University Hospitals Birmingham NHS Foundation Trust

Chapters

Status Drug name NICE TAs Comments
Status: Red Brivaracetam (Briviact ®) injection
Status: Amber Brivaracetam (Briviact®)

Initiation by Tertiary Epilepsy Specialist only. For adjunctive therapy in the treatment of partial-onset seizures with or without secondary generalisation in adult and adolescent patients from 16 years of age, with severe refractory epilepsy warranting tertiary specialist input for patients who have tried three or more AEDs. The patient has used levetiracetam and has documentation of intolerance and patient is using a third line agent (perampanel, zonisamide, lacosamide, eslicarbazepine) which would be replaced by brivaracetam. ESCA required.

Status: Red Cannabidiol (Epidyolex®)
Status: Green Carbamazepine M/R tablets

Tegretol

Status: Green Carbamazepine SF liquid

Tegretol

Status: Green Carbamazepine suppositories

Tegretol

Status: Green Carbamazepine tablets

Tegretol

Status: Amber Cenobamate (Ontozry®)
Status: Amber Clobazam tablets

MHRA Category 2: the need for continued supply of a particular manufacturer’s product should be based on clinical judgement and consultation with patient and/or carer, taking into account factors such as seizure frequency and treatment history

Status: Red Clonazepam injection

MHRA Category 2: the need for continued supply of a particular manufacturer’s product should be based on clinical judgement and consultation with patient and/or carer, taking into account factors such as seizure frequency and treatment history

Status: Amber Clonazepam tablets

MHRA Category 2: the need for continued supply of a particular manufacturer’s product should be based on clinical judgement and consultation with patient and/or carer, taking into account factors such as seizure frequency and treatment history

Status: Red Diazepam emulsion injection
Status: Red Diazepam injection#4.8
Status: Green Diazepam rectal tubes
Status: Amber Eslicarbazepine tablets

ESCA. MHRA - Category 2

Status: Amber Ethosuximide capsules

MHRA - Category 3

Status: Red Fenfluramine
Status: Amber Gabapentin capsules#4.8
Status: Amber Gabapentin tablets#4.8

High relative cost

Status: Red Lacosamide injection
Status: Amber Lacosamide syrup

ESCA

Status: Amber Lacosamide tablets

ESCA

Status: Amber Lamotrigine dispersible tablets
Status: Amber Lamotrigine tablets
Status: Red Levetiracetam infusion
Status: Amber Levetiracetam SF oral solution
Status: Amber Levetiracetam tablets
Status: Green Midazolam buccal liquid - buccolam
Status: Amber Oxcarbazepine suspension
Status: Amber Oxcarbazepine tablets
Status: Amber Paraldehyde rectal solution 50% in olive oil (10ml)
Status: Amber Perampanel tablets

ESCA

Status: Amber Phenobarbital 50mg/5ml liquid (unlicensed)

Ethanol free

Status: Red Phenobarbital injection

Hospital only

Status: Amber Phenobarbital tablets
Status: Amber Phenytoin capsules
Status: Red Phenytoin sodium injection

Hospital only

Status: Amber Phenytoin suspension
Status: Amber Pregabalin capsules

Prescribers should prescribe generically.

Status: Amber Primidone tablets
Status: Amber Rufinamide tablets

ESCA

Status: Amber Sodium valproate crushable tablets
Status: Amber Sodium valproate E/C tablets
Status: Red Sodium valproate injection
Status: Amber Sodium valproate M/R tabs
Status: Amber Sodium valproate SF liquid
Status: Red Stiripentol

APC supports the continuation treatment in adults for those started as children (off label use). Inheriting BCH RAG status. 

Status: Amber Toripamate tablets
Status: Amber Vigabatrin tablets

ESCA

Status: Amber Zonisamide capsules
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