netFormulary
 Report : A-Z of formulary items 17/11/2019 18:04:37
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Section Name Details
19.12.03 Acamprosate 1,2  666mg tds according to BMI (the higher the dose the better the anti-craving effect). No need to weigh patient but reduce dose if diarrhoea persists. Medication should be continued for 6-12 months. LFTs should be checked every 3 months
11.03.03 Aciclovir eye ointment Zovirax®
19.01.02 Add Olanzapine to an SSRI or Clomipramine 1,* OR Combine Clomipramine and Citalopram 1,* 
04.03.04 Agomelatine  Acute Depression
Agomelatine is useful where sexual side effects and sleep are problematic. However liver toxicity is a side effect, prescribers must test liver function before starting and regularly during treatment (see BNF)
10.01.04 Allopurinol 
11.03.01 Amikacin 
19.05.02 Amisulpride * 
19.05.01 Amisulpride 1,2,3  Price band is for 6 200mg. If 3 x 400mg used price band would be £30-£100
19.05.02 Amitriptyline * 
19.01.02 Amitriptyline 1,* £0-£5
11.03.02 Amphotericin (eye) 
19.04 Antidepressant + Aripiprazole 1,2,*  Please see Depression Section for choice of antidepressant
Please see BNF for antipsychotic titration regimens
Aripiprazole range: 5mg-20mg daily
19.04 Antidepressant + Olanzapine 1,2,*  Please see Depression Section for choice of antidepressant
Please see BNF for antipsychotic titration regimens
Olanzapine range: 12.5mg daily
19.04 Antidepressant + Quetiapine IR 1,2,*  Please see Depression Section for choice of antidepressant
Please see BNF for antipsychotic titration regimens
Quetiapine range: 150mg-300mg daily
19.04 Antidepressant + Risperidone 1,2,*  Please see Depression Section for choice of antidepressant
Please see BNF for antipsychotic titration regimens
Risperidone range: 0.5mg-3mg daily
19.04 Antidepressant with Lamotrigine 2,* 
19.04 Antidepressant with Lithium 1,2,* 
04.02.01 Aripiprazole Abilify®
19.03 Aripiprazole + Lamotrigine 2,3 Maintenance Be aware of the interaction between lamotrigine and valproate and the need to adjust the dose of lamotrigine appropriately. Be aware of serious skin reactions and follow the appropriate titration regimen, start at a low dose and titrate slowly (see BNF).
19.03 Aripiprazole + Lithium 2,3 Maintenance Lithium should be prescribed by brand, ensure the monitoring requirements are met
19.03 Aripiprazole + Valproic Acid * 2,3 Maintenance
19.05.01 Aripiprazole 1,2,3 LAI
19.05.01 Aripiprazole 1,2,3  Price band is for 2 x 15mg. If Aripiprazole 30mg used price band would be £101-£200
19.14 Aripiprazole 2,*  Aripiprazole is licensed for schizophrenia in children aged between 15-17
19.14 Aripiprazole 2,* 
19.14 Aripiprazole 2,* 
19.15 Aripiprazole 2,* 
19.03 Aripiprazole 2,3 Mania & Hypomania Aripiprazole is licensed for the treatment and maintenance of mania
10.01.01 aspirin 
19.08 Atomoxetine 1 
19.14 Atomoxetine 1,2  Service users and carers should be advised of the risk and be told how to recognize symptoms of hepatic disorder; prompt medical attention should be sought in cases of abdominal pain, unexplained nausea, malaise, darkening of the urine or jaundice. Service users and carers should be advised of the risk and be told to report clinical worsening, suicidal thoughts or behavior, irritability, agitation and depression.
19.08 Atomoxetine 1,3 
10.03.02 Axsain® 
10.01.03 Azathioprine 
10.02.02 Baclofen 
19.14 Bio-Melatonin 1,2,3,*,**  If prescribing an unlicensed product, because e.g. the patient is unable to swallow tablets, Bio-Melatonin 3mg is recommended
19.15 Bio-melatonin 1,2,3,*,**  If prescribing an unlicensed product, because e.g. the patient is unable to swallow tablets, Bio-melatonin 3mg is recommended
19.13.03 Bisacodyl 1 
19.12.01 Buprenorphine + Lofexidine + Naltrexone 2  Useful for the minority of patient who are stuck on 30mls or below
Buprenorphine: days 1:3
Lofexidine: days 5-14
Naltrexone: day 12
19.12.01 Buprenorphine 1,2  5-7 days detox
Buprenorphine/Naloxone (Suboxone)is a useful combination for rare cases of people injecting buprenorphine, this remains off Formulary
19.10 Buprenorphine 10mcg and above 1,2  Seek specialist advice
19.10 Buprenorphine 2 Low Dose 5mcg For patients who cannot tolerate codeine or have swallowing difficulties.
10.02.02 Cannabis extract Sativex®
10.03.02 Capsaicin Qutenza®
10.03.02 Capsaicin Zacin®
19.15 Carbamazapine 1,2  May exacerbate absence seizures
19.14 Carbamazepine *  Carbamazepine has a product license for the prophylaxis of bipolar disorder. Be aware of possible interactions; should not be combined with clozapine
19.13.01 Carbamazepine 1,2 
19.13.01 Carbamazepine 1,2 
19.15 Carbamazepine 1,2  Carbamazepine is also suggested as a first line but caution in people with a learning disability due to cognitive side effects
19.13.01 Carbamazepine 1,2,* 
19.03 Carbamazepine 2 Maintenance
19.03 Carbamazepine 2,* Milder Forms
19.15 Carbaxazepine 1,2 
11.03.01 Ceftazidime  
11.03.01 Cefuroxime  
19.12.03 Chlordiazepoxide 1,2  Reduction regimen in divided doses as per the SADQ score
10.01.03 Chloroquine 
19.05.01 Chlorpromazine 1,2 
11.03.01 Ciprofloxacin 
19.14 Citaloporam 2,*  Citalopram is contraindicated in any other drug that prolongs the QT interval, please see the MHRA Drug Safety Update
04.03.03 Citalopram  Acute Depression
Citalopram & Escitalopram are contraindicated with any other drug that prolongs the QT interval, please see the MHRA Drug Safety Update: Citalopram and escitalopram: QT interval prolongation
19.14 Citalopram *  Citalopram is contraindicated with any other drug that prolongs the QT interval, please see the MHRA Drug Safety Update: Citalopram and escitalopram: QT interval prolongation
19.01.02 Citalopram 1,* £0-£5 Citalopram may have an additive effect to other drugs that prolong the QT interval. Coadministration of citalopram with medicines that prolong the QT interval is therefore contraindicated
19.01.02 Citalopram 1,* £0-£5 Citalopram may have an additive effect to other drugs that prolong the QT interval. Coadministration of citalopram with medicines that prolong the QT interval is therefore contraindicated
19.01.02 Citalopram 1,2  Citalopram may have an additive effect to other drugs that prolong the QT interval. Coadministration of citalopram with medicines that prolong the QT interval is therefore contraindicated
19.04 Citalopram 1,2  Citalopram & Escitalopram are contraindicated with any other drug that prolongs the QT interval, please see the MHRA Drug Safety Update: Citalopram and escitalopram: QT interval prolongation
19.13.01 Clobazam 1,2  FP10 prescription: endorse ’SLS’
19.13.01 Clobazam 1,2  FP10 prescription endorse ’SLS’
19.15 Clobazam 1,2  FP10 prescription endorse ’SLS’
19.15 Clobazam 1,2  FP10 prescription endorse ’SLS’
04.03.01 Clomipramine  Acute Depression
All tricyclics have a cardio vascular side effect profile and are dangerous in over dose. Lofepramine has the safest profile in overdose see NICE for text
19.04 Clomipramine  All tricyclics have a cardio vascular side effect profile and are dangerous in over dose. Lofepramine has the safest profile in overdose see NICE for text
19.01.02 Clomipramine 1 £6-£15
19.01.02 Clomipramine 1,*  please refer to the unlicensed/off label policy
19.14 Clomipramine 2,* 
19.15 Clomipramine 2,* 
19.15 Clomipramine 2,* 
19.14 Clonidine 2,*  Adverse effects of antipsychotics may outweigh beneficial effects of the treatment of tics and so it is recommended that clonidine is tried first, build up doses slowly, service users and carers should be advised not to stop suddenly, Ref: Maudsley, 12th Edition, page 398
19.05.01 Clozapine 1,2,3 
19.10 Codeine 2 
10.01.04 Colchicine 
10.03.01 Collagenase Xiapex®
19.14 Concerta XL 1,2 
19.04 Current Antidepressant + Aripiprazole 1,2 
19.04 Current Antidepressant + Haloperidol 1,2  Haloperidol: In common with other neuroleptics, has the potential to cause rare prolongation of the QT interval. Use of haloperidol is therefore contra-indicated in patients with clinically significant cardiac disorders. Haloperidol should not be used concomitantly with other QT prolonging drugs. Baseline ECG required before treatment – assess need for further ECGs during treatment on an individual basis
19.04 Current Antidepressant + Olanzapine 1,2 
19.04 Current Antidepressant + Quetiapine IR 1,2 
19.04 Current Antipsychotic + Amisulpride 1,2 
19.04 Current Antipsychotic + Risperidone 1,2 
10.01.03 Cyclophosphamide 
10.02.02 Dantrolene 
19.13.02 Desmopressin 1 
10.01.02.02 Dexamethasone 
19.08 Dexamfetamine 1,3  Caution: be aware of the abuse potential
19.10 Diamorphine 1,2  Seek specialist advice - should only be used in the palliative care setting
19.01.02 Diazepam 1 £0-£5 At any step only offer benzodiazepines as a short term measure during crises
19.12.01 Diazepam 2 oral Anxiety/agitation: 2mg-5mg up to a maximum of 5 days in patients with no history of dependence ONLY

CSM Advice:
a) Benzodiazepines are indicated for the short-term relief (two to four weeks only) of anxiety that is severe, disabling or subjecting the individual to unacceptable distress, occurring alone or in association with insomnia or short-term psychosomatic, organic or psychotic illness
b) The use of benzodiazepines to treat short-term ’mild’ anxiety is inappropriate and unsuitable
c) Benzodiazepines should be used to treat insomnia only when it is severe, disabling, or subjecting the individual to extreme distress
19.12.03 Diazepam 2  In patients with no history of benzodiazepine dependence only
19.12.02 Diazepam 2,3  Diazepam Dose above 30mg
Doses above 30mg should be reduced in a community setting by 5-10mg/week down to 30mg.

Diazepam Dose between 20mg to 30mg
2mg-5mg reduction every 2 weeks as negotiated during the initial treatment plan.

Diazepam Dose between 4mg to 20mg
2mg reduction every one to two weeks

Diazepam Dose below 4mg
1mg reduction every one to two weeks

In exceptional circumstances the above treatment plan may be deviated from. However this should only be done following consultation with the full MDM (which includes senior prescribing clinicians). Additionally a thorough discussion must be had with the patient in which the risks and benefits are outlined to the patient and the patient is in agreement

Illicit benzodiazepines should be converted into equivalent long acting diazepam, only after a multi-disciplinary team discussion and then only to be prescribed with a clear treatment contract in place, on a reducing basis, between the patient, prescriber and GP
10.01.01 Diclofenac 
19.12.03 Disulfiram 1,2  200mg daily, increasing to 400mg if able to tolerate alcohol on lower dose. Needs to be supervised on a daily basis. LFTs should be checked every 3 months
19.13.03 Docusate Sodium 1 
19.09 Donepezil 1,3 Mild to Moderate
19.14 Equasym XL 1,2 
04.03.03 Escitalopram  Acute Depression
Citalopram & Escitalopram are contraindicated with any other drug that prolongs the QT interval, please see the MHRA Drug Safety Update: Citalopram and escitalopram: QT interval prolongation
19.01.02 Escitalopram 1 £0-£5 Escitalopram may have an additive effect to other drugs that prolong the QT interval. Coadministration of escitalopram with medicines that prolong the QT interval is therefore contraindicated
19.01.02 Escitalopram 1,2  Escitalopram may have an additive effect to other drugs that prolong the QT interval. Coadministration of escitalopram with medicines that prolong the QT interval is therefore contraindicated
19.04 Escitalopram 1,2  Citalopram & Escitalopram are contraindicated with any other drug that prolongs the QT interval, please see the MHRA Drug Safety Update: Citalopram and escitalopram: QT interval prolongation
19.13.01 Ethosuximde * 
19.15 Ethosuximde 1,2 
19.13.01 Ethosuximide 1,2 
19.13.01 Ethosuximide 1,2 
19.10 Fentanyl 1,2  Seek specialist advice - psychiatric reactions have been reported
19.03 First Choice Antipsychotic Milder Forms
04.03.03 Fluoxetine  Acute Depression
04.03.03 Fluoxetine 
19.14 Fluoxetine * 
19.03 Fluoxetine + Olanzapine 1,3,* 
19.01.02 Fluoxetine 1 £0-£5 Fluoxetine – price band is for 3 x 20mg. If fluoxetine 60mg used the price band is £6-£15
19.01.02 Fluoxetine 1 £0-£5 Fluoxetine – price band is for 3 x 20mg. If fluoxetine 60mg used the price band is £6-£15
19.14 Fluoxetine 2,* 
19.14 Fluoxetine 2,* 
19.15 Fluoxetine 2,*  Fluoxetine price band is for 3 x 20mg, if fluoxetine 60mg used the price band is £6-£15
19.15 Fluoxetine 2,*  Price band is for 3 x 20mg, if fluoxetine 60mg used the price band is £6-£15
19.05.01 Flupenthixol 1,2 
19.05.01 Flupenthixol 1,2,3 
19.05.01 Fluphenazine 1,2,3 
04.03.03 Fluvoxamine Maleate  Acute Depression
11.03.03 Foscarnet intravitreal injection 
A2.01.01.01 Fresubin® Original Fibre 
A2.01.01.01 Fresubin® Soya Fibre 
A2.01.01.01 Fresubin® Original 
11.03.01 Fusidic Acid 
19.13.01 Gabapentin 1,2  Be aware of the potential for abuse
19.15 Gabapentin 1,2  Be aware of the potential for abuse
19.09 Galantamine 1,3 Mild to Moderate
11.03.03 Ganciclovir 0.15% ophthalmic gel Virgan®
11.03.01 Gentamicin Genticin®
11.03.01 Gentamicin Genticin®
10.01.03 Golimumab Simponi®
19.14 Guanfacine 2  Specialist Consultant prescribing only
04.02.01 Haloperidol Haldol® £££ £££
04.02.01 Haloperidol Serenace®
04.02.03 HALOPERIDOL 
19.03 Haloperidol 1 Mania & Hypomania Haloperidol an ECG required before treatment—assess need for further ECGs during treatment on an individual basis
19.05.01 Haloperidol 1,2 
19.05.01 Haloperidol 1,2,3 
19.12.04 Hepatitis A Vaccine 
19.12.04 Hepatitis B Vaccine 3  Accelerated course
10.03.01 Hyaluronidase Hyalase®
01.01.01 Hydrotalcite 
10.01.03 Hydroxychloroquine 
19.12.01 Hyoscine Butylbromide Buscopan Abdominal cramps: 10mg-20mg qds PRN (according to BMI). ONLY if mebeverine is not tolerated, be aware of the potential for abuse
19.05.02 Hyoscine Hydrobromide 300 micrograms ’Kwells’ * 
19.05.02 Hyoscine Hydrobromide TTS 1mg * 
10.01.01 Ibuprofen 
19.12.01 Ibuprofen 2  Muscle/joint pains: 400mg tds PRN, only if no history of GI or cardiovascular risk
10.03.02 Ibuprofen 5 % gel 
19.10 Ibuprofen IR 2  Patients receiving an NSAID who are at risk of or develop gastrointestinal side effects should receive Omeprazole or Lansoprazole
04.03.01 Imipramine  Acute Depression
All tricyclics have a cardio vascular side effect profile and are dangerous in over dose. Lofepramine has the safest profile in overdose see NICE for text
19.01.02 Imipramine 1,*  please refer to the unlicensed/off label policy
19.04 Imipramine 1,2  All tricyclics have a cardio vascular side effect profile and are dangerous in over dose. Lofepramine has the safest profile in overdose see NICE for text
10.01.01 Indometacin 
10.01.01 Indometacin 
10.01.03 Infliximab Remicade®
A2.01.01.01 Isosource® Fibre 
A2.01.01.01 Isosource® Standard 
19.13.03 Isphagula Husk * 
A2.01.01.01 Jevity®  
10.01.01 Ketoprofen Axorid®
10.01.01 Ketoprofen 
19.13.03 Lactulose 1 
19.15 Lamogtrigine 1,2 
04.02.03 Lamotrigine  Bipolar Depression
19.13.01 Lamotrigine 
19.03 Lamotrigine + Lithium 1,2,3,*  Be aware of serious skin reactions and follow the appropriate titration regimen, start at a low dose and titrate slowly (see BNF)

Lithium should be prescribed by brand, ensure the monitoring requirements are met
19.03 Lamotrigine 1,*  Be aware of serious skin reactions and follow the appropriate titration regimen, start at a low dose and titrate slowly (see BNF)
19.13.01 Lamotrigine 1,2 
19.13.01 Lamotrigine 1,2 
19.13.01 Lamotrigine 1,2 
19.13.01 Lamotrigine 1,2 
19.13.01 Lamotrigine 1,2 
19.13.01 Lamotrigine 1,2 
19.15 Lamotrigine 1,2 
19.15 Lamotrigine 1,2 
19.15 Lamotrigine 1,2 
19.15 Lamotrigine 1,2 
19.15 Lamotrigine 1,2 
19.13.01 Lamotrigine 1,2,* 
10.01.03 Leflunomide 
19.13.01 Levetiracetam 1,2 
19.13.01 Levetiracetam 1,2 
19.13.01 Levetiracetam 1,2 
19.15 Levetiracetam 1,2 
19.15 Levetiracetam 1,2 
19.15 Levetiracetam 1,2 
19.15 Levetiracetam 1,2 
19.13.01 Levitiracetam 1,2,* 
19.13.05 Levothyroxine 
19.08 Lisdexamfetamine 
19.14 Lisdexamfetamine 2 
19.03 Lithium + Fluoxetine 2  Lithium should be prescribed by brand, ensure the monitoring requirements are met
19.03 Lithium + Olanzapine IR 1,2,3 Maintenance Lithium should be prescribed by brand, ensure the monitoring requirements are met
19.03 Lithium + Quetiapine IR 2,3,*  Quetiapine XL formulation is licensed as adjunctive treatment in major depressive disorder. However for Bipolar depression and prevention in recurrence of episodes the immediate release represents best value, in addition the titration and once daily schedule is the same for both preparations. Therefore quetiapine XL is not included in the Formulary for this reason.

Lithium should be prescribed by brand, ensure the monitoring requirements are met
19.03 Lithium + Valproic Acid * 1,3 Maintenance Off label use - Please refer to the unlicensed/off label policy

Lithium should be prescribed by brand, ensure the monitoring requirements are met
19.03 Lithium 1,2,3 Maintenance Compliance with lithium is important and frequency of relapse is increased by abrupt discontinuation. Lithium therapy is not advisable where there is significant doubt over patient concordance

Lithium should be prescribed by brand, ensure the monitoring requirements are met
19.03 Lithium 1,2,3 Mania & hypomania adjunctive treatment Of the mood stabilisers, lithium is the longest established with greatest evidence for its efficacy in treatment & prophylaxis of bipolar affective disorder.

Lithium should be prescribed by brand, ensure the monitoring requirements are met
19.03 Lithium 2,3 Milder Forms Of the mood stabilisers, lithium is the longest established with greatest evidence for its efficacy in treatment & prophylaxis of bipolar affective disorder

Lithium should be prescribed by brand, ensure the monitoring requirements are met
19.03 Lithium 2,3  Lithium should be prescribed by brand, ensure the monitoring requirements are met
04.02.03 Lithium Carbonate1,2,3 Priadel® Indication: maintenance of mania and hypomania.

Compliance with lithium is important and frequency of relapse is increase by abrupt discontinuation. Lithium therapy is not advisable where there is significant doubt over patient concordance.
04.02.03 Lithium Citrate Priadel®
04.02.03 Lithium2,3 + Olanzapine1,2,3  Indication: maintenance of mania and hypomania


Amber Traffic Light  Lithium



Green Traffic Light  Olanzapine


04.03.01 Lofepramine  Acute Depression
All tricyclics have a cardio vascular side effect profile and are dangerous in over dose. Lofepramine has the safest profile in overdose see NICE for text
19.04 Lofepramine 1,2  All tricyclics have a cardio vascular side effect profile and are dangerous in over dose. Lofepramine has the safest profile in overdose see NICE for text
19.12.01 Lofexidine 1  7-10 days
19.12.01 Loperamide 2  Diarrhoea: 4mg initially, 2mg-4mg each loose stool, max 16mg in 24hrs
19.01.02 Lorazepam 1 £6-£15 At any step only offer benzodiazepines as a short term measure during crises
19.05 Lurasidone Latuda

Lurasidone is not an alternative to clozapine. If the patient clinically responds to conventional antipsychotics but struggles to tolerate their side effects, Lurasidone can be considered as a treatment option. Prescribing responsibility for Lurasidone will remain with the Trust if the GP is not willing to prescribe due to the absence of a shared care agreement.

19.12.01 Mebeverine 2  Abdominal cramps: 135mg tds, preferably 1 hr before food. NB: mebeverine gives a positive result to amphetamine in urine tests
19.14 Medikinet XL 1,2 
19.13.04 Melatonin *  Circadin is first choice and the only licensed product, is to be used first line, in an off-label way, if clinically appropriate. If prescribing an unlicensed product, because e.g. the patient is unable to swallow tablets,, Bio-melatonin 3mg is recommended.
19.14 Melatonin MR 1,2,3,*  Circadin (melatonin MR) is indicated as monotherapy for the short-term treatment of primary insomnia characterized by poor quality of sleep in patients who are aged 55 or over
19.15 Melatonin MR 1,2,3,*  Circadin (melatonin MR) is indicated as monotherapy for the short-term treatment of primary insomnia characterized by poor quality of sleep in patients who are aged 55 or over
19.09 Memantine 1,3 Moderate Memantine is indicated for patients in moderate to severed dementia that are intoleant of or have a contraindication to AChE inhibitors (usually if intolerant to one then likely to be intolerant to all).
For patients who are progressing from mild/moderate to severe, a cross over with donepezil and Memantine can be useful
19.09 Memantine 1,3 Severe
19.12.01 Methadone Solution 1mg/1ml Sugar Free 1,2  3-4 weeks (not recommended for in-patients due to low success rate)
19.12.01 Methadone Solution 1mg/1ml Sugared 1,2  3-4 Weeks (not recommended for in-patients due to low success rate)
10.01.03 Methotrexate 
19.14 Methylphenidate IR 1,2  Long acting formulations are the preferred choice
19.08 Methylphenidate MR 1 
19.08 Methylphenidate MR 1,3 
10.01.02.02 Methylprednisolone Acetate Depo-Medrone® with Lidocaine
19.12.01 Metoclopramide 2  Nausea: 10mg tds PRN oral/IM
19.12.03 Metoclopramide 2  Nausea/Vomiting: 10mg oral tds PRN
19.13.01 Midazolam Bucccal Buccolam is the preferred product. Midazolam MUST be prescribed by brand, not generically to avoid confusion. Licensed products should be used wherever possible
19.15 Midazolam (Buccal) 1  Buccolam is the preferred product
Midazolam MUST be prescribed by brand, not generically to avoid confusion. Licensed products should be used wherever possible
04.03.04 Mirtazapine  Acute Depression
19.14 Mirtazapine * 
19.04 Mirtazapine + another Antidepressant 1,2,*  Please see Depression section for choice of antidepressant
19.01.02 Mirtazapine 1,* £0-£5
19.04 Mirtazapine 1,2 
19.04 Moclobamide 1,2  Moclobamide has dangerous interactions with some foods, alcohol and other drugs, avoid consuming tyramine rich food. Be aware of the wash out times of other antidepressants before starting (generally 2 weeks but 5 weeks with fluoxetine) see BNF for details
04.03.02 Moclobemide  Acute Depression
Moclobemide & Phenelzine: have dangerous interactions with some foods, alcohol and other drugs, avoid consuming tyramine rich food. Be aware of the wash out times of other antidepressants before starting (generally 2 weeks but 5 weeks with fluoxetine) see BNF for details
19.04 Moclobemide 1,2  Moclobemide & Phenelzine: have dangerous interactions with some foods, alcohol and other drugs, avoid consuming tyramine rich food. Be aware of the wash out times of other antidepressants before starting (generally 2 weeks but 5 weeks with fluoxetine) see BNF for details
19.10 Morphine MR 1,2 Zomorph Nausea and vomiting is common when starting morphine, and may last up to 7 days. All patients should be offered an antiemetic during this time
19.10 Morphine Sulphate IR 1,2  Nausea and vomiting is common when starting morphine, and may last up to 7 days. All patients should be offered an antiemetic during this time
19.13.03 Movicol Paediatric 1 
10.01.01 Nabumetone Relifex®
19.12.01 Naloxone 2 
19.12.01 Naltrexone 1,2  U&Es & LFTs prior to starter dose of 25mg or within 7 days of commencement, then 50mg daily: preferably supervised consumption by partner or carer
19.12.03 Naltrexone 1,2  25mg-50mg daily to help with alcohol craving. Increased effect if taken together with acamprosate. LFTs should be checked every 3 weeks
10.01.01 Naproxen 
19.10 Naproxen IR 2  Patients receiving an NSAID who are at risk of or develop gastrointestinal side effects should receive Omeprazole or Lansoprazole
11.03.01 Neomycin Sulphate with antibacterials Neosporin®
10.02.01 Neostigmine 
04.10.02 Nicotine Gum  Gum is not recommended for use in the Forensic & PICU settings
04.10.02 Nicotine Inhalator 
04.10.02 Nicotine Lozenge/Mini Lozenge 
04.10.02 Nicotine Microtab 
04.10.02 Nicotine Nasal Spray  Use with caution in acutely unwell patients
04.10.02 Nicotine Oral Spray  Use with caution in acutely unwell patients
04.10.02 Nicotine Oral Strips 
04.10.02 Nicotine Patches 24hr & 16hr 
19.09 Non Pharmacological Therapy 1,2,3 
A2.01.01.01 Novasource® Gl Control 
19.07 NRT Gum 1,2,3  Gum is not recommended for use in the Forensic & PICU settings
19.07 NRT Inhalator 1,2,3 
19.07 NRT Lozenge/Mini Lozenge 1,2,3 
19.07 NRT Microtab 1,2,3 
19.07 NRT Nasal Spray 1,2,3  Use with caution in acutely unwell patients
19.07 NRT Oral Spray 1,2,3  Use with caution in acutely unwell patients
19.07 NRT Oral Strips 
19.07 NRT Patches 16hr or 24hr 1,2,3 
A2.01.01.01 Nutrison Low Sodium 
A2.01.01.01 Nutrison Peptisorb 
A2.01.01.01 Nutrison®  
A2.01.01.01 Nutrison® Multi Fibre 
A2.01.01.01 Nutrison® Soya 
A2.01.01.01 Nutrison® Soya Multi Fibre 
04.02.01 Olanzapine 
04.02.01 Olanzapine  Bipolar depression
04.02.03 OLANZAPINE 
19.03 Olanzapine Maintenance
19.03 Olanzapine + Lithium 1,3,*  Lithium should be prescribed by brand, ensure the monitoring requirements are met
19.05.01 Olanzapine 1,2,3 
19.03 Olanzapine 1,3 Mania & Hypomania Olanzapine is licensed for mania (both acute and maintenance if good response) and by injection for control of agitation and disturbed behaviour in mania
19.03 Olanzapine 1,3,* 
19.14 Olanzapine 2,*  Olanzapine is licensed for schizophrenia in children aged between 12-17
A2.01.01.01 Osmolite®  
19.04 Other SSRI 1,2 
19.13.01 Oxcabazepine 1,2 
19.13.01 Oxcarbazepine 1,2 
19.15 Oxcarbazepine 1,2  May exacerbate absence seizures
19.15 Oxcarbazepine 1,2 
19.13.01 Oxcarbazepine 2 
19.15 Oxcarbazepine 2 
19.13.02 Oxybutynin  
19.10 Oxycodone 1,2 
19.12.03 Pabrinex IM 2  Should be offered to all patients for the first 3-5 days depending on the individual physical and mental health conditions. PROPHYLAXIS: IM 1 vial of No. 1 and 1 vial of No.2, bd for 6 doses
Pabrinex - CHM Advice
Although potentially serious allergic adverse reactions may rarely occur during, or shortly after, parenteral administration, the CHM has recommended that:
a) This should not preclude the use of parenteral thiamine in patients where this route of administration is required, particularly those at risk of Wernicke-Korsakoff Syndrome where treatment with thiamine is essential
b) Facilities for treating anaphylaxis (including resuscitation facilities) should be available when parenteral thiamine is administered
19.05.01 Paliperidone 1,2,3 LAI Paliperidone 3 monthly LAI is included in the Formulary but a Managed Entry Mechanism is in place which must be completed prior to prescribing
19.10 Paracetamol 2  If patients cannot swallow paracetamol tablets, be aware that the effervescent/soluble tablets contain high levels of sodium. For patients with hypertension, heart failure or renal impairment use liquid suspensions
04.03.03 Paroxetine  Acute Depression
19.01.02 Paroxetine 1 
19.01.02 Paroxetine 1 £0-£5
19.01.02 Paroxetine 1 £0-£5
10.01.03 Penicillamine 
A2.01.01.01 Peptamen®  
A2.01.01.01 Peptisorb®  
19.01.02 Phenelzine 1,* £31-£100
19.05.02 Pirenzepine ** 
10.01.01 Piroxicam 
19.12.04 Pneumococcal Vaccine 
11.03.01 Polihexanide 
11.03.01 Polymyxin B Sulphate eye ointment Polyfax®
19.01.02 Pregabalin £31-£100 Only if all SSRIs or SNRIs are not tolerated
Be aware of the risk of misuse and dependence, it can be used as an alternative or in addition to an SSRI
10.01.04 Probenecid 
19.05.02 Procyclidine * 
19.12.01 Promethazine 2,4  Night time sedation: 25mg-50mg at night
11.03.01 Propamidine Isetionate Brolene®
19.14 Psychological Therapies 
04.02.01 Quetiapine  Quetiapine XL formulation is licensed as adjunctive treatment in major depressive disorder. However for bipolar depression and prevention in recurrence of episodes the immediate release represents best value, in addition the titration and once daily schedule is the same for both preparations. Therefore, Quetiapine XL is not included in the formulary for this reason.
04.02.03 QUETIAPINE  IMMEDIATE REALEASE ONLY
19.03 Quetiapine IR Maintenance Only if it has been effective during an episode of mania previously
19.05.01 Quetiapine IR 1,2,3  Following loss of patent, only Quetiapine immediate release (IR) prices have dropped significantly, for this reason Quetiapine XL is not included in the Formulary
19.03 Quetiapine IR 1,3  Quetiapine XL formulation is licensed as adjunctive treatment in major depressive disorder. However for Bipolar depression and prevention in recurrence of episodes the immediate release represents best value, in addition the titration and once daily schedule is the same for both preparations. Therefore quetiapine XL is not included in the Formulary for this reason.
19.03 Quetiapine IR 1,3 Mania & Hypomania Quetiapine is licensed for treatment and prevention of bipolar disorder
19.14 Quetiapine IR 2,*  Quetiapine is licensed for schizophrenia in children aged between 12-17 years
19.14 Quetiapine IR 2,* 
19.15 Quetiapine IR 2,* 
10.02.02 Quinine 
04.02.01 Risperidone Risperdal®
04.02.03 Risperidone 
19.05.01 Risperidone 1,2,3 LAI
19.05.01 Risperidone 1,2,3 
19.09 Risperidone 1,2,3  Risperidone is the only licensed antipsychotic, however NICE CG advises against the use of antipsychotic for non-cognitive symptoms or challenging behaviour of dementia unless the person is severely distressed or there is an immediate risk of harm to them or others
Treatment must be reviewed at least every 6 weeks
19.03 Risperidone 1,3 Mania & Hypomania Risperidone is licensed for moderate to severe mania
19.14 Risperidone 2,*  Risperidone is licensed for acute and chronic psychosis in children of 12-17 years
19.14 Risperidone 2,* 
19.14 Risperidone 2,* 
19.15 Risperidone 2,* 
19.15 Risperidone 2,* 
19.15 Risperidone 2,*  Low dose
10.01.03 Rituximab (rheumatology) MabThera®
04.11 Rivastigmine Exelon®
19.09 Rivastigmine 1,3 Mild to Moderate Rivastigmine is also licensed for mild to moderate dementia in Parkinsons Disease
19.12.04 Seasonal Flu Vaccine 
04.02.03 SEMISODIUM VALPORATE DEPAKOTE® Bipolar Depression
19.13.03 Senna 1 
04.03.03 Sertraline  Acute Depression
19.14 Sertraline * 
19.01.02 Sertraline 1 
19.01.02 Sertraline 1,* £0-£5 Please refer to the unlicensed/off label policy
If sertraline is ineffective, offer an alternative SSRI or a serotonin–noradrenaline reuptake inhibitor (SNRI), taking into account the following factors:
• tendency to produce a withdrawal syndrome (especially with paroxetine and venlafaxine)
• side-effect profile and potential for drug interactions.
• the risk of suicide and likelihood of toxicity in overdose (especially with venlafaxine).
• the person’s prior experience of treatment with individual drugs (particularly adherence).
• effectiveness, side effects, experience of withdrawal syndrome and the person’s preference).
• Venlafaxine - XL formulation has licence for GAD
• Citalopram and escitalopram may have an additive effect to other drugs that prolong the QT interval. Coadministration of citalopram and escitalopram with medicines that prolong the QT interval is therefore contraindicated
Advise Patients On:
the risk of activation with SSRIs and SNRIs, with symptoms such as increased anxiety, agitation and problems sleeping
• the gradual development, over 1 week or more, of the full anxiolytic effect
• the importance of taking medication as prescribed and the need to continue drug treatment after remission to avoid relapse.
19.01.02 Sertraline 1,* £0-£5
19.04 Sertraline 1,2 
19.14 Sertraline 2 
19.14 Sertraline 2,* 
19.15 Sertraline 2,* 
19.15 Sertraline 2,* 
19.13.04 Sleep Hygeine 
19.14 Sleep Hygiene  Sleep hygiene should always be used FIRST LINE
19.15 Sleep Hygiene 1 
19.13.03 Sodium Picosulfate 1 
04.08.01 Sodium Valproate 
19.13.01 Sodium Valproate  Myoclonic seizures may be exacerbated.
If valproate is used for females of child bearing age then the teratogenic risks should be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however the available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure
19.13.01 Sodium Valproate 1,2  If valproate is used for females of child bearing age then the teratogenic risks should be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however the available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure
19.13.01 Sodium Valproate 1,2  If valproate is used for females of child bearing potential then the teratogenic risks shold be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however the available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure
19.13.01 Sodium Valproate 1,2  If valproate is used for females of child bearing age then the teratogenic risks should be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however the available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure
19.13.01 Sodium Valproate 1,2  If valproate is used for females of child bearing age then the teratogenic risks should be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however the available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure
19.13.01 Sodium Valproate 1,2  If valproate is used for females of child bearing age then the teratogenic risks should be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however the available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure
19.13.01 Sodium Valproate 1,2 
19.13.01 Sodium Valproate 1,2 
19.15 Sodium Valproate 1,2 
19.15 Sodium Valproate 1,2  If valproate is used for women of child bearing age then the teratogenic risks should be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however the available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure (MHRA Jan 15)
19.15 Sodium Valproate 1,2  If valproate is used for women of child bearing age then the teratogenic risks should be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however the available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure (MHRA Jan 15)
19.15 Sodium Valproate 1,2  If valproate is used for women of child bearing age then the teratogenic risks should be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however the available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure (MHRA Jan 15)
19.15 Sodium Valproate 1,2  If valproate is used for women of child bearing age then the teratogenic risks should be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however the available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure (MHRA Jan 15)
19.15 Sodium Valproate 1,2  If valproate is used for women of child bearing age then the teratogenic risks should be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however the available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure (MHRA Jan 15)
19.13.01 Sodium Valproate 2  If valproate is used for females of child bearing potential then the teratogenic risks should be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure
19.15 Sodium Valproate 2  If valproate is used for women of child bearing age then the teratogenic risks should be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however the available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure (MHRA Jan 15)
10.01.03 Soldium Aurothomalate Myocrisin®
19.04 SSRI 1,2  See acute section
10.01.03 Sulfasalazine 
19.05.01 Sulpride 1,2 
19.16 Sun Protection 50+  Sun protection creams are only available on prescription when the patient(s) involved is receiving medication that makes them photosensitive i.e. Phenothiazines, Amiodarone and Demeclocycline or have a diagnosed medical condition that renders them photosensitive as per the BNF.
For all other service users sun protection is considered a cosmetic product and should be ordered by each ward/department via eProcurement, (500ml Pump pack of sunsense 50+ sun protection Code MRC 00077A).
A2.01.01.01 Survimed® OPD 
19.01.01 Temazepam 1,2,3 
19.15 Temazepam 1,2,3 
19.12.03 Thiamine 2  100mg tds for up to 4weeks
10.01.03 Tocilizumab RoActemra®
19.13.01 Topiramate 1,2 
19.13.01 Topiramate 1,2 
19.15 Topiramate 1,2 
19.15 Topiramate 1,2 
19.13.01 Topiramate 1,2,* 
19.15 Topiramate 1,2,* 
10.03.02 Transvasin 
19.05.02 Trihexyphenidyl * Benzhexol
19.05.02 Tryhexyphenidyl * 
19.03 Valproate (Semisodium or Episenta) 2 Mania & hypomania adjunctive treatment Valproic acid is the active ingredient so sodium valproate in the form of Episenta could be used, and is appropriate, for patients with swallowing difficulties. Granules can be mixed with cold food or liquid.
19.03 Valproate 2 Milder Forms Valproic acid is the active ingredient so sodium valproate in the form of Episenta could be used, and is appropriate, for patients with swallowing difficulties. Granules can be mixed with cold food or liquid.
19.15 Valproate 2,*  If valproate is used for women of child bearing age then the teratogenic risks should be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however the available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure (MHRA Jan 15)
04.02.03 Valproic Acid Depakote®
19.03 Valproic Acid (Semisodium or Episenta) Maintenance Off Label Use - Please refer to the unlicensed/off label policy
Valproate should not be prescribed for women of child-bearing potential, see NICE Guidance CG185. If valproate is used in exceptional cases for women of child bearing age then the teratogenic risks should be explained. Folate supplementation before the pregnancy may decrease the risk of neural tube defects common to all pregnancies; however the available evidence does not suggest it prevents the birth defects or malformations due to valproate exposure (MHRA Jan 15)
19.03 Valproic Acid + Olanzapine * 2 Maintenance
19.03 Valproic Acid 2,* 
04.03.04 Venlafaxine  Acute Depression
19.14 Venlafaxine * 
19.14 Venlafaxine * 
19.01.02 Venlafaxine 1,* £0-£5
19.04 Venlafaxine 1,2 
19.12.03 Vitamine B Compound Strong 2  1 tablet tds, up to 4 weeks
04.03.03 Vortioxetine  Acute Depression
19.04 Vortioxetine 1 
19.01.01 Zolpidem 1,2,3  Maximum daily dose of 10mg
19.15 Zolpidem 1,2,3 
19.01.01 Zopicline 1,2,3  Maximum daily dose of 7.5mg
19.15 Zopiclone 1,2,3 
19.14 Zopiclone 1,2,3,* 
19.12.01 Zopiclone 2  Night time sedation: maximum of 7 days in patients with no history of zopiclone or benzodiazepine dependence only
CSM Advice:
• Benzodiazepines are indicated for the short-term relief (two to four weeks only) of anxiety that is severe, disabling or subjecting the individual to unacceptable distress, occurring alone or in association with insomnia or short-term psychosomatic, organic or psychotic illness.
• The use of benzodiazepines to treat short-term ‘mild’ anxiety is inappropriate and unsuitable.
• Benzodiazepines should be used to treat insomnia only when it is severe, disabling, or subjecting the individual to extreme distress.
19.05.01 Zuclopenthixol 1,2 
19.05.01 Zuclopenthixol 1,2,3 
Midlands Partnership