FTG approved for focal spasticity in limbs, migraine, vaginismus, blepharospasm, hemifacial spasm, and anal fissure. All usage in accordance to trust agreed pathways and guidelines.

In psychoses and related disorders this is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary and for nausea and labyrinth disorders it is Red.

Patches - Pain clinic & Injection - ITU/NNU

Initiation and maintenance by Mental Health team.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary

For peri-operative sedation this is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is AI (can be prescribed in primary care after specialist initiation by the Mental Health team) in the Black Country IMOG formulary.

Neurologists and Parkinson's disease. Prescribe generically.

This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

The injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Prescribe generically.

This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

Consultant Neurologists and Consultant Paediarticians specialising in neuro-disability or epilepsy.

This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

Not regularly stocked in the Trust. This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only and AI (can be prescribed in primary care after specialist initiation) for Parkinson's disease in the Black Country IMOG formulary.

Neurologists and Parkinson's disease.

This is AS (is appropriate for shared care) in the Black Country IMOG formulary.

Suppression of lactation only.

This is AR in the Black Country IMOC formulary, i.e. may be prescribed in primary care after specialist recommendation.

Consultant gynaecologists and endocrinology, (it is also allowed for Neurologists and Parkinson's disease second-line noting MHRA guidance - see chapter 4).

This is AR in the Black Country IMOC formulary, i.e. may be prescribed in primary care after specialist recommendation.

Prescribe generically.

Prescibe generically. Most brands are non-formulary

For consultant neurologists only in patient's who meet the criteria in the shared care agreement.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

Initiation and stabilisation by specialist before transfer to primary care.  Specialist to retain prescribing for minimum of 3 months to establish efficacy/benefit. Second line therapy to entacapone, in patients who fail to respond to, or are intolerant of, entacapone, in situations where apomorphine therapy has been considered. 

Neurologists and Parkinson's disease. Prescribe generically.

This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

Patients of Dr Clarke and Dr Nicholls for third-line use.

This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

Third-line use.

This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

For psychoses and related disorders this is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

For peri-operative sedation this is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is Red in the Black Country IMOG formulary, i.e for hospital prescribing only, for substance misuse after specialist initiation and maintenance.

The patches are Green for pain.

For palliative care methadone is AI in the Black Country IMOC formulary, i.e. for prescribing in primary care after specialist initiation

As per protocol for patients with opioid dependence in accordance with the NICE guidelines and criteria.

See indiviudal products for formulary status

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only, but Black for use in pain.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only, but Black for use in pain.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

lidocaine 2% with adrenaline 1 in 80,000 is restricted to dental, ENT and local anaesthesia by those experienced.

The 4% cream and 5% ointment ares Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Pain Clinic for neuropathic pain. For post hepatic neuralgia this is Green in the Black Country IMOG formulary.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Theatres.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Theatres.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

The 400mg in 200ml infusion is restricted to the Enhanced Recevery protocol only

This is Red in the Black Country formulary, i.e. for hospital prescribing only.

Donepezil has the lowest acquistion costs and should be used first-line for continuation of treatment.

This is AS (is suitable for shared care) in the Black Country IMOG formulary.

Donepezil has the lowest acquistion costs and should be used first-line.
Galantamine can be continued in patients who are stable on it.

This is AS (is suitable for shared care) in the Black Country IMOG formulary.

Donepezil has the lowest acquistion costs and should be used first-line
Memantine can be continued in patients who are stable on it.

This is AS (is suitable for shared care) in the Black Country IMOG formulary.

Acute mania, add-on therapy for patients who have not responded adequately to SSRIs in obsessive-compulsive disorder, and schizophrenia according to NICE guidelines.

For use in psychoses and related disorders this is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

The oral solution is second-line and the orodispersible tablet third-line.

Donepezil has the lowest acquistion costs and should be used first-line
The capsules can be continued in patients stable on the drug

This is AS (is suitable for shared care) in the Black Country IMOG formulary.

Second-line agent in patients who have failed with 5HT₃ antagonists.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

In psychoses and related disorders this is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary and for nausea and labyrinth disorders it is Red.

The injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Palliative care use only.

The injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

For peri-operative use the injection is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

The injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Second line treatment - after antihistamines have been tried. Prescribe generically.

This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

The injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Prescribe generically.

Suitable for self-care/purchase, if appropriate, for short term use for insomnia, urticaria, allergies, and travel sickness.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

The 5mg in 10ml  and 1mg in 2ml strengths are restricted to Theatres.

This is Red (hospital prescribing only) in the Black Country IMOC formulary for per-operative analgesia, and AR (can be prescribed in primary care after specialist recommendation) for pain relief in palliative care patients with advanced renal disease.

Dispersible tablets and suppositories for use in the Trust only.

Enteric coated tablets are for second-line use and for blister packs.

Gastro-resistant tablets are available for the PGD for patients at moderate or high risk of pre-eclampsia ONLY

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only, but Black for use in pain.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only, but Black for use in pain.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is Red in the Black Country IMOG formulary, i.e for hospital prescribing only, for substance misuse after specialist initiation and maintenance.

The patches are Green for pain.

The 15/300 tablets are first line. The 8/300 tablets are oral solution are Black in the Black Country IMOG formulary.

The effervescent tablets are restricted to patients with swallowing difficulties.

The capsules are 2nd line - only to be considered for patients unable to swallow tablets and where salt content with effervescent formulation would not be favourable for those patients requiring good blood pressure control.

The injection is restricted to A&E, ITU only and is Red in the Black Country IMOG formulary.

Codeine is now contraindicated in children under the age of 12.

See MHRA advice here

Please prescribe generically, branded products are Black in the Black Country IMOG formulary

Theatres, ITU, Pain team and Consultants in palliative care.

The injection is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

For use in pain products are restricted to Palliative Care specialists and are AR. Fencino and Mezolar Matrix are the preferred brands of patches.

The lozenges and spray are Black and non-formulary.

This is Black for pain but AR for cancer pain and palliative care.

Please prescribe generically. The injection and any use for dysmenorrhoea is Red in the Black Country IMOG formulary, i.e. for hospital prescribing only.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Palliative care use only.

The injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Gynaecology for dysmennorhoea only. Please prescribe generically, all branded products, tablets and oral suspension are Black in the Black Country IMOG formulary.

For palliative care methadone is AI in the Black Country IMOC formulary, i.e. for prescribing in primary care after specialist initiation

As per protocol for patients with opioid dependence in accordance with the NICE guidelines and criteria.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

XL formulations only to be used when twice daily MR prearations are not suitable and ONCE daily preparation is required. XL more expensive.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

For use in palliative care this is AR in the Black Country IMOC formulary, i.e can be prescribed in primary care after specialist recommendation. Check preferred brands.

See MHRA Drug Safety Update

Suppositories should be used when the oral route is not available or suitable.

The infusion is restricted to patients who are unable to take oral medications and is Red (for hospital prescribing only) in the Black Country IMOG formulary.

N.B. There have been cases of accidental overdosing with IV paracetamol. Please ensure that your dose is appropriate for the weight of your patient.

The British National Formulary (BNF) suggests caution in patients with hepatocellular insufficiency, chronic alcoholism, chronic malnutrition or dehydration, and to administer a maximum daily infusion dose of 3 g in adults in these patient groups.

In patients who have exceeded a maximum daily dose of 60 mg/kg please discuss urgently with the Clinical Toxicology team or National Poisons Information Service (NPIS).

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Theatres.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

The 400mg in 200ml infusion is restricted to the Enhanced Recevery protocol only

Rheumatology consultants and Pain team (see also acute pain guidelines).

The injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Patches - Pain clinic & Injection - ITU/NNU

Please prescribe generically.

Tablets are AR (can be prescribed in primary care after specilaist recommendation) for cluster headaches only in the Black Country IMOG formulary.

FTG approved for focal spasticity in limbs, migraine, vaginismus, blepharospasm, hemifacial spasm, and anal fissure. All usage in accordance to trust agreed pathways and guidelines.

Patches - Pain clinic & Injection - ITU/NNU

The injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Blueteq form must be completed where available for this drug and required indication. Please contact the Pharmacy High Cost Drug team if any support needed.

https://www.blueteq-secure.co.uk/Trust/default.aspx

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Second-line for patients who have failed oral treatments

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

The injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

The injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Prescribe generically.

See MHRA guidance on prescribing 

https://www.gov.uk/guidance/valproate-use-by-women-and-girls

This is AR (can be prescribed in primary care after specialist recommendation) in men and women of non-childbearing potential in the Black Country IMOG formulary.

This is AS (is suitable for shared care) for use in women of childbearing potential and girls.

This is Red (for hospital prescribing only) in pregnancy, in women planning pregnancy an in women of childbearing potential where PREVENT applies, who decline or are unable to use effective contraception.

Please prescribe generically.

This is AR in the Black Country formulary, i.e. may be prescribed in primary care after specialist recommendation.

Consultant Neurologists and Consultant Paediatricians specialising in neuro-disability or epilepsy.

For use in migraine this is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

Drug Safety Update January 2015

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

Not regularly stocked in the Trust. This is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only and AI (can be prescribed in primary care after specialist initiation) for Parkinson's disease in the Black Country IMOG formulary.

Qutenza is Red in the Black Country IMOC formulary, i.e. for hospital prescribing only.

Please prescribe by brand.

For psychoses and related disorders this is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

Please see January 2026 MHRA Drug Safety Update regarding addiction, dependence, withdrawal, and tolerance for gabapentin, pregabalin, benzodiazepines, and z-drugs.

The oral solution is for second-line use.

The oral solution is Black in the Black Country IMOG formulary for neuropathic pain but allowed for hospital use as an antidepressant.

For use in palliative care this is AR in the Black Country IMOC formulary, i.e can be prescribed in primary care after specialist recommendation. Check preferred brands.

See MHRA Drug Safety Update

The solution for injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Please see January 2026 MHRA Drug Safety Update regarding addiction, dependence, withdrawal, and tolerance for gabapentin, pregabalin, benzodiazepines, and z-drugs.

Pain Clinic, otherwise for continuation of treatment.

For neuropathic pain the capsules are first-line and oral solution second-line.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Theatres only.

Theatres.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Theatres, ITU.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Please prescribe generically.

Theatres.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Theatres, ITU, A&E.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Please prescribe generically, the branded products are non-formulary.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Please prescribe generically

Theatres, ITU, NNU.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Theatres, ITU.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

NNU.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Theatres, ITU.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Theatres, ITU, ED.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Theatres, ITU.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

For perioperative sedation only this is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Use of dexmedetomidineis restricted to Critical Care consultants according to the published guidelines.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

For peri-operative sedation this is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

10mg/ ml - Neonates, for caudal anaesthesia in paediatrics by those experienced ---
50mg/ ml - Theatres, ITU, A&E, pain team

For peri-operative use the injection is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

The 50mg in 50ml and 10mg in 5ml strengths are restricted to ITU.

The 10mg in 2ml is restricted to palliative care for the indication of catastrophic bleed, or stridor in community, and seizures.

For status epilepticus prescribe as Buccolam brand.

Buccal product for use in status epilepticus for patients attending school.

Please prescribe generically.

Theatres, ITU.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Please prescribe generically.

Theatres, ITU.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Please prescribe generically.

N.B. only the 1mg preparation is stocked for theatres; 5mg vials strictly for ITU use only

For peri-operative sedation this is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Theatres.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Theatres.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

The 5mg in 10ml  and 1mg in 2ml strengths are restricted to Theatres.

This is Red (hospital prescribing only) in the Black Country IMOC formulary for per-operative analgesia, and AR (can be prescribed in primary care after specialist recommendation) for pain relief in palliative care patients with advanced renal disease.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is Red in the Black Country IMOG formulary, i.e for hospital prescribing only, for substance misuse after specialist initiation and maintenance.

The patches are Green for pain.

Theatres, ITU, Pain team and Consultants in palliative care.

The injection is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

For use in pain products are restricted to Palliative Care specialists and are AR. Fencino and Mezolar Matrix are the preferred brands of patches.

The lozenges and spray are Black and non-formulary.

Please prescribe generically. The injection and any use for dysmenorrhoea is Red in the Black Country IMOG formulary, i.e. for hospital prescribing only.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

30mg in 1ml only - Theatre recovery, ITU

Gynaecology for dysmennorhoea only. Please prescribe generically, all branded products, tablets and oral suspension are Black in the Black Country IMOG formulary.

For use in palliative care this is AR in the Black Country IMOC formulary, i.e can be prescribed in primary care after specialist recommendation. Check preferred brands.

See MHRA Drug Safety Update

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Theatres, ITU.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Please prescribe generically.

N.B. only the 1mg preparation is stocked for theatres; 5mg vials strictly for ITU use only

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is Black for high-altitude sickness and Red (for hospital prescribing only) for epilepsy in the Black Country IMOG formulary. 

For ophthalmological indications the injection is Red and oral formulations are AR

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary except the injection is Red (for hospital prescribing only) 

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

This is commssioned by NHSE for the indications below and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

Any other use is non-formulary and the non-formulary request process should be followed. 

Adjuvant treatment of seizures associated with Dravet syndrome or Lennox-Gastaut syndrome

For psychoses and related disorders this is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

Consultant Neurologists and Consultant Paediatricians specialising in neuro-disability or epilepsy.

This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

To be initiated by consultant paediatricians with epilepsy interest/consultant neurologists. Prescribe the most cost-effective brand in primary care.

This is AS (is suitable for shared care) in the Black Country IMOG formulary.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

This is commssioned by NHSE for the indications below and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required.

Dravet syndrome

Please see January 2026 MHRA Drug Safety Update regarding addiction, dependence, withdrawal, and tolerance for gabapentin, pregabalin, benzodiazepines, and z-drugs.

The oral solution is for second-line use.

Only the solution for infusion is formulary and Red (for hospital prescribing only) in the Black Country IMOG formulary.

Third-line use. Prescribe generically. This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary

Consultant Neurologists and Consultant Paediatricians specialising in neuro-disability or epilepsy.

Prescribe generically. The solution for infusion is Red (for hospital prescribing only) in the Black Country IMOG formulary.

TFor prevention of seizures this is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Neurology.

This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

Consultant Neurologists or Associate Specialists in Neurology for third- or fourth-line use in accordance with a RICaD.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

The oral solution is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary but the solution for injection is Red.

The solution for injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Please see January 2026 MHRA Drug Safety Update regarding addiction, dependence, withdrawal, and tolerance for gabapentin, pregabalin, benzodiazepines, and z-drugs.

Pain Clinic, otherwise for continuation of treatment.

For neuropathic pain the capsules are first-line and oral solution second-line.

Neurologists and in movement disorder.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

See MHRA guidance on prescribing 

https://www.gov.uk/guidance/valproate-use-by-women-and-girls

This is AR (can be prescribed in primary care after specialist recommendation) in men and women of non-childbearing potential in the Black Country IMOG formulary.

This is AS (is suitable for shared care) for use in women of childbearing potential and girls.

This is Red (for hospital prescribing only) in pregnancy, in women planning pregnancy an in women of childbearing potential where PREVENT applies, who decline or are unable to use effective contraception.

Consultant Neurologists and Consultant Paediatricians specialising in neuro-disability or epilepsy.

For use in migraine this is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

Consultant Neurologists and Consultant Paediatricians specialising in neuro-disability or epilepsy.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

Consultant Neurologists or Associate Specialists in Neurology for third- or fourth-line use in accordance with an ESCA

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

For peri-operative sedation this is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

For peri-operative use the injection is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

The 50mg in 50ml and 10mg in 5ml strengths are restricted to ITU.

The 10mg in 2ml is restricted to palliative care for the indication of catastrophic bleed, or stridor in community, and seizures.

For status epilepticus prescribe as Buccolam brand.

Buccal product for use in status epilepticus for patients attending school.

Please prescribe generically.

The oral solution is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary but the solution for injection is Red.

The solution for injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Theatres, ITU, A&E.

This is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is AI (can be prescribed in primary care after specialist initiation by a Mental Health Specialist) in the Black Country IMOG formulary.

For peri-operative sedation this is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Prescribe generically.

For urinary uses the 40 mg strength is the only product available.

Second- or third-line use in anxiety. Prescibe generically.

For peri-operative use the injection is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

In liver impairment or third-line.

This is AI (can be prescribed in primary care after specialist initiation by the Mental Health team) in the Black Country IMOG formulary.

Please see January 2026 MHRA Drug Safety Update regarding addiction, dependence, withdrawal, and tolerance for gabapentin, pregabalin, benzodiazepines, and z-drugs.

Pain Clinic, otherwise for continuation of treatment.

For neuropathic pain the capsules are first-line and oral solution second-line.

Prescribe generically.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

The oral solution is non-formulary.

This is AS (is suitable for shared care) in the Black Country IMOG formulary.

This is AS (is suitable for shared care) in the Black Country IMOG formulary. There is a RMOC ESCA available.

This is AS (is suitable for shared care) in the Black Country IMOG formulary. A RMOC ESCA is available.

Consultant Neurologists and Consultant Paediatricians specialising in neuro-disability.

This is AS (is suitable for shared care) in the Black Country IMOG formulary. An RMOC ESCA is available

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

Consultant dermatologists - 3rd-line use only

Prescribe generically.

For urinary uses the 40 mg strength is the only product available.

Second- or third-line use in anxiety. Prescibe generically.

Prescribe generically.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary following recommendation from the Mental Health team.

This is AS (is suitable for shared care) in the Black Country IMOG formulary.

Any brand can be used but it must remain consistent.

This is AS (is suitable for shared care) in the Black Country IMOG formulary.

Any brand can be used but it must remain consistent.

The tablets are first-line, orodispersible tablets second-line and the oral solution third-line and very expensive.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

The oral solution is Black in the Black Country IMOG formulary for neuropathic pain but allowed for hospital use as an antidepressant.

In liver impairment or third-line.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Acute mania, add-on therapy for patients not responding to SSRIs in obsessive-compulsive disorder, and schizophrenia according to NICE guidelines

Treatment of delirium in intensive care (second-line use)

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary. The XL tablets are AR

Prescribe generically.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

The oral solution is non-formulary.

This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

For third-line use.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

Please prescribe generically.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary but the injection is Red.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary and requires prior approval of the Black Country Healthcare NHS Foundation Trust.

In psychoses and related disorders this is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary and for nausea and labyrinth disorders it is Red.

Initiation and maintenance by Mental Health team.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Psychiatrists.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

For treatment of psychoses and schizophrenia it is restricted to Psychiatrists.

This is AI (can be prescribed in primary care after specialist initiation) for psychoses and related disorders in the Black Country IMOG formulary and AR in nausea and vertigo and sssential tremor, chorea, tics, and related disorders.

It is Black for dystonia or or involuntary movement in Parkinsons Disease.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary and requires prior approval of the Black Country Healthcare NHS Foundation Trust.

Acute mania and schizophrenia in accordance with NICE guidelines.
Treatment of delirium in intensive care (second-line use).

This is Red in the Black Country IMOG formulary, i.e. can only be prescribed in hospital and requires prior approval of the Black Country Healthcare NHS Foundation Trust.

Acute mania and schizophrenia in accordance with NICE guidelines

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

The oral form is for Mental Health use only and requires prior approval of the Black Country Healthcare NHS Foundation Trust.

This is AI (can be prescribed in primary care after specialist initiation by the Mental Health team) in the Black Country IMOG formulary.

The injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Prescribe generically.

Acute mania, add-on therapy for patients not responding to SSRIs in obsessive-compulsive disorder, and schizophrenia according to NICE guidelines

Treatment of delirium in intensive care (second-line use)

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary. The XL tablets are AR

Acute mania, add-on therapy for patients who have not responded adequately to SSRIs in obsessive-compulsive disorder, and schizophrenia according to NICE guidelines.

For use in psychoses and related disorders this is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

The oral solution is second-line and the orodispersible tablet third-line.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

The tablet is first line and the oral solution, which is very epxensive, is for those with swallowing difficulties only.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary but the solution for injection is Red.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Please prescribe generically.

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary but the injection is Red.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary and requires prior approval of the Black Country Healthcare NHS Foundation Trust.

For psychoses and related disorders this is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary.

In psychoses and related disorders this is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary and for nausea and labyrinth disorders it is Red.

Third-line use. Prescribe generically. This is AR (can be prescribed in primary care after specialist recommendation) in the Black Country IMOG formulary

This is AS (is suitable for shared care) in the Black Country IMOG formulary.

Any brand can be used but it must remain consistent.

This is AS (is suitable for shared care) in the Black Country IMOG formulary.

Any brand can be used but it must remain consistent.

Acute mania and schizophrenia in accordance with NICE guidelines.
Treatment of delirium in intensive care (second-line use).

This is Red in the Black Country IMOG formulary, i.e. can only be prescribed in hospital and requires prior approval of the Black Country Healthcare NHS Foundation Trust.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

The oral form is for Mental Health use only and requires prior approval of the Black Country Healthcare NHS Foundation Trust.

The injection is Red (for hospital prescribing only) in the Black Country IMOG formulary.

Prescribe generically.

Acute mania, add-on therapy for patients not responding to SSRIs in obsessive-compulsive disorder, and schizophrenia according to NICE guidelines

Treatment of delirium in intensive care (second-line use)

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary. The XL tablets are AR

See MHRA guidance on prescribing 

https://www.gov.uk/guidance/valproate-use-by-women-and-girls

This is AR (can be prescribed in primary care after specialist recommendation) in men and women of non-childbearing potential in the Black Country IMOG formulary.

This is AS (is suitable for shared care) for use in women of childbearing potential and girls.

This is Red (for hospital prescribing only) in pregnancy, in women planning pregnancy an in women of childbearing potential where PREVENT applies, who decline or are unable to use effective contraception.

Drug Safety Update January 2015

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

NNU, or in line with childhood sedation policy.

For peri-operative sedation this is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

Prescribe generically.

Slenyto is also approved for ASD and Smith-Magenis syndrome

Suitable for self-care/purchase, if appropriate, for short term use for insomnia, urticaria, allergies, and travel sickness.

For peri-operative sedation this is Red in the Black Country IMOC formulary, i.e for hospital prescribing only.

This is AS (is suitable for shared care) in the Black Country IMOG formulary. There is a RMOC ESCA available.

Consultant Neurologists and Consultant Paediatricians specialising in neuro-disability.

This is AS (is suitable for shared care) in the Black Country IMOG formulary. An RMOC ESCA is available

This is AI (can be prescribed in primary care after specialist initiation) in the Black Country IMOG formulary.

This is commssioned by NHSE for the indications below and a Blueteq form must be completed before prescribing. Please contact the Pharmacy High-Cost Drugs team if any assistance is required

Symptom control of narcolepsy with cataplexy in patients aged 7 to 18 years of age treated in a paediatric service

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.

This is Red (for hospital prescribing only) in the Black Country IMOG formulary.