Tabs - 500microgram, 1mg, 2mg, 3mg, 4mg, 6mg
Orodispersible tabs - 500micrograms, 1mg, 2mg, 3mg, 4mg
Orodispersible tablets should only be prescribed for patients who are unable to swallow solid dose form.
Paliperidone (Trevicta)175mg / 0.875ml; 263mg/1.315ml; 350mg/1.75ml; 525mg/2.625ml prolonged realease suspension for injection prefilled syringes
Paliperidone (Xeplion) 100mg/1ml; 150mg / 1.5ml; 50mg / 0.5ml; 75mg/0.75ml suspension for injection pre-filled syringes
Should be prescribed and administered by NTW specialist nurses according to local guidelines.
Tablets - 25mg, 100mg
Oral suspension - 50mg/ml
Important safety information:
MHRA/CHM advice: Clozapine: reminder of potentially fatal risk of intestinal obstruction, faecal impaction, and paralytic ileus (October 2017)
Clozapine has been associated with varying degrees of impairment of intestinal peristalsis. Patients and their carers should be advised to seek immediate medical advice before taking the next dose of clozapine if constipation develops.
Refer to NICE Guideline Bipolar Disorder CG185
Antipsychotics drugs can be useful in acute episodes of mania and hypomania.
Tabs - 250mg, 400mg (Camcolit), Tabs 200mg, 400mg (Priadel)
MR Tabs - 450mg (Liskonum)
Must be prescribed as brand
Oral Solution - 509mg/5ml (Li-Liquid), 520mg/5ml (Priadel)
Must be prescribed as brand
NICE CG28: Depression in children and young people: Identification and management in primary, community and secondary care
Tabs - 10mg, 25mg, 50mg
Oral Solution - 25mg/5ml, 50mg/5ml
For use unlicensed for neuropathic pain
Caps - 50mg
Tabs - 10mg, 25mg
Not formulary for depression. Only to be prescribed in exceptional circumstances when requested by a specialist
Caps - 30mg, 60mg
For use in diabetic neuropathy where other treatments are unsuitable or inadequate and initiated by a specialist
Tabs - 25mg
Agomelatine (Valdoxan®) is recommended for the treatment of depression only following an adequate trial of at least three alternative antidepressant drugs at maximally tolerated doses. Prescribing and monitoring should be initiated by specialist mental health physicians. After a minimum of 12 week’s treatment, responsibility for prescribing may be transferred to primary care
Tabs - 15mg, 30mg, 45mg
Orodispersible Tabs - 15mg, 30mg, 45mg
Orodispersible tablets should only be prescribed for patients who are unable to swallow solid dose forms
Caps - 10mg, 18mg, 25mg, 40mg, 60mg or 80mg hard capsules
Initiated by specialist only - shared care protocol available. Use in adults unlicensed
Tabs - 5mg
Initiated by specialist only - shared care protocol available. Use in adults unlicensed
Capsules- 20mg, 30mg, 40mg, 50mg, 60mg and 70mg
Initiated by specialist only - shared care protocol available. Use in adults unlicensed
Tabs - 5mg, 10mg, 20mg
MR Tabs - 18mg, 27mg, 36mg, 54mg (Concerta XL)
MR Caps - 10mg, 20mg, 30mg, 40mg (medikinet XL)
Initiated by specialist only - shared care protocol available, MR products must be prescribed by brand. Use in adults unlicensed
Tablets - 1mg, 2mg, 3mg 4mg
Third line to atomoxetine and methylphenidate. Only to be initiated by a specialist when 1st line alternatives ineffective or not tolerated. Shared care protocol available
Tabslets - 10mg
Oral Solution - 5mg/5ml
Caution in elderly, young adults and children
Patches - 12microgram/hour, 25microgram/hour, 50microgram/hour, 75microgram/hour, 100microgram/hour
Tablets - 10mg, 20mg, 50mg (Sevredol),
MR capsules - 10mg, 30mg, 60mg, 10mg, 200mg (Zomorph) (Morphgesic tablets when Zomorph not appropriate) Liquid
Injection - 10mg/ml, 15mg/ml, 20mg/ml, 30mg/ml
Refer to NICE guidance CG 137. The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care.
Tablets - 100mg, 200mg, 400mg
MR Tablets - 200mg, 400mg
Liquid - 100mg/5ml
Capsules - 25mg50mg, 75mg, 100mg, 150mg, 200mg, 225mg, 300mg
Also licensed for neuropathic pain
Tablets - 25mg, 50mg, 100mg, 200mg
Dispersible Tablets - 2mg (only Chewable), 5mg, 25mg, 100mg
Tablets - 25mg, 50mg, 100mg, 200mg
Dispersible Tablets - 2mg (only Chewable), 5mg, 25mg, 100mg
Capsules - 25mg, 50mg, 100mg, 300mg,
Chewable Tablets - 50mg
Suspension - 30mg/5ml
Suspension contains phenytoin base - care need when changing to or from capsules
Tablets - 25mg, 50mg, 100mg, 200mg
Capsules (Sprinkle) - 15mg, 25mg, 50mg
Tablets e/c - 200mg, 500mg,
Tablets MR - 200mg, 300mg, 500mg,
Oral Solution - 200mg/5ml,
Tablets (crushable) - 100mg
Tablets - 10mg
Only prescribable on NHS for epilepsy. Must be endorsed SLS
NICE CG186: Multiple sclerosis: management of multiple sclerosis in primary and secondary care
Capsules - 62.5mg, 125mg, 250mg
Dispersible Tablets - 62.5mg, 125mg
MR Capsules - 125mg
Tablets - 62.5mg, 110mg, 125mg, 275mg
MR Tablets - 125mg, 250mg
Tablets (as Base) - 88microgram, 180microgram, 350microgram, 700microgram
Tablets - 250microgram, 500microgram, 1mg, 2mg, 5mg
Tablets MR - 2mg, 4mg, 8mg
Patches - 1mg/24hours, 2mg/24hours, 3mg/24hours, 4mg/24hours6mg/24hours, 8mg/24hours
Tablets - 18mg
Requires prescribing in accordance with NICE guidance: http://www.nice.org.uk/guidance/ta325. For patients who:
The marketing authorisation states that nalmefene should:
Patches, lozenges, chewing gum, inhalator, oral spray, mini lozenge, microtab, nasal spray, strips (oral film)
Prescribe according to Smoking Cessation policy.
Tablets - 5mg, 10mg
Orodispersible Tablets - 5mg, 10mg
Only use orodispersible if patient has genuine
Tablets - 8mg, 12mg
Oral solution - 4mg/ml
MR Capsules - 8mg, 16mg, 24mg
MR capsules only to be used when a once a day dose is essential or patient has tried standard release galantamine and is intolerant.
Capsules - 1.5mg, 3mg, 4.5mg, 6mg
Oral solution - 2mg/ml
Patches - 4.6mg / 24hours; 9.5mg/24hours
Patches should only be used when other formulations inappropriate