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Joint Formulary
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 Formulary Chapter 4: Central nervous system - Full Chapter
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04.07.04.02  Expand sub section  Prophylaxis of migraine
Amitriptyline
(Migraine prophylaxis)
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Formulary
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NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
Botulinum Toxin Type A
(Botox)
(Migraine prophylaxis)
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Formulary
GP - Red
High Cost Medicine
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NOTE: There is more than one monograph for Botulinum toxin type A, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • Positive NICE TA but service not offered at NMUH.
  • RFL:
    • As per NICE TA260
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Link  NICE TA260: Botulinum toxin type A for the prevention of headaches in adults with chronic migraine
Clonidine
(Migraine prophylaxis)
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Restricted Drug Restricted
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NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
Dosulepin
(Migraine prophylaxis, Neuropathic pain, Chronic Headache)
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Formulary
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NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Not approved for any indication in line with NHS England 'Items which should not routinely be prescribed in primary care' guidance (JFC January 2020)

Provider notes

  • NMUH:
    • For contiuation of treatment ONLY
    • Non-formulary for iniation in all indications
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
Nortriptyline
(Tension headache)
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Formulary
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NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Approved for prophylaxis of tension headache (JFC May 2019).

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
    • No restriction stated
  • WH:
    • As above
 
Pizotifen
(Migraine prophylaxis)
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Formulary
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Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
Propranolol
(Migraine prophylaxis)
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Formulary
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NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
Sodium valproate
(Migraine prophylaxis)
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Formulary
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Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Restricted to neurology
    • Patient, prescriber and supplying pharmacy must comply with a pregnancy prevention programme
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • No restriction stated
 
Topiramate
(Migraine)
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Restricted Drug Restricted
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NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Neurology initiation only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Verapamil
(Cluster headache)
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Formulary
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NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Approved for prophylaxis of cluster headache (JFC May 2019).

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
    • No restriction stated
  • WH:
    • No restriction stated
 
 ....
 Non Formulary Items
Erenumab inj

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Non Formulary
Fremanezumab inj

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Non Formulary
GP - Red

See NICE TA for eligibility criteria

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
Link  NICE TA631: Fremanezumab for preventing migraine
Galcanezumab solution for injection

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Non Formulary
GP - Red
Methysergide (Deseril)

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Non Formulary
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
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Link to children's BNF
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Link to SPCs
Homecare
Homecare

Traffic Light Status Information

Status Description

GP - Amber

Medicines that should be initiated by a specialist. Prescribing can be transferred to primary care once the patient has been stabilised.

Shared care: For drugs with regular, ongoing need for monitoring and/or assessment of efficacy or toxicity. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the North Central London JFC.

Fact sheet: For drugs with some concerns surrounding safety or efficacy but do not require regular monitoring and/or monitoring of effectiveness/toxicity.

  

GP - Red

Medicines which should normally be prescribed by specialists only (hospital only).

For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.

See link for the complete NCL Red List https://www.ncl-mon.nhs.uk/wp-content/uploads/2017/08/ncl_red_list.pdf

  

Black

Medicines not recommended for routine use in primary or secondary care.

Medicines, which the North Central London JFC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.

  

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