North East and North Cumbria
ICS Formulary
 
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4 Central nervous system
04-08-02 Drugs used in status epilepticus

Diazepam
Formulary

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Midazolam Oromucosal solution
Formulary

Prescribe by brand

Status epilepticus in children aged 3 months to 18 years.

  • First Choice
    • Buccolam® pre-filled oral syringes (2.5mg/0.5ml, 5mg/1ml, 7.5mg/1.5ml and 10mg/2ml)
  • Alternative
    • Epistatus® oromucosal solution pre-filled oral syringes (10mg in 1ml)
      • Use in patients under 3 months is off-label. 

Status epilepticus in adults (>18 years)

  • Buccolam® pre-filled oral syringe (10mg/2ml only)
  • Epistatus® oromucosal solution pre-filled oral syringes (10mg in 1ml)

Buccolam® products are alcohol free

Injection solutions (section 15.1.4) can also be given buccally - This use is off-label



 

Link  MHRA Letters sent to healthcare professionals (January 2018): Buccolam (midazolam) – risk of inhalation/ingestion of tip cap of prefilled plastic syringes.

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Phenobarbital Sodium
Formulary

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Clonazepam
Formulary

  • For initiation by neurologists only.


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Lorazepam
Formulary

  • For initiation by neurologists only.

  • Lorazepam  2mg/ml suspension & 4mg/ml suspension are also approved but are unlicensedunlicensed.

  • Buccal administration of lorazepam suspensions are only approved for use in paediatrics in children with status epilepticus in whom buccal midazolam, rectal paraldehyde or rectal diazepam are ineffective.Red Traffic Light


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Phenytoin sodium 250mg in 5ml injection
Formulary

 

    • For initiation by neurologists only.

 


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Paraldehyde rectal liquid
Formulary

 

    • For initiation by neurologists only.

 


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