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NHS Bath and North East Somerset, Swindon and Wiltshire CCG
Royal United Hospitals Bath NHS Foundation Trust
Great Western Hospitals NHS Foundation Trust
Salisbury NHS Foundation Trust
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 Formulary Chapter 4: Central nervous system - Full Chapter
Notes:

CNS-related Prescribing Guidance

Please see our Prescribing Guidelines page for all prescribing guidance relating to this chapter.

CNS-related Shared Care Agreements

Please see our Shared Care Agreements page for all shared care agreements (SCAs) relating to this chapter.

 

 Details...
04.07.04.01  Expand sub section  Treatment of the acute migraine attack
04.07.04.01  Expand sub section  Analgesics
04.07.04.01  Expand sub section  5HT1 agonists
Almotriptan
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Formulary
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  • Swindon only
  • Tablets 12.5mg
  • The maximum recommended dose is two doses in 24 hours.
 
 
Sumatriptan
(Oral, injection, nasal)
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Formulary
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  • Tablet 50mg, 100mg
  • Injection 6mg or 3mg/0.5ml syringe
  • Nasal spray 10mg/0.1ml actuation, 20mg/0.1ml actuation
  • Do not prescribe as film coated tablets.
 
 
Zolmitriptan
(Oral, nasal)
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Formulary
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  • Tablets 2.5mg/5mg and orodispersible tablets 2.5mg/5mg
  • Nasal spray 5mg/0.1ml actuation
  • Also used for menstrual migraine 2.5mg twice to three times a day on days when migraine expected (off-label).
 
 
Frovatriptan
(Oral)
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Formulary
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  • 2.5mg tablets
  • Current evidence base supports the use of Frovatriptan as a first-line acute treatment for Menstrual Migraine and for perimenstrual prophylaxis. No triptan is specifically licensed for this indication (off-label).
  • For the treatment of menstrual migraine only when other triptans (sumatriptan / zolmitriptan) have proven ineffective. Give 2.5mg twice daily on days when migraine expected.
  • Frovatriptan is distinctive from other triptans due to its long elimination half-life of 26 hours, which confers a longer duration of action.
 
 
04.07.04.01  Expand sub section  Ergot alkaloids
04.07.04.01  Expand sub section  Anti-emetics to top
04.07.04.01  Expand sub section  Other drugs for migrane
 ....
 Non Formulary Items
Eletriptan (Relpax)

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Non Formulary
 
Naratriptan (Naramig)

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Non Formulary
 
Rizatriptan
(Maxalt®)

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Non Formulary
 
Sumatriptan
(Imigran® Radis)

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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
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Link to adult BNF
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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
Blueteq
High Cost Drug Approval System

Traffic Light Status Information

Status Description

Traffic LightRed

RED - Hospital only to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.  

Traffic LightAmber

Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.  

Traffic LightAmber with Shared Care

Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.  

Traffic LightGreen

These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.  

Traffic LightSelf

Suitable for patient to be directed to buy themselves  

Traffic LightGrey

Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.   

Traffic LightBlack

(In use from Oct 2020) Used where a decision has been made by the BSW APC not to routinely commission this preparation for its licensed indications. Do not prescribe.   

Traffic LightRed Specialist Centre

Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.  

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