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
Formulary
  • Buccolam® 5mg in 1ml alcohol-free buccal solution, and Buccolam® 2.5mg, 5mg, 7.5mg and 10mg prefilled oral syringes are approved as first choice for status epilepticus in children aged 3 months to 18 years. 
  • Epistatus® 10mg in 1ml oromucosal solution pre-filled oral syringes are approved for use in the treatment of epileptic seizures in patients 3 months old and over. Use in patients under 3 months is off-label.

 

  • 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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