North East and North Cumbria
ICS Formulary
 
back
4 Central nervous system
04-04 CNS stimulants and other drugs used for attention deficit hyperactivity disorder

Methylphenidate
Formulary

Prescribe by brand name

  • 5mg & 10mg tablets
  • 5mg, 10mg, 20mg, 30mg and 40mg m/r capsules (Medikinet®Black Triangle XL)
  • 10mg, 20mg & 30mg m/r capsules (Equasym® XL)
  • 18mg, 27mg, 36mg & 54mg m/r tablets (first choice: Atenza® XL; second choice: Xaggitin® XL)
    • Existing patients who are prescribed Concerta® XL should be reviewed and switched to an appropriate bioequivalent option
    • Atenza XL and Xaggitin XL are bioequivalent to Concerta XL
  • 2mg/ml oral solution sugar free (Consilient Health Ltd). Only for those patients unable to take solid dosage forms across the whole dosage range. This preparation contains the following excipients with known effect: Propylene glycol 90mg/ml, Sorbitol 175mg/ml, Sodium benzoate 1mg/ml NPPG Position statement ‘Choosing an Oral Liquid Medicine for Children’ advises on maximum content of propylene glycol and benzoates dependent on age.

 

Approved for use: 

  • in line with NENC shared care protocols in adults and children aged 6-17 years for treatment of:

    • ADHD
    •  Narcolepsy
  • improving working memory and processing speed following neurocognitive damage secondary to brain injury from; a brain tumour and its associated treatment (e.g. hydrocephalus and radiotherapy) or neurotoxic chemotherapy.

See also: formulary entry in chapter 7 for management of giggle incontinence.

Link  MHRA Drug Safety Update (Sep 2022): Methylphenidate long-acting (modified-release) preparations: caution if switching between products due to differences in formulations
Link  NENC Shared Care Protocol – Methylphenidate for patients within adult services
Link  NENC Shared Care Protocol – Methylphenidate for patients within children’s services
Link  North of Tyne, Gateshead and North Cumbria Shared Care Guideline - Methylphenidate secondary to brain injury

Controlled Drug  Amber View adult BNF  View SPC online  View childrens BNF
Atomoxetine
Formulary
  • 10mg, 18mg, 25mg, 40mg, 60mg, 80mg & 100mg capsules
  • 4mg/1ml oral solution - approved for patients with more complex needs e.g. younger patients and those with swallowing difficulties.

Approved for use in line with NENC shared care protocols for treatment of ADHD in adults and children aged 6-17 years

Link  NENC Shared Care Protocol – Atomoxetine for patients within adult services
Link  NENC Shared Care Protocol – Atomoxetine for patients within children’s services

Amber View adult BNF  View SPC online  View childrens BNF
Dexamfetamine
Formulary
  • 5mg, 10mg and 20mg tablets

Approved for use in line with NENC shared care protocols in adults and children aged 6-17 years for treatment of:

  • ADHD
  •  Narcolepsy

 

Link  NENC Shared Care Protocol – Dexamfetamine for patients within adult services
Link  NENC Shared Care Protocol – Dexamfetamine for patients within children’s services

Controlled Drug  Amber View adult BNF  View SPC online  View childrens BNF
Lisdexamfetamine
Formulary
  • 20mg, 30mg, 40mg, 50mg, 60mg & 70mg capsules

 

Approved for use in line with NENC shared care protocols as a first line pharmacological treatment option for children aged 6-17 years and adults with ADHD who have been appropriately diagnosed, or as an alternative treatment when the response to a 6-week trial of methylphenidate is considered clinically inadequate.

 

Link  NENC Shared Care Protocol – Lisdexamfetamine for patients within adult services
Link  NENC Shared Care Protocol – Lisdexamfetamine for patients within children’s services

Controlled Drug  Amber View adult BNF  View SPC online  View childrens BNF
Modafinil
Formulary
  • Approved for:
    • treatment of patients with narcolepsy
    • treatment of idiopathic hypersomnia


 

Link  MHRA Drug Safety Update (Nov 2020): Modafinil (Provigil): increased risk of congenital malformations if used during pregnancy

Green plus View adult BNF  View SPC online  View childrens BNF
Solriamfetol  Sunosi®
Formulary
  • 75mg and 150mg tablet
    • Approved for treating excesive daytime sleepiness caused by narcolepsy in line with NICE

 

 

Link  NICE TA758: Solriamfetol for treating excessive daytime sleepiness caused by narcolepsy
Link  NICE TA777: Solriamfetol for treating excessive daytime sleepiness caused by obstructive sleep apnoea (Not Recommended)

Red View adult BNF  View SPC online  View childrens BNF
Pitolisant Wakix®
Formulary
  • Approved for use in patients with narcolepsy who experience psychomotor side effects with modafinil and dexamfetamine.
  • To be used in line with NTAG

 

Link  NICE TA776: Pitolisant hydrochloride for treating excessive daytime sleepiness caused by obstructive sleep apnoea (NOT RECOMMENDED BY NICE)
Link  NTAG - Treatment Appraisal Decision Summary - Pitolisant (Wakix®) for the treatment of narcolepsy with or without cataplexy in adults.
Link  NTAG - Pitolisant for Narcolepsy Treatment Pathway

Red View adult BNF  View SPC online  View childrens BNF
Guanfacine Intuniv®
Formulary
  • 1mg, 2mg, 3mg & 4mg prolonged release tablets

 

Approved for use in line with NENC shared care protocols for treatment of ADHD in

  • adults (off-label) - should only be considered on the advice of a tertiary ADHD service, for people who have not responded to one or more stimulants, and one non-stimulant
  • children aged 6-17 years - for people who have not responded to one or more stimulants, and one non-stimulant
Link  NENC Shared Care Protocol – Guanfacine for patients within adult services
Link  NENC Shared Care Protocol – Guanfacine for patients within children’s services

Amber View adult BNF  View SPC online  View childrens BNF