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

 
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4 Central nervous system
04-07-04-02 Prophylaxis of migraine

Propranolol Hydrochloride
First Choice

Propranolol Hydrochloride Tablet 10mg 
Propranolol Hydrochloride Tablet 40mg
Propranolol Hydrochloride Tablet 80mg 
Propranolol Hydrochloride Tablet 160mg 
Propranolol Hydrochloride MR Capsule 80mg
Propranolol Hydrochloride MR Capsule 160mg
Propranolol Hydrochloride Oral Solution 5mg/5ml
Propranolol Hydrochloride Oral Solution 10mg/5ml
Propranolol Hydrochloride Oral Solution 40mg/5ml
Propranolol Hydrochloride Oral Solution 50mg/5ml

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


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Topiramate
First Choice

Topiramate Tabs 25mg
Topiramate Tabs 50mg
Topiramate Tabs 100mg 
Topiramate Tabs 200mg

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


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Gabapentin
Second Choice

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

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

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


Controlled Drug  Green View adult BNF  View SPC online  View childrens BNF
Sodium valproate
Second Choice

Sodium Valproate Tablet 100mg 
Sodium Valproate Tablet 300mg M/R 
Sodium Valproate Tablet 500mg M/R 
Sodium Valproate Tablet E/C 200mg 
Sodium Valproate Tablet E/C 500mg 
Sodium Valproate Oral Solution 200mg/5ml S/F

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

Contraindicated in women of childbearing potential unless part of the Pregnancy Prevention Programme (MHRA, March 2018).

Women of Childbearing Potential: Educational Risk Minimisation Materials

Patient Card – to be given by pharmacists to all female patients who are dispensed valproate medicines to inform them of the risks


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Amitriptyline Hydrochloride
Formulary

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

For patients already established
(As per Anti-Migraine Prescribing Guide)


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Botulinum Toxin Type A Botox®
Formulary

Restriction: In line with NICE Guidance only

Commissioned by the CCG for chronic migraine and other agreed indications.

Link  NICE TA260: Botulinum toxin type A for the prevention of headaches in adults with chronic migraine
 

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Fremanezumab Ajovy®
Formulary

Restriction: In line with NICE Guidance only

Link  NICE TA631: Fremanezumab for preventing migraine
 

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Galcanezumab Emgality®
Formulary

Restriction: In line with NICE Guidance only

Link  NICE TA659: Galcanezumab for preventing migraine
 

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