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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
04.09.01 Dopaminergic drugs used in Parkinsons disease
NICE NG71: Parkinson’s disease in adults
04.09.01 Dopamine receptor agonists
NICE NG71: Parkinson’s disease in adults

Apomorphine

SCG
Formulary

Entry reviewed: May 2025

BNF BNFc SPC
BLMK Apomorphine in Parkinson’s disease – shared care guideline MHRA Drug Safety Update (April 2016) - Apomorphine with domperidone: minimising risk of cardiac side effects

Bromocriptine

Amber SPA
Restricted Drug Restricted
5mg & 10mg Capsule
Consultant initiation. Risk of fibrotic reactions so careful monitoring required.
BNF BNFc SPC

Pramipexole

Amber SPA
Formulary

88 mmicrograms, 180 micrograms, 350 micrograms, 700 micrograms

260 microgram modified-release tablets

N.B. other prolonged release formulation non-formulary.

Entry reviewed May 2025

BNF BNFc SPC

Ropinirole

Amber SPA
Formulary

500micrograms, 2mg tablets

 


Modified-release tablets - Current preferred brands are Ipinnia® XL or Repinex® XL

BNF BNFc SPC

Rotigotine (Neupro®)

Amber SPA
Restricted Drug Restricted

1mg, 2mg, 4mg, 6mg & 8mg Transdermal 24 hour patch

Restricted Item  Only for patients who are nil by mouth.

For conversion calculations from levodopa and dopamine agonists, refer to Trust Guideline 336 - The Management of Patients with Parkinson’s Disease In an Emergency and when Nil By Mouth. Also see attached protocol from these guidelines.

Please note doses are different when used for Restless Leg Syndrome - see BNF or SPC for further information

BNF BNFc SPC
GUIDELINES FOR TREATMENT OF PATIENTS WITH PARKINSON’S DISEASE (PD) IN AN EMERGENCY OR WHEN NIL‐BY‐MOUTH Parkinson’s UK: Emergency management of patients with Parkinson’s
04.09.01 Levodopa
04.09.01 Monoamine-oxidase-B inhibitors
04.09.01 Catachol-O-methyltransferase inhibitors
04.09.01 Amantadine
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.