North Staffordshire Joint Formulary
North Staffordshire Clinical Commissioning Group
Stoke-on-Trent Clinical Commissioning Group

 
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4 Central nervous system
04-07-03 Neuropathic pain

Amitriptyline Hydrochloride
Formulary

Amitriptyline Hydrochloride Tablets 10mg
Amitriptyline Hydrochloride Tablets 25mg
Amitriptyline Hydrochloride Tablets 50mg
Amitriptyline Hydrochloride Oral Solution 25mg/5ml S/F 
Amitriptyline Hydrochloride Oral Solution 50mg/5ml S/F

Restriction: 1st line therapy in line with the Non-Malignant Chronic Pain Guide


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Gabapentin
Formulary

Gabapentin Capsules 100mg
Gabapentin Capsules 300mg
Gabapentin Capsules 400mg
Gabapentin Tablets 600mg
Gabapentin Oral Solution 50mg/ml

CD As of the 1st April 2019 Gabapentin is re-classified as a Schedule 3 Controlled Drug

Restriction: 2nd line in line with the Non-Malignant Chronic Pain Guide

Reserve liquid preparation for patients with swallowing difficulties as expensive. For cost effective prescribing choose generic in non-epileptic indications.(Applicable in Primary care only)

 

MHRA/CHM advice: Gabapentin (Neurontin®): risk of severe respiratory depression (October 2017)

 

Link  MHRA Guidance on Gabapentin
 

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Duloxetine Cymbalta®
Formulary

Duloxetine (as Duloxetine hydrochloride) Capsule G/R 30mg 
Duloxetine (as Duloxetine hydrochloride) Capsule G/R 60mg 

Restriction: 3rd line for diabetic neuropathy in line with the Non-Malignant Chronic Pain Guide


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Pregabalin
Formulary

Pregabalin Capsule 25mg 
Pregabalin Capsule 50mg 
Pregabalin Capsule 75mg 
Pregabalin Capsule 100mg 
Pregabalin Capsule 150mg 
Pregabalin Capsule 200mg 
Pregabalin Capsule 225mg 
Pregabalin Capsule 300mg

CD As of the 1st April 2019 Pregabalin is re-classified as a Schedule 3 Controlled Drug

Restriction: 3rd line for neuropathic pain in line with the Non-Malignant Chronic Pain Guide

Restriction: 4th line for diabetic neuropathy in line with the Non-Malignant Chronic Pain Guide

For cost effective prescribing choose generic in non epileptic indications. Reserve the oral solution (100mg/5ml SF) for patients with swallowing difficulties ONLY as very expensive.(Applicable in Primary care only)


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Carbamazepine
Formulary

Carbamazepine Tablets 100mg
Carbamazepine Tablets 200mg
Carbamazepine Tablets 400mg


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Tramadol Hydrochloride immediate release
Formulary

Tramadol Capsules 50mg

Restriction: Only to be used in line with the Non-Malignant Chronic Pain Guide

More costly than other weak opioids (Applicable in Primary care only)


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Lidocaine 5% plasters Versatis®
Restricted

Not approved for inclusion in the North Staffordshire Joint Formulary

 

NHS England has identified this product as an item that should not be routinely prescribed in primary care (July 2017).


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