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Nottinghamshire Area Prescribing Committee
Joint Formulary
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 Formulary Chapter 4: Central nervous system - Full Chapter
04.10.01  Expand sub section  Alcohol dependence
Acamprosate (Campral EC)
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Formulary
Amber 2
  • In primary care, GPs/NMPs who have received appropriate training may initiate as per Notts Primary Care Alcohol Community Detox Protocol (see below).
  • Specialist advice of Alcohol and Drug Liaison Team in secondary care 
  • Link  Primary care alcohol community detox protocol
       
    Disulfiram (Antabuse)
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    Formulary
    Amber 2

    Tablet

    • In primary care, GPs/NMPs who have received appropriate training may initiate as per Notts Primary Care Alcohol Community Detox Protocol. In secondary care on specialist advice of Alcohol and Drug Liaison Team
    • Loading dose not considered necessary
     
    Link  Primary care alcohol community detox protocol
       
    Nalmefene
    (Selincro)
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    Formulary
    Amber 2
    Tablets
  • Specialist initiation by community based specialist alcohol services in line with NICE TA325 . GPs are not expected to prescribe in County CCGs (prescribing should remain with CRI) but GPs in City CCG may be requested to prescribe after initiation by alcohol service.  
  • Link  Link to reviews
       
    Naltrexone
    (alcohol dependence)
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    Formulary
    Amber 2
    Tablet
  • Some brands are licensed for treatment of alcohol dependence.
  • In primary care, GPs/NMPs who have received appropriate training may initiate as per Notts Primary Care Alcohol Community Detox Protocol.
  • In secondary care on specialist advice of Alcohol and Drug Liaison Team. 
  • Link  Notts APC Naltrexone information sheet (June 2019)
    Link  Primary Care Alcohol Community Detox Protocol
       
     ....
    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
    click to search medicines.org.uk
    Link to children's BNF
    click to search medicines.org.uk
    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

    Traffic Light Status Information

    Status Description

    Grey

    Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.
    Grey / Non-Formulary (undergoing assessment): Work is ongoing and will be reviewed at a future APC meeting.
    Grey / Non-Formulary (no formal assessment): APC has not formally reviewed this medicine or indication because it had never been requested for formulary inclusion. Often used for drugs new to market.
      

    Red

    Medicines which should normally be prescribed by specialists only. eg hospital only.
    For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.
      

    Amber 1

    Medicines that should be initiated by a specialist and prescribed by primary care prescribers only under a shared care protocol, once the patient has been stabilised.
    Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the Nottinghamshire APC.
      

    Amber 2

    Medicines suitable to be prescribed in primary care / general practice after specialist* recommendation or initiation.
    A supporting prescribing guideline may be requested which must have been agreed by the relevant secondary care trust DTCs and approved by the Nottinghamshire APC.
    *Specialist is defined by the APC as a clinician who has undertaken an appropriate formal qualification or recognised training programme within the described area of practice
      

    Amber 3

    Primary care/ non specialist may initiate as per APC guideline.
    The supporting prescribing guideline must have been agreed by the relevant secondary care trust D&TC(s) and approved by the Nottinghamshire APC.
      

    Green

    Medicines suitable for routine use within primary care.
    Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.   

    OTC

      

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