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) .

Please see MHRA advice on the risks of switching between different manufacturers products here

Expand All / Expand All (incl. cost)

Pack Price
100 capsule
14 capsule
56 capsule £1.23
84 capsule
Pack Price
21 capsule
56 capsule
84 capsule £1.71
Pack Price
100 capsule
14 capsule
56 capsule £1.39
Pack Price
21 capsule
56 capsule
84 capsule £1.98
Pack Price
100 capsule
14 capsule
56 capsule £1.83
Pack Price
21 capsule
56 capsule
84 capsule £2.68
Pack Price
56 capsule £2.09
Pack Price
56 capsule £2.64

Capsules can be opened and contents dissolve in water for administration. The capsule contents may have an unpleasant taste.

Pack Price
473 ml £96.19
500 ml
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
Pack Price
100 capsule £1.97
50 capsule
90 capsule
Pack Price
100 capsule £2.27
40 capsule
50 capsule
90 capsule
Pack Price
100 capsule £3.05
30 capsule
50 capsule
90 capsule
Pack Price
10 tablet
100 tablet £9.92

This is a high cost product and it will be more cost effective to prescribe multiples of lower strengths

Pack Price
100 tablet £26.91
Pack Price
150 ml £65.24

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
14 tablet
21 tablet
28 tablet
30 tablet
42 tablet
56 tablet £1.47
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 £1.80

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 £2.12

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 £2.59
Pack Price
30 tablet £18.81
Pack Price
28 tablet £8.81
30 tablet
56 tablet
60 tablet
Pack Price
28 tablet
30 tablet
56 tablet £8.37
Pack Price
30 tablet
56 tablet £13.74
Pack Price
28 capsule £7.24
Pack Price
28 capsule £7.07
Pack Price
100 capsule
84 capsule £9.04
Pack Price
28 capsule £9.11
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

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 £2.50

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 £5.54

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 £7.18
Pack Price
5 ampoule £57.90
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

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
112 capsule
50 capsule
56 capsule £210.68
Pack Price
200 ml £173.00

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
50 tablet
60 tablet £1.93

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 £2.75

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 £3.28
Pack Price
30 tablet
60 tablet £5.00

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 £18.59
Pack Price
50 tablet £17.30
Pack Price
50 tablet £6.46
Pack Price
100 tablet
50 tablet £38.71
Pack Price
250 ml £48.96

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
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 £5.96

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 £10.68

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
28 tablet
56 tablet
60 tablet £10.40

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 £31.18
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