4.2.1 Epilepsy and other seizure disorders
All other antiepileptics not listed here are for Neurologist and Paediatrician initiation only.
Drug Safety Updates
MHRA 2017 guidance - Antiepileptic drugs: It is advised that prescribers ensure that the patient is maintained on a specific manufacturer’s product.
MHRA 2017 guidance -Antiepileptic drugs: Guidance for prescribing antiepileptic drugs
MHRA 2018 Valproate medicines (Epilim▼, Depakote▼): Pregnancy Prevention Programme materials online
MHRA 2019 guidance - Valproate medicines and serious harms in pregnancy: new Annual Risk Acknowledgement Form and clinical guidance from professional bodies to support compliance with the Pregnancy Prevention Programme.
For the above guidance Click Here
For SPS Guidance on Phenytoin and Sodium Valproate monitoring in Adults in Primary Care please click here
For Controlled drugs/benzodiazepine prescribing patient treatment
agreement Click Here
MEDWAY ONLY: For Benzodiazepine prescribing guidance in Primary Care (Do NOT Use the ‘treatment agreement’ in appendix 5. Please use the K&M Treatment agreement Mar/Apr 22) Click Here
Cenobamate prescribing
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
For NICE guidance TA753 Cenobamate for treating focal onset seizures in epilepsy Click Here
Pack |
---|
14 tablet |
Pack |
---|
56 tablet |
Pack |
---|
56 tablet |
Pack |
---|
56 tablet |
Pack |
---|
56 tablet |
Pack |
---|
300 ml |
Pack |
---|
10 vial |
(Control of epilepsy)
MHRA 2017 guidance - Advice for healthcare professionals
It is advised that prescribers ensure that the patient is maintained on a specific manufacturer’s product.
MHRA Guidance for prescribing antiepileptic drugs can be found here .
Pack |
---|
28 tablet |
500 tablet |
56 tablet |
84 tablet |
Pack |
---|
100 tablet |
28 tablet |
500 tablet |
56 tablet |
84 tablet |
Pack |
---|
100 tablet |
28 tablet |
56 tablet |
Pack |
---|
1 ml |
Pack |
---|
30 tablet |
50 tablet |
56 tablet |
60 tablet |
Pack |
---|
30 tablet |
50 tablet |
56 tablet |
60 tablet |
For Specialist initiation by Tertiary epilepsy centre (Kings College Hospital London) for Cenobamate Prescribing Guidance Click Here
Pack |
---|
14 tablet |
28 tablet (2 x 14 tablets) |
Pack |
---|
14 tablet |
Pack |
---|
14 tablet |
28 tablet (2 x 14 tablets) |
Pack |
---|
14 tablet |
28 tablet (2 x 14 tablets) |
Pack |
---|
14 tablet |
Pack |
---|
14 tablet |
28 tablet (2 x 14 tablets) |
Pack |
---|
100 tablet |
150 tablet |
60 tablet |
Pack |
---|
100 tablet |
60 tablet |
Pack |
---|
100 capsule |
50 capsule |
90 capsule |
Pack |
---|
100 capsule |
40 capsule |
50 capsule |
90 capsule |
Pack |
---|
100 capsule |
30 capsule |
50 capsule |
90 capsule |
Pack |
---|
30 tablet |
Pack |
---|
28 tablet |
Pack |
---|
300 ml |
Pack |
---|
56 tablet |
Pack |
---|
56 tablet |
Pack |
---|
56 tablet |
Pack |
---|
56 tablet |
Pack |
---|
56 tablet |
Pack |
---|
56 tablet (7 x 8 tablets) |
Keppra brand preferred
Pack |
---|
100 tablet |
30 tablet |
50 tablet |
60 tablet |
Pack |
---|
100 tablet |
50 tablet |
60 tablet |
Pack |
---|
50 tablet |
60 tablet |
Pack |
---|
30 tablet |
60 tablet |
Pack |
---|
150 ml |
300 ml |
Pack |
---|
50 tablet |
Pack |
---|
50 tablet |
Pack |
---|
100 tablet |
50 tablet |
For Perampanel Prescribing Guidance Click Here
Pack |
---|
28 tablet |
7 tablet |
Pack |
---|
28 tablet |
Pack |
---|
28 tablet |
Pack |
---|
28 tablet |
Pack |
---|
28 tablet |
Pack |
---|
28 tablet |
MHRA 2017 guidance - Advice for healthcare professionals
It is advised that prescribers ensure that the patient is maintained on a specific manufacturer’s product.
Guidance for prescribing antiepileptic drugs can be found here (html).
Pack |
---|
28 capsule |
Pack |
---|
28 capsule |
Pack |
---|
100 capsule |
84 capsule |
Pack |
---|
28 capsule |
Pack |
---|
500 ml |
Pack |
---|
1 ampoule |
10 ampoule |
5 ampoule |
Pack |
---|
100 capsule |
14 capsule |
56 capsule |
84 capsule |
Pack |
---|
21 capsule |
56 capsule |
84 capsule |
Pack |
---|
100 capsule |
14 capsule |
56 capsule |
Pack |
---|
21 capsule |
56 capsule |
84 capsule |
Pack |
---|
100 capsule |
14 capsule |
56 capsule |
Pack |
---|
21 capsule |
56 capsule |
84 capsule |
Pack |
---|
56 capsule |
Pack |
---|
56 capsule |
Pack |
---|
473 ml |
500 ml |
Epilim brand preferred. If a patient is stabilised on an alternative brand, please continue prescribing the alternative brand.
MHRA 2018 guidance – Action required now from healthcare professionals
- Valproate medicines must not be used in women of childbearing potential unless the Pregnancy Prevention Programme is in place
- Provide the Patient Guide to the patient (or her parents or responsible person as necessary)
If you are involved in the care of female patients on valproate in the UK, see a reminder of actions required and how to order more patient guides for this medicine on the MHRA website (click here).
For Sodium Valproate Pathway for GP reviews and referral to specialist 2019 Guidance click here
Pack |
---|
100 tablet |
30 tablet |
Pack |
---|
100 tablet |
30 tablet |
Pack |
---|
100 tablet |
30 tablet |
Pack |
---|
100 tablet |
30 tablet |
Pack |
---|
100 tablet |
30 tablet |
Pack |
---|
100 tablet |
30 tablet |
Topamax brand preferred. If a patient is stabilised on an alternative brand, please continue prescribing the alternative brand.
Topiramate - Topiramate is contraindicated in pregnancy and in women of childbearing potential unless the conditions of a Pregnancy Prevention Programme are fulfilled. For Implementing MHRA Safety Measures in Kent & Medway Click Here
Pack |
---|
28 tablet |
60 tablet |
Pack |
---|
28 tablet |
60 tablet |
Pack |
---|
28 tablet |
60 tablet |
Pack |
---|
28 tablet |
60 tablet |
Pack |
---|
60 capsule |
Pack |
---|
60 capsule |
Pack |
---|
60 capsule |
- First Line Choice
- On Formulary
- Specialist Initiation Only
- Hospital Only
- KMPT Initiation Only