NHS Logo
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
04.08.02 Drugs used in status epilepticus
NICE NG217: Epilepsy

Lorazepam
(Injection)

RED
Formulary

4mg/1mL injection

BNF BNFc SPC

Diazepam 10mg/2mL
(Injection)

RED
Formulary
Note: Diazepam injection comes in two forms - solution (IM or IV) and emulsion Diazemuls® (IV only). Emulsion is preferred for IV as it is less irritant to the vein.
BNF BNFc SPC

Midazolam (Buccolam ®)
(Oromucosal solution, prefilled syringe)

Amber SPA
Formulary

Must be prescribed by brand name

Start all new patients on Buccolam (licensed brand)

Whole dose must be given (syringes are not graduated)

2.5mg/0.5ml, 5mg/1 ml, 7.5mg/1.5ml & 10mg/2ml Pre-filled oral syringe. See link for visual of the products.


Entry reviewed: June 2022

BNF BNFc SPC
BLMK Buccal midazolam prescribing guidance

Paraldehyde - Enema In Olive Oil

RED
Restricted Drug Restricted
Paediatrics only
BNF BNFc SPC

Phenobarbital
(Injection)

RED
Restricted Drug Restricted
30mg/1mL, 60mg/1mL & 200mg/1mL Injection
BNF BNFc SPC

Phenytoin
(Injection)

RED
Formulary
250mg/5mL Injection
BNF BNFc SPC
L&D Protocol for IV Phenytoin for Status Epilepticus in Adults Dec 2016

Midazolam
(Injection)

RED
Restricted Drug Restricted
Restricted - intravenous route to be used on ITU only



BNF BNFc SPC

Midazolam multi dose bottle 5mL (Epistatus®)

Amber SPA
Unlicensed Drug Unlicensed

To be used where a fixed dose cannot be given from one of the four available strengths of Buccolam syringe.

NB: Unlicensed special 10mg/ml solution

 

See link for visual of the product

 

 

Entry reviewed: June 2022

BNF BNFc SPC
BLMK Buccal midazolam prescribing guidance Epistatus, Midazolam 10mg in 1ml Buccal Liquid x 5ml - packs containing new syringes to be distributed
Non formulary items

Midazolam prefilled syringe (Epistatus®) (Prefilled syringe for oromucosal use)

 
Non Formulary

2.5mg, 5mg, 7.5mg and 10mg are licensed.

Existing patients who are stabilised on Epistatus may continue if it is not appropriate to switch to Buccolam.

Entry reviewed: May 2025

BNF BNFc SPC
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.