netFormulary North of Tyne, Gateshead and North Cumbria NHS
Area Prescribing Committee Formulary  
 Search
 Formulary Chapter 4: Central nervous system - Full Chapter
04.07.04.02  Expand sub section  Prophylaxis of migraine
Pizotifen
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Metoprolol
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Propranolol
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Topiramate
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
 
   
Clonidine
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Green
  • Clonidine is not generally recommended for migraine prophylaxis; may aggravate depression/cause insomnia.
 
   
Fremanezumab (Ajovy®)
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • 225mg/1.5ml solution for injection (Pre-filled pens/syringes)
    • Approved for the prevention of chronic migraine in adults.
 
Link  NICE TA 631: Fremanezumab for preventing migraine
   
Botulinum Toxin Type A
View adult BNF View SPC online View childrens BNF  Track Changes
Formulary
Red
  • Only approved for use in accordance with NICE guidance. 
 
Link  NICE TA 260 - Botulinum toxin type A for the prevention of headaches in adults with chronic migraine
   
Amitriptyline
View adult BNF View SPC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Green
 
   
Imipramine
View adult BNF View SPC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Green
 
   
Sodium valproate
View adult BNF View SPC online View childrens BNF  Track Changes
Unlicensed Drug Unlicensed
Green
  • 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.
 
Link  Valproate medicines: Pregnancy Prevention Programme materials
   
 ....
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
click to search medicines.org.uk
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

Red

Drugs for hospital use only. The responsibility for initiation and monitoring treatment should rest with an appropriate hospital clinician and the drug should be supplied through the hospital throughout the duration of treatment. In some very exceptional circumstances (e.g. due to distance from the hospital, storage, supply or mobility/transport problems) it may be appropriate for the GP to be asked to prescribe a Red drug. This should be negotiated on an individual patient basis and should only be done with the GP’s prior informed agreement where the roles of the GP and hospital services are clearly defined and agreed. The GP should not feel under pressure to prescribe in these circumstances.   

Amber

Drugs initiated by hospital specialist, but where continuing treatment by GPs may be appropriate under a shared care arrangement. The specialist should send the GP a copy of the shared care agreement to sign. The GP should sign the shared care agreement, or indicate they do not want to be part of such an agreement, and return a copy back to the specialist. Shared care guidelines are available or are being developed for most of the drugs listed as Amber. If no shared care guideline is available, the hospital specialist should provide the patient’s GP with sufficient information and support to allow treatment to be continued and managed safely in primary care.  

Green plus

Drugs normally recommended or initiated by hospital specialist, but where the provision of an information leaflet may be appropriate to facilitate continuing treatment by GPs. Many of these information sheets are in the process of development.  

Green

Drugs where prescribing by GPs is appropriate. Drugs not classified as Red, Amber or Green Plus (formerly blue in North of Tyne) are generally classified as ‘Green’ by default. The Green drugs listed here include those products normally initiated by hospital specialists where there was a need for discussion and debate as to the category in which they should be placed.  

netFormulary