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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 4 - Central nervous system 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
04.06 Drugs used in nausea and vertigo
NICE CG84: Vomiting and diarrhoea in children under 5
04.06 Vomiting during pregnancy
04.06 Postoperative nausea and vomiting
04.06 Motion sickness
04.06 Other vestibular disorders
04.06 Cytotoxic chemotherapy
04.06 Palliative care
04.06 Migraine
04.06 Antihistamines
04.06 Phenothiazines and related drugs
04.06 Domperidone and metoclopramide
NICE CG84: Vomiting and diarrhoea in children under 5

Domperidone

GREEN
Formulary

10mg Tablets
5mg/5mL Suspension

Restricted - MHRA have advised domperidone should only be used for nausea and vomiting.

Its use is contraindicated in patients with underlying cardiovascular conditions and risk factors. Dose and duration have been revised to a maximum of 10mg three times daily for one week in adults. For more details see MHRA link below.

NB: Use for lactation stimulation is NOT recommended.

 

Entry reviewed: May 2024

BNF BNFc SPC
MHRA Drug Safety Update (December 2019) - Domperidone for nausea and vomiting: lack of efficacy in children; reminder of contraindications in adults and adolescents MHRA Drug Safety Update (April 2016) - Apomorphine with domperidone: minimising risk of cardiac side effects MHRA Drug Safety Update (May 2014) - Domperidone: risks of cardiac side effects

Metoclopramide

GREEN
Formulary

10mg Tablets
5mg/5mL Sugar Free Solution

Dot Metoclopramide should only be prescribed for short-term use (up to 5 days)
Dot Use of metoclopramide is contraindicated in children younger than 1 year
Dot In children, age 1–18 years, metoclopramide should only be used as a second-line option for prevention of delayed chemotherapy-induced nausea and vomiting, and for treatment of established postoperative nausea and vomiting

 

Restricted Use

As a prokinetic for Colon Capsule Endoscopy (Bedford Hospital) and 24-hour gastric feeding (Luton and Dunstable Hopsital)

DTC Approved February 2023

BNF BNFc SPC
MHRA Drug Safety Update (August 2013) - Metoclopramide risk of neurological adverse effects

Metoclopramide

GREEN
Formulary
10mg/2mL Injection
BNF BNFc SPC
MHRA Drug Safety Update (August 2013) - Metoclopramide risk of neurological adverse effects
Non formulary items

Domperidone ( for lactation stimulation)

DNP
Non Formulary

 

Use for lactation stimulation is NOT recommended.

 

Entry reviewed: May 2024

BNF BNFc SPC
MHRA Drug Safety Update (December 2019) - Domperidone for nausea and vomiting: lack of efficacy in children; reminder of contraindications in adults and adolescents MHRA Drug Safety Update (April 2016) - Apomorphine with domperidone: minimising risk of cardiac side effects MHRA Drug Safety Update (May 2014) - Domperidone: risks of cardiac side effects
04.06 5HT3 antagonists
04.06 Neurokinin receptor antagonist
04.06 Cannabinoid
04.06 Hyoscine
04.06 Other drugs for Ménière's disease
Classifications
GREEN
May be initiated in any care setting
Amber SPA
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Amber SPIS
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
SCG
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
RED
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
DNP
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
SELF
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.