test announcement
27/04/23 - Solriamfetol film coated tablets 75mg, 150mg, SMC2439 indication, added.
CNS stimulant medication (methylphenidate, lisdexamfetamine) is only indicated for the treatment of attention deficit hyperactivity disorder (ADHD) under specialist supervision. Initiation, stabilisation and ongoing supervision are provided by the relevant specialist. Unacceptable side-effects or a poor response to first-line treatment can be discussed with the specialist. When response to stimulants is inadequate or when stimulants are unsuitable or not tolerated, use of the non-stimulant atomoxetine or guanfacine may be considered.
For information on prescribing in ADHD and the characteristics and release profiles of immediate and modified-release formulations of methylphenidate, refer to SIGN guidance (www.sign.ac.uk) and to the shared-care protocol. In a small minority of patients response to methylphenidate therapy may differ if the formulation changes; brand name prescribing may be required as per BNF advice.
MHRA advice: Atomoxetine (Strattera▼): increases in blood pressure and heart rate (December 2014) (www.gov.uk).
Capsules 10mg, 18mg, 25mg, 40mg, 60mg, 80mg, 100mg (s)
Oral solution 4mg/mL (s)
Modified release tablets 1mg, 2mg, 3mg, 4mg (s)
As per SMC 1123/16: treatment of attention deficit hyperactivity disorder (ADHD) in children and adolescents 6 to 17 years old for whom stimulants are not suitable, not tolerated or have been shown to be ineffective. Treatment must be used as part of a comprehensive ADHD treatment programme, typically including psychological, educational and social measures.
Capsules (CD schedule 2) 20mg, 30mg, 40mg, 50mg, 60mg, 70mg (s)
MHRA advice: Methylphenidate long-acting (modified-release) preparations: caution if switching between products due to differences in formulations (September 2022) (www.gov.uk).
17/09/24: There is a known shortage with this product see: Medicines shortage log (NHS Highland intranet access required)
Tablets (CD schedule 2) 5mg, 10mg, 20mg (s)
Modified release tablets (CD schedule 2) (s)
Prescribe methylphenidate MR products by brand, but see notes above.
Modified release capsules (CD schedule 2) (s)
Prescribe methylphenidate MR products by brand, but see notes above.
To be used second line after the use of modafinil with the goal of improving wakefulness in patients with narcolepsy who did not respond to or did not tolerate modafinil.
Film-coated tablets 75mg, 150mg (specialist recommendation only)
As per SMC 2439: to improve wakefulness and reduce excessive daytime sleepiness in adult patients with narcolepsy (with or without cataplexy).
SMC restriction: for use in patients who have failed modafinil or have a contraindication or intolerance to modafinil
TAM (Treatments and Medicines) NHS Highland