• MHRA Drug Safety Update (July 2022): Topiramate (Topamax): start of safety review triggered by a study reporting an increased risk of neurodevelopmental disabilities in children with prenatal exposure

• Clonidine is not generally recommended for migraine prophylaxis; may aggravate depression/cause insomnia.

• 100mg/1ml concentrate for solution for infusion
  • Approved for the prevention of chronic migraine in adults in line with NICE only if
    • they have 4 or more migraine days a month
    • at least 3 preventative drug treatments have failed

• 70mg/1ml and 140mg/1ml solution for injection (pre-filled pens)
  • Approved for the prevention of chronic migraine in adults in line with NICE only if
    • they have 4 or more migraine days a month
    • at least 3 preventative drug treatments have failed

• 225mg/1.5ml solution for injection (Pre-filled pens/syringes)
  • Approved for the prevention of chronic migraine in adults in line with NICE only if
    • they have 4 or more migraine days a month
    • at least 3 preventative drug treatments have failed
    
    
    

• 120mg/1ml injection
  
  • Approved for the prevention of chronic migraine in adults in line with NICE only if
    • they have 4 or more migraine days a month
    • at least 3 preventative drug treatments have failed

• 75mg oral lyophilisates
• Approved for preventing migraine in line with NICE 
  • First three month's supply from secondary care followed by 12 week review and then transfer to primary care with a 4 week prescription to allow for handover
• Approved for treating migraine in line with NICE 

• Only approved for use in accordance with NICE guidance. 

• Note: sodium valproate 500mg & 1000mg MR granules (Episenta®) are also approved for use in those who have difficulty swallowing sodium valproate tablets. MR granules may be more convenient to use than large volumes of liquid formulations.

Black Triangle in Females

Valproate must no longer be prescribed to women and girls of
childbearing potential unless there is no alternative and they are on the
Pregnancy Prevention Programme (PPP)  

For information relating to alerts regarding valproate, including Drug Safety Updates and links to PPP materials, please use the following link:

MHRA Drug Safety Updates (valproate)