Shared Care Protocol for the Management of Attention Deficit Hyperactivity Disorder (ADHD) for DONCASTER: children, adolescents and adults BASSETLAW: children and adolescents (upto age 17yrs 364 days) click here & for Proforma click here
Modafinil in Narcolepsy Shared Care Protocol & Proforma click here
ADHD
Use as part of a comprehensive treatment programme for attention-deficit/ hyperactivity disorder in children aged ≥6 years and adults when remedial measures alone prove insufficient
Rationale:1,2,3
Restricted Prescribing
Refer to Shared Care Protocol & Proforma
MR methylphenidate products should be prescribed by brand and are not interchangeable under normal circumstances, but where there are stock shortages product substitution should be made with caution and following the SPS guidance. For more information click here
Brands:
- Affenid XL tablets
- Concerta XL tablets
- Delmosart tablets
- Equasym XL capsules
- Matoride XL tablets
- Medikinet XL capsules
- Meflynate XL capsules
- Metyrol XL capsules
- Xaggitin XL tablets
- Xenidate XL tablets
Methylphenidate long-acting (modified-release) preparations: caution if switching between products due to differences in formulations Drug Safety Update Sept 2022
Advice To Community Pharmacy Teams Re ADHD (Methylphenidate) Stock Shortages Sent On Behalf Of NHS South Yorkshire Integrated Care Board (ICB) Dear Pharmacy Teams, As part of the actions taken to help mitigate the impact of the shortage on patients and healthcare professional, South Yorkshire ICB colleagues are working to explore ways to support Practices and Pharmacies, help meet the supply needs of their patients. In Rotherham and Doncaster: working with RDaSH, ICB colleagues have produced a MethylPhenidate M/R Preparations Comparison Aid to support Practices and Pharmacies with recommending/prescribing alternatives. In addition, local Prescribers would greatly welcome any ADHD stock availability intel Pharmacies are able to share to support prescribing decisions. Please use Feedback Form link or scan QR code to feedback what you have/can get in-stock. ADHD Medication Stock Availability – Feedback Form In Rotherham: polite reminder that since March 2024, Accurx OOS process became the preferred way for Pharmacies to contact GPs re medicines out-of-stocks for ALL Rotherham GP Practices. The Accurx OOS process streamlines medicine availability/stock communications (between CPs to GPs) into “one single way”, aiding prompt responses to queries and reducing workload for both parties. If you are not already using or have any questions re Accurx OOS process, please use this link, to sign-up and/or further info. Useful ADHD References:
Reminder: SPS Medicines Supply Tool provides info on most supply issues, actions to take, alternatives to use and expected resolution dates. (Content regularly updated by DHSC and CMU) |
Pack | Price |
---|---|
30 capsule | £25.00 |
Pack | Price |
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30 capsule | £30.00 |
Pack | Price |
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30 capsule | £35.00 |
Pack | Price |
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30 capsule | £57.72 |
Review Date: 01/07/2023
Dexamfetamine Tablets
ADHD
Brand: Dexedrine
Restricted Prescribing
Refer to Shared Care Protocol & Proforma
Rationale: 1,2,6,8
NICE NG87
Attention deficit hyperactivity disorder: diagnosis and management
NICE CG 158 Antisocial behaviour and conduct disorders in children and young people: recognition and management
Pack | Price |
---|---|
28 tablet | £21.24 |
Review Date: 01/07/2023
Atomoxetine Capsules
ADHD
Brand : Strattera
Restricted Prescribing
Refer to Shared Care Protocol & Proforma
NICE NG87 Attention deficit hyperactivity disorder: diagnosis and management
NICE CG158 Antisocial behaviour and conduct disorders in children and young people: recognition and management
Drug safety update Volume 2, Issue 8 March 2009
Pack | Price |
---|---|
28 capsule | £59.05 |
Pack | Price |
---|---|
28 capsule | £58.67 |
Pack | Price |
---|---|
28 capsule | £58.55 |
Pack | Price |
---|---|
28 capsule | £57.21 |
Pack | Price |
---|---|
28 capsule | £62.03 |
Pack | Price |
---|---|
300 ml | £85.00 |
Review Date: 01/07/2023
ADHD in children and adolescents
Brand: Intuniv
Restricted prescribing
Refer to Shared Care Protocol & Proforma
NICE NG87 Attention deficit hyperactivity disorder: diagnosis and management
Pack | Price |
---|---|
28 tablet | £56.00 |
Pack | Price |
---|---|
28 tablet | £58.52 |
Pack | Price |
---|---|
28 tablet | £65.52 |
Pack | Price |
---|---|
28 tablet | £76.16 |
Review Date: 01/07/2023
ADHD when response to previous methylphenidate treatment is considered clinically inadequate.
Brand: Elvanse
Refer to Shared Care Protocol
Restricted prescribing
NICE NG87 Attention deficit hyperactivity disorder: diagnosis and management
Review Date: 01/07/2023
ADHD
Rationale: 1,2,6,8
Restricted Prescribing
Refer to Shared Care Protocol & Proforma
NICE NG87 Attention deficit hyperactivity disorder: diagnosis and management
Pack | Price |
---|---|
30 tablet | £3.46 |
Pack | Price |
---|---|
30 tablet | £3.03 |
Review Date: 01/01/2026
Excessive sleepiness associated with narcolepsy with or without cataplexy
Brand : Provigil
Rationale 1,2
Refer to Shared Care Protocol for Modafinil in Narcolepsy
MHRA warns modafinil should not be used during pregnancy and women of childbearing potential must use effective contraception during treatment and for 2 months after stopping modafinil. November 2020
http://www.nice.org.uk/mpc/evidencesummariesunlicensedofflabelmedicines/ESUOM9.jsp
ESU0M9 April 2013
The European Medicines Agency has recommended that the use of modafinil should be restricted to treat only sleepiness associated with narcolepsy, and that it should no longer be used for the treatment of excessive sleepiness associated with obstructive sleep apnoea or chronic shift work sleep disorder.
On the basis of the available data, the Agency's Committee for Medicinal Products for Human Use (CHMP) concluded that the benefits of these medicines only outweighed their risks in the therapeutic indication narcolepsy. For all other indications the Committee found that the risks outweighed the
benefit shown in clinical trials. Therefore, the Committee concluded that all other indications should be withdrawn from the marketing authorisations of these medicines.
MHRA Drug Safety Update Volume 4, Issue 1 August 2010
The MHRA Drug Safety Update has issued a reminder advising that modafinil should be withdrawn in patients who experience a rash or psychiatric symptoms, and makes the following recommendations:
* Modafinil should be discontinued at the first sign of rash and not restarted
* Modafinil should be discontinued in patients who experience any psychiatric symptoms and not restarted *Update 2020* Letter sent to Healthcare Professionals - Modafinil: potential risk of congenital malformations during pregnancy
Pack | Price |
---|---|
30 tablet | £2.07 |
Pack | Price |
---|---|
30 tablet | £8.43 |
Review Date: 01/07/2026
Counteracting sedation with opioids in palliative care (off-label use)
Methylphenidate is indicated for use in opioid-related drowsiness, and depression where prognosis <2-4 weeks.
The dose should be stable before asking the GP to prescribe and is usually within the range of 5mg BD to 20mg BD, where the second daily dose is given around lunchtime.
DBHFT Aug 2015
Pack | Price |
---|---|
30 tablet | £3.46 |
Pack | Price |
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30 tablet | £10.92 |
Pack | Price |
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30 tablet | £3.03 |