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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

04.07.04.01 Treatment of the acute migraine attack

Atogepant 60mg tablets (Aquipta®)
(Treatment of migraine)

Restricted Drug Restricted

May be prescribed in any care setting for treating migraine, in accordance with the recommendations in NICE TA1172:

Atogepant can be used as an option for the acute treatment of migraine with or without aura in adults, only if, for previous migraines:

  • at least 2 triptans were tried and they did not work well enough, or

  • triptans were contraindicated or not tolerated, and nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol were tried but did not work well enough.

Entry added: July 2026

Rimegepant 75 mg oral lyophilisate (Vydura®)
(Treatment of migraine)

Restricted Drug Restricted

May be prescribed in any care setting for treating migraine, in accordance with the recommendations in NICE TA919:

Rimegepant is recommended as an option for the acute treatment of migraine with or without aura in adults, only if for previous migraines:

  • at least 2 triptans were tried and they did not work well enough or

  • triptans were contraindicated or not tolerated, and nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol were tried but did not work well enough.

Entry reviewed: July 2024

04.07.04.01 Analgesics
04.07.04.01 5HT1 agonists
04.07.04.01 Ergot alkaloids
04.07.04.01 Anti-emetics
04.07.04.01 Other drugs for migrane
Classifications
May be initiated in any care setting
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to 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).
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.