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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
04.09.01 Levodopa
NICE NG71: Parkinson’s disease in adults

Co-Beneldopa

GREEN
Formulary

Ensure doses are prescribed at exact times as per patient's medication history using the 'free form' option on ePMA

62.5mg, 125mg & 250mg Capsules
62.5mg & 125mg Dispersible Tablets - for NBM patients only.
125mg Sustained Release Tablets 

Generic available. In hospital: contract brand will be supplied.

Primary care: Most cost effective brand to be advised via OptimiseRx



If nil by mouth consult trust guidelines 336 - The Management of Patients with Parkinson’s Disease in an emergency and when Nil By Mouth.

BNF BNFc SPC

Co-Careldopa

GREEN
Formulary

Ensure doses are prescribed at exact times as per patient's medication history using the 'free form' option on ePMA

Generic available. In hospital: contract brand will be supplied.

Primary care: Most cost effective brand to be advised via OptimiseRx

Carbidopa / levodopa: 12.5/50mg, 10/100mg, 25/ 100mg & 25/250mg 
Carbidopa / levodopa: 25/100mg, 50/200mg Controlled Release tablets

L&D Hospital: If nil by mouth consult trust guidelines 336 - The Management of Patients with Parkinson’s Disease in an emergency and when Nil By Mouth.

BNF BNFc SPC

Co-Careldopa and Entacapone (Levodopa/Carbidopa/Entacapone)
(Tablets)

Amber SPA
Formulary

Ensure doses are prescribed at exact times as per patient's medication history using the 'free form' option on ePMA

Levodopa 50mg/Carbidopa 12.5mg/Entacapone 200mg Tablets
Levodopa 75mg/Carbidopa 18.75mg/Entacapone 200mg Tablets
Levodopa 100mg/Carbidopa 20mg/Entacapone 200mg Tablets
Levodopa 125mg/Carbidopa 31.25mg/Entacapone 200mg Tablets
Levodopa 150mg/Carbidopa 37.5mg/Entacapone 200mg Tablets
Levodopa 200mg/Carbidopa 50mg/Entacapone 200mg Tablets

Secondary care: the current contract generic product will be supplied against any prescriptions. Generic brands include Sastravi and Stanek.

Primary care: Sastravi® or Stanek® are the current recommended brands for prescribing in primary care

BNF BNFc SPC

Foslevodopa and foscarbidopa (Produodopa®)
(240 mg/ml + 12 mg/ml solution for infusion)

RED
Restricted Drug Restricted

FOR ALL PRESCRIBING – Blueteq or High cost drug form required – see link from Formulary homepage.

Specialist use only in line with NICE recommendations and NHS Commissioning Policy.

BNF BNFc SPC BlueTeq
NICE TA934: Foslevodopa–foscarbidopa for treating advanced Parkinson’s with motor symptoms
Non formulary items

Levodopa inhalation (Inbrija®)

 
Non Formulary

 New product - no formal assessment. Contact ICB for advice.

Levodopa inhaled for patients with Parkinson’s disease who experience ‘off’ episodes (motor response fluctuations) [TSID8778]

 

BNF BNFc SPC
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.