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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
04.11 Drugs for dementia
NICE CG42: Dementia NICE TA217: Alzheimers disease - donepezil, galantamine, rivastigmine (review) and memantine

Donepezil

SCG
Formulary

5mg & 10mg Tablets
5mg & 10mg Orodispersible Tablet

Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE TA217.

BNF BNFc SPC
Drugs for the Treatment of Dementia – Shared and Transfer of Care Guideline (Alzheimer’s Disease, dementia with Lewy bodies, vascular dementia & Parkinson’s disease dementia).

Galantamine

SCG
Formulary

8mg Tablets
8mg, 16mg & 24mg Modified release capsules

Current preferred brand: Gazylan XL capsule


Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE TA217.

BNF BNFc SPC
Drugs for the Treatment of Dementia – Shared and Transfer of Care Guideline (Alzheimer’s Disease, dementia with Lewy bodies, vascular dementia & Parkinson’s disease dementia).

Galantamine

SCG
Restricted Drug Restricted

4mg/1mL oral solution.

Restricted - to patients who cannot swallow ordinary tablets AND
Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE TA217.

N.B. Much more expensive than tablets / capsules.

BNF BNFc SPC
Drugs for the Treatment of Dementia – Shared and Transfer of Care Guideline (Alzheimer’s Disease, dementia with Lewy bodies, vascular dementia & Parkinson’s disease dementia).

Memantine

SCG
Formulary

10mg & 20mg Tablets
10mg/1mL pump actuation oral solution

Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE TA217.

BNF BNFc SPC
Drugs for the Treatment of Dementia – Shared and Transfer of Care Guideline (Alzheimer’s Disease, dementia with Lewy bodies, vascular dementia & Parkinson’s disease dementia).

Rivastigmine
(Patches)

SCG
Restricted Drug Restricted


Restricted - to patients who are nil by mouth AND
Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE TA217.

BNF BNFc SPC
Drugs for the Treatment of Dementia – Shared and Transfer of Care Guideline (Alzheimer’s Disease, dementia with Lewy bodies, vascular dementia & Parkinson’s disease dementia). MHRA Drug safety Update (June 2010) - Rivastigmine (Exelon) transdermal patch: risk of medication errors

Rivastigmine
(Oral)

SCG
Formulary

1.5mg & 6mg Capsules

Restricted to prescribing by Consultant Psychiatrists, Neurologists and physicians specialising in the care of the elderly, with continuation by GPs, in accordance with NICE 217.

BNF BNFc SPC
Drugs for the Treatment of Dementia – Shared and Transfer of Care Guideline (Alzheimer’s Disease, dementia with Lewy bodies, vascular dementia & Parkinson’s disease dementia).
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.