4.2.1 Antiepileptics
MHRA Drug Safety Update and Guidance: Valproate must not be used in any woman or girl able to have children unless there is a pregnancy prevention programme (PPP) in place. Please see MHRA guidance (here) and Drug Safety Update (here) .
Topiramate: introduction of new safety measures, including a Pregnancy Prevention Programme. Topiramate is now contraindicated in pregnancy and in women of childbearing potential unless the conditions of a Pregnancy Prevention Programme are fulfilled. See MHRA Drug Safety Update (here) and Topiramate – Implementing MHRA Safety Measures in Kent & Medway (here).
Please see MHRA advice on the risks of switching between different manufacturers products here
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Documents
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Primary Care
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Secondary Care
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Primary and Secondary Care
Brivaracetam information sheet
Uploaded By:
Renewal: 12/2021
Approved: 12/2021
Last Reviewed: 12/2021
Caution: This document is due for renewal and may be out of date
Document linked to:
| Drug | Section |
|---|---|
| Brivaracetam |
4.2.1 Antiepileptics
|
| Pack | Price |
|---|---|
| 14 tablet | £34.64 |
| Pack | Price |
|---|---|
| 56 tablet | £129.64 |
| Pack | Price |
|---|---|
| 56 tablet | £129.64 |
| Pack | Price |
|---|---|
| 56 tablet | £129.64 |
| Pack | Price |
|---|---|
| 56 tablet | £129.64 |
| Pack | Price |
|---|---|
| 300 ml | £115.83 |
| Pack | Price |
|---|---|
| 10 vial |
| Pack | Price |
|---|---|
| 28 tablet | |
| 500 tablet | |
| 56 tablet | |
| 84 tablet | £2.07 |
| Pack | Price |
|---|---|
| 100 tablet | |
| 28 tablet | |
| 500 tablet | |
| 56 tablet | |
| 84 tablet | £3.83 |
| Pack | Price |
|---|---|
| 100 tablet | |
| 28 tablet | |
| 56 tablet | £5.02 |
| Pack | Price |
|---|---|
| 56 tablet |
| Pack | Price |
|---|---|
| 56 tablet |
| Pack | Price |
|---|---|
| 30 tablet | |
| 50 tablet | |
| 56 tablet | £5.20 |
| 60 tablet |
| Pack | Price |
|---|---|
| 30 tablet | |
| 50 tablet | |
| 56 tablet | £10.24 |
| 60 tablet |
| Pack | Price |
|---|---|
| 1 ml |
| Pack | Price |
|---|---|
| 5 suppository | £120.00 |
| Pack | Price |
|---|---|
| 5 suppository | £177.22 |
Documents
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Primary Care
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Secondary Care
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Primary and Secondary Care
Cenobamate Prescribing v1.3
Uploaded By:
Renewal: 10/2022
Approved: 10/2022
Last Reviewed: 10/2022
Caution: This document is due for renewal and may be out of date
Document linked to:
| Drug | Section |
|---|---|
| Cenobamate |
4.2.1 Antiepileptics
|
Tertiary initiation only
Cenobamate is recommended for treating focal onset seizures in epilepsy, in accordance with NICE TA753
It is indicated for the adjunctive treatment of focal-onset seizures with or without secondary generalisation in adult patients with epilepsy who have not been adequately controlled despite treatment with at least 2 anti-epileptic medicinal products.
NICE recommend Cenobamate only if:
• it is used as an add-on treatment, after at least 1 other add-on treatment has not controlled seizures, and
• treatment is started in a tertiary epilepsy service.
The specialist will initiate the medication accordingly and adjust the dose until the patient is stable.
Patients are expected to reach their stable dose after approximately 3 months, at which point GPs will be asked to continue prescribing. Some patients may require a slower titration, in which case the GP would not be asked to prescribe until the patient has reached their stable dose.
On-going prescribing can be continued by a GP. The responsibility for titrating the dose or stopping treatment due to lack of effect or side effects remains with the specialist. The GP is not expected to titrate the dose.
Specialist Team Contact Details
Email: kch-tr.epilepsycns@nhs.net
Please see Cenobamate prescribing guidance here.
| Pack | Price |
|---|---|
| 14 tablet | £87.36 |
| 28 tablet | £136.50 |
| Pack | Price |
|---|---|
| 14 tablet |
| Pack | Price |
|---|---|
| 14 tablet | £89.18 |
| 28 tablet | £182.00 |
| Pack | Price |
|---|---|
| 14 tablet | £91.00 |
| 28 tablet | £182.00 |
| Pack | Price |
|---|---|
| 14 tablet |
| Pack | Price |
|---|---|
| 14 tablet | £85.54 |
| 28 tablet | £91.00 |
| Pack | Price |
|---|---|
| 100 capsule | £1.84 |
| 50 capsule | |
| 90 capsule |
| Pack | Price |
|---|---|
| 100 capsule | £2.30 |
| 40 capsule | |
| 50 capsule | |
| 90 capsule |
| Pack | Price |
|---|---|
| 100 capsule | £3.05 |
| 30 capsule | |
| 50 capsule | |
| 90 capsule |
| Pack | Price |
|---|---|
| 10 tablet | |
| 100 tablet | £8.64 |
This is a high cost product and it will be more cost effective to prescribe multiples of lower strengths
| Pack | Price |
|---|---|
| 100 tablet | £24.92 |
| Pack | Price |
|---|---|
| 150 ml | £59.71 |
Documents
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Primary Care
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Secondary Care
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Primary and Secondary Care
Eslicarbazepine Prescribing Guidelines - EKPG September 2014
Uploaded By:
Renewal:
Approved:
Last Reviewed:
Document linked to:
| Drug | Section |
|---|---|
| Eslicarbazepine |
4.2.1 Antiepileptics
|
Specialist Initiation Only.
| Pack | Price |
|---|---|
| 30 tablet | £125.86 |
| Pack | Price |
|---|---|
| 112 capsule | |
| 50 capsule | |
| 56 capsule | £186.08 |
| Pack | Price |
|---|---|
| 200 ml | £173.28 |
| Pack | Price |
|---|---|
| 28 capsule | £8.19 |
| Pack | Price |
|---|---|
| 28 capsule | £7.07 |
| Pack | Price |
|---|---|
| 100 capsule | |
| 84 capsule | £9.94 |
| Pack | Price |
|---|---|
| 28 capsule | £10.40 |
| Pack | Price |
|---|---|
| 500 ml | £4.27 |
| Pack | Price |
|---|---|
| 1 tablet | |
| 100 tablet | |
| 112 tablet | |
| 200 tablet | £13.18 |
| Pack | Price |
|---|---|
| 1 ampoule | |
| 10 ampoule | |
| 5 ampoule |
| Pack | Price |
|---|---|
| 100 capsule | |
| 14 capsule | |
| 56 capsule | £1.20 |
| 84 capsule |
| Pack | Price |
|---|---|
| 21 capsule | |
| 56 capsule | |
| 84 capsule | £1.66 |
| Pack | Price |
|---|---|
| 100 capsule | |
| 14 capsule | |
| 56 capsule | £1.32 |
| Pack | Price |
|---|---|
| 21 capsule | |
| 56 capsule | |
| 84 capsule | £1.90 |
| Pack | Price |
|---|---|
| 100 capsule | |
| 14 capsule | |
| 56 capsule | £1.76 |
| Pack | Price |
|---|---|
| 21 capsule | |
| 56 capsule | |
| 84 capsule | £2.57 |
| Pack | Price |
|---|---|
| 56 capsule | £1.91 |
| Pack | Price |
|---|---|
| 56 capsule | £2.43 |
Capsules can be opened and contents dissolve in water for administration. The capsule contents may have an unpleasant taste.
| Pack | Price |
|---|---|
| 473 ml | £87.41 |
| 500 ml |
Documents
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Primary Care
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Secondary Care
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Primary and Secondary Care
Lacosamide Prescribing Guidelines - EKPG September 2014
Uploaded By:
Renewal:
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Document linked to:
| Drug | Section |
|---|---|
| Lacosamide |
4.2.1 Antiepileptics
|
Specialist Initiation Only.
| Pack | Price |
|---|---|
| 14 tablet | £1.59 |
| 56 tablet |
Specialist Initiation Only.
| Pack | Price |
|---|---|
| 14 tablet | |
| 56 tablet | £7.10 |
Specialist Initiation Only.
| Pack | Price |
|---|---|
| 14 tablet | |
| 56 tablet | £129.74 |
Specialist Initiation Only.
| Pack | Price |
|---|---|
| 56 tablet | £11.67 |
Specialist Initiation Only.
| Pack | Price |
|---|---|
| 200 ml |
| Pack | Price |
|---|---|
| 200 ml | £25.74 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 14 tablet | |
| 21 tablet | |
| 28 tablet | |
| 30 tablet | |
| 42 tablet | |
| 56 tablet | £2.13 |
| 60 tablet |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 14 tablet | |
| 28 tablet | |
| 30 tablet | |
| 42 tablet | |
| 56 tablet | £3.03 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 28 tablet | |
| 30 tablet | |
| 56 tablet | £3.45 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 28 tablet | |
| 30 tablet | |
| 56 tablet | £4.59 |
| Pack | Price |
|---|---|
| 30 tablet | £18.81 |
| Pack | Price |
|---|---|
| 28 tablet | £9.13 |
| 30 tablet | |
| 56 tablet | |
| 60 tablet |
| Pack | Price |
|---|---|
| 28 tablet | |
| 30 tablet | |
| 56 tablet | £8.73 |
| Pack | Price |
|---|---|
| 30 tablet | |
| 56 tablet | £14.31 |
For third line use in those patients for whom tablets or dispersible tablets are not suitable (or if unavailable).
| Pack | Price |
|---|---|
| 300 ml | £43.87 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 100 tablet | |
| 30 tablet | |
| 50 tablet | |
| 60 tablet | £1.71 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 100 tablet | |
| 30 tablet | |
| 50 tablet | |
| 60 tablet | £2.52 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 50 tablet | |
| 60 tablet | £3.29 |
| Pack | Price |
|---|---|
| 30 tablet | |
| 60 tablet | £4.92 |
On formulary though please note-the tablets can be crushed and administered. The active drug will dissolve but the excipients will not. Crushed levetiracetam tablets taste unpleasant. They can be diluted in orange juice to taste.
| Pack | Price |
|---|---|
| 150 ml | |
| 300 ml | £9.53 |
| Pack | Price |
|---|---|
| 50 tablet | £16.25 |
| Pack | Price |
|---|---|
| 50 tablet | £7.00 |
| Pack | Price |
|---|---|
| 100 tablet | |
| 50 tablet | £35.49 |
| Pack | Price |
|---|---|
| 250 ml | £48.96 |
Documents
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Primary Care
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Secondary Care
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Primary and Secondary Care
Kent and Medway Perampanel Prescribing Guidance
Uploaded By:
Renewal: 09/2022
Approved: 09/2022
Last Reviewed: 09/2022
Caution: This document is due for renewal and may be out of date
Document linked to:
| Drug | Section |
|---|---|
| Perampanel |
4.2.1 Antiepileptics
|
SPECIALIST INITIATION ONLY. Prescribe Generically. East Kent Prescribing Group Guideline:
http://www.eastkentformulary.nhs.uk/media/1252/perampanel-prescribing-information-ekpg-june-2014.pdf
| Pack | Price |
|---|---|
| 28 tablet | £140.00 |
| 7 tablet | £35.00 |
SPECIALIST INITIATION ONLY. Prescribe Generically. East Kent Prescribing Group Guideline:
http://www.canterburycoastalccg.nhs.uk/EasysiteWeb/getresource.axd?AssetID=386267&type=full&servicetype=Attachment
| Pack | Price |
|---|---|
| 28 tablet | £140.00 |
SPECIALIST INITIATION ONLY. Prescribe Generically. East Kent Prescribing Group Guideline:
http://www.canterburycoastalccg.nhs.uk/EasysiteWeb/getresource.axd?AssetID=386267&type=full&servicetype=Attachment
| Pack | Price |
|---|---|
| 28 tablet | £140.00 |
SPECIALIST INITIATION ONLY. Prescribe Generically. East Kent Prescribing Group Guideline:
http://www.canterburycoastalccg.nhs.uk/EasysiteWeb/getresource.axd?AssetID=386267&type=full&servicetype=Attachment
| Pack | Price |
|---|---|
| 28 tablet | £140.00 |
SPECIALIST INITIATION ONLY. Prescribe Generically. East Kent Prescribing Group Guideline:
http://www.canterburycoastalccg.nhs.uk/EasysiteWeb/getresource.axd?AssetID=386267&type=full&servicetype=Attachment
| Pack | Price |
|---|---|
| 28 tablet | £140.00 |
SPECIALIST INITIATION ONLY. Prescribe Generically. East Kent Prescribing Group Guideline:
http://www.canterburycoastalccg.nhs.uk/EasysiteWeb/getresource.axd?AssetID=386267&type=full&servicetype=Attachment
| Pack | Price |
|---|---|
| 28 tablet | £140.00 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 100 tablet | |
| 30 tablet | £1.68 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 100 tablet | |
| 30 tablet | £2.66 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 100 tablet | |
| 30 tablet | £5.73 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 100 tablet | |
| 30 tablet | £3.50 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 100 tablet | |
| 30 tablet | £5.24 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 100 tablet | |
| 30 tablet | £8.73 |
| Pack | Price |
|---|---|
| 300 ml | £9.33 |
| Pack | Price |
|---|---|
| 300 ml | £7.52 |
| Pack | Price |
|---|---|
| 5 ampoule | £57.90 |
Documents
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Primary Care
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Secondary Care
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Primary and Secondary Care
Topiramate – Implementing MHRA Safety Measures In Kent & Medway
Uploaded By:
Renewal: 10/2024
Approved: 10/2024
Last Reviewed: 10/2024
Caution: This document is due for renewal and may be out of date
Document linked to:
| Drug | Section |
|---|---|
| Topiramate |
4.2.1 Antiepileptics
|
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 60 capsule | £14.79 |
Prescribing Topiramate 50mg tablets instead of capsules is more cost effective. (1) If prescribing for MIGRAINE consider switching to tablets. (2) If
prescribing for EPILEPSY, topiramate is in category 2 of the CHM guidance on switching between different manufacturers product for antiepileptics (i.e.
the need for continued supply of a particular manufacturer’s product should be based on clinical judgement and consultation with patient and/or carer,
taking into account factors such as seizure frequency and treatment history) A switch has NOT been provide to prevent accidental switching in epilepsy
http://tinyurl.com/zptn6ge
| Pack | Price |
|---|---|
| 60 capsule | £22.18 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 28 tablet | |
| 60 tablet | £4.59 |
Prescribing Topiramate 50mg tablets instead of capsules is more cost effective. (1) If prescribing for MIGRAINE consider switching to tablets. (2) If
prescribing for EPILEPSY, topiramate is in category 2 of the CHM guidance on switching between different manufacturers product for antiepileptics (i.e.
the need for continued supply of a particular manufacturer’s product should be based on clinical judgement and consultation with patient and/or carer,
taking into account factors such as seizure frequency and treatment history) A switch has NOT been provide to prevent accidental switching in epilepsy
http://tinyurl.com/zptn6ge
| Pack | Price |
|---|---|
| 60 capsule | £36.45 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 28 tablet | |
| 56 tablet | |
| 60 tablet | £8.29 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 28 tablet | |
| 56 tablet | |
| 60 tablet | £7.19 |
If patient is seizure free and stable, consistent supply of a particular manufacturer's AED preparation isrecommended.If a specific product is required (generic or brand) specify the manufacturer alongside the dose.
| Pack | Price |
|---|---|
| 28 tablet | |
| 56 tablet | |
| 60 tablet | £29.09 |
| Pack | Price |
|---|---|
| 60 capsule |
| Pack | Price |
|---|---|
| 60 capsule |
| Pack | Price |
|---|---|
| 60 capsule |
| Pack | Price |
|---|---|
| 100 tablet | £44.41 |
| 50 tablet |
| Pack | Price |
|---|---|
| 50 sachet | £24.60 |
Documents
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Primary Care
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Secondary Care
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Primary and Secondary Care
Zonisamide Prescribing Guidelines - EKPG September 2014
Uploaded By:
Renewal:
Approved:
Last Reviewed:
Document linked to:
| Drug | Section |
|---|---|
| Zonisamide |
4.2.1 Antiepileptics
|
For prescribing guidelines please see http://www.eastkentformulary.nhs.uk/media/1255/zonisamide-prescribing-guidelines-ekpg-september-2014.pdf
| Pack | Price |
|---|---|
| 14 capsule | £12.76 |
| 56 capsule |
For prescribing guidelines please see http://www.eastkentformulary.nhs.uk/media/1255/zonisamide-prescribing-guidelines-ekpg-september-2014.pdf
| Pack | Price |
|---|---|
| 28 capsule | |
| 56 capsule | £13.47 |
For prescribing guidelines please see http://www.eastkentformulary.nhs.uk/media/1255/zonisamide-prescribing-guidelines-ekpg-september-2014.pdf
| Pack | Price |
|---|---|
| 56 capsule | £18.35 |
| 65 capsule |