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

 
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4 Central nervous system
04-07-04-01 5HT1 agonists

Sumatriptan
First Choice

Sumatriptan (as Sumatriptan succinate) Tablet 100mg 
Sumatriptan (as Sumatriptan succinate)  Tablet 50mg 

1st line triptan.
(As per Anti-Migraine Prescribing Guide)


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Sumatriptan nasal spray
First Choice

Sumatriptan Aq Nasal Spray 10mg/0.1ml Unit dose
Sumatriptan Aq Nasal Spray 20mg/0.1ml Unit dose

1st line triptan for young people 12-17 years 
(As per Anti-Migraine Prescribing Guide)


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Zolmitriptan
Second Choice

Zolmitriptan Orodispersible Tablets 2.5mg
Zolmitriptan Orodispersible Tablets 5mg
Zolmitriptan Tablets 2.5mg
Zolmitriptan Tablets 5mg

2nd line triptan. 
(As per Anti-Migraine Prescribing Guide)

NICE (CG150) recommends this for Menstrual-related Migraine. If this is not tolerated then consider Frovatriptan 2.5mg tablets instead (Unlicensed indication).

Link  NICE CG150: Headaches in over 12s: diagnosis and management
 

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Almotriptan Almogran®
Third Choice

Almotriptan (as Almotriptan hydrogen malate) Tablets 12.5mg

3rd line triptan
(As per Anti-Migraine Prescribing Guide)


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Rizatriptan Maxalt®
Fourth Choice

Rizatriptan (as Rizatriptan benzoate) Orodispersible Tablets 10mg
Rizatriptan (as Rizatriptan benzoate) Tablets 5mg
Rizatriptan (as Rizatriptan benzoate) Tablets 10mg
Rizatriptan (as Rizatriptan benzoate) Oral Lyophilisates 10mg

4th line triptan
(As per Anti-Migraine Prescribing Guide)


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Frovatriptan
Formulary

Frovatriptan (as Frovatriptan succinate monohydrate) Tablets 2.5mg

Restriction: For menstrual-related migraine not responding to standard treatment. (As per Anti-Migraine Prescribing Guide)

NICE (CG150) Recommend this for Menstrual-related Migraine. If this is not tolerated then consider Zolmitriptan 2.5mg tablets instead (Unlicensed indication).

Link  NICE CG150: Headaches in over 12s: diagnosis and management
 

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Zolmitriptan nasal spray Zomig®
Formulary

Zolmitriptan 5mg/0.1ml Nasal Spray 0.1mg unit dose

Not for children under 18 years
(As per Anti-Migraine Prescribing Guide)

1 spray of Zomig® nasal spray = 5 mg zolmitriptan.


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