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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
04.10.03 Opioid dependence
NICE CG52: Opioid detoxification (Drug misuse) NICE TA114: Drug misuse - methadone and buprenorphine
04.10.03 Opioid substitution therapy
NICE CG52: Opioid detoxification (Drug misuse) NICE TA114: Drug misuse - methadone and buprenorphine

Buprenorphine 2mg, 8mg
(Sublingual tablets)

RED
Restricted Drug Restricted

Restricted - prescribing by specialist dependency services according to NICE TA114.

Prescribe generically.

BNF BNFc SPC

Buprenorphine 2mg, 8mg (Espranor®)
(Orodispersible tablets)

RED
Restricted Drug Restricted
Restricted - prescribing by specialist dependency services according to NICE TA114.

N.B. Must ensure the correct formulation is prescribed as these are not interchangeable with the sublingual tablets.

L&D:Listed on JAC as 'buprenorphine (Espranor) orodispersible tablets'
BNF BNFc SPC

Buprenorphine / Naloxone
(Sublingual tablet)

RED
Restricted Drug Restricted

Buprenorphine 2mg / naloxone 500micrograms
Buprenorphine 8mg / naloxone 2mg
Restricted - prescribing by specialist dependency services according to NICE TA114.

Prescribe generically

BNF BNFc SPC

Buprenorphine prolonged release injection (Buvidal®)
(subcutaneous injection)

RED
Restricted Drug Restricted

For use by addiction services and in secondary care, where patients already on therapy do not have own supply and dose is due.

Confirm with patients usual provider of buprenorphine the dose and due date of injection (usually given weekly or monthly)

 

Entry reviewed: Nov 2021

BNF BNFc SPC

Methadone 1mg/ 1mL
(Oral Solution)

RED
Restricted Drug Restricted

Restricted for continuation of patients already on Methadone as part of their drug withdrawal scheme. For new patients refer to Drugs & Alcohol services.

This strength is only to be prescribed for addicts.

BNF BNFc SPC
04.10.03 Adjunctive therapy and symptomatic treatment
04.10.03 Opioid-receptor antagonists
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.