| Therapeutic Area | Formulary Choices | Cost for 28 (unless otherwise stated) | Rationale for decision / comments |
|---|---|---|---|
| Dopaminergic drugs | |||
| Levodopa with decarboxylase inhibitors | Co-beneldopa (Levodopa/Benserazide) | ||
| Immediate release | 12.5/50mg capsule: £4.96 (100) | ||
| 25/100mg capsule: £6.91 (100) |
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| 50/200mg capsule: £11.78 (100) | |||
| Modified release | 25/100mg capsule: £12.77 (100) | Modified release is not levodopa equivalent See Parkinson’s UK Calculate Adjusted Levodopa Equivalent Daily Dose |
|
| Dispersible | 12.5/50mg tablet: £5.90 (100) | Dispersible has a faster onset and shorter duration of action. | |
| 50/100mg tablet: £10.45 (100) | |||
| Co-careldopa (Levodopa/Carbidopa) | |||
| Immediate release | 12.5/50mg tablet: £3.37 (90) | ||
| 10/100mg tablet: £13.98 (100) | |||
| 25/100mg tablet: £5.87 (100) | |||
| 25mg/250mg tablet: £35.23 (100) | |||
| Modified release | 25/100mg tablet:£11.60 (60) 50/200mg tablet: £11.60 (60) | Modified release is not levodopa equivalent See Parkinson’s UK Calculate Adjusted Levodopa Equivalent Daily Dose |
|
| Catechol-o-methyltransferase inhibitors | Entacapone | 200mg tablet: £3.07 (30) | Maximum 2g daily. NHS Somerset classify as an Amber drug as per Traffic light guidance |
| Opicapone | 50mg capsule: £93.90 (30) | Maximum 50mg daily. NHS Somerset classify as an Amber drug as per Traffic light guidance |
|
| NHS Somerset classify Tolcapone as a Red drug (specialist prescribing only) as per Traffic light guidance | |||
| Levodopa with catechol-o-methyltransferase inhibitor | Levodopa/ Carbidopa/ Entacapone as Sastravi or Stanek® | 50mg/12.5mg/200mg tablet: £10.35 (30) £34.66 (100) | Maximum 10 tablets per day. |
| 75mg/18.75mg/200mg tablets: £10.35 (30) £34.66 (100) | |||
| 100mg/25mg/200mg tablets: £10.35 (30) £34.66 (100) | |||
| 125mg/31.25mg/200mg tablets: £10.35 (30) £34.66 (100) | |||
| 150mg/37.5mg/200mg tablets: £10.35 (30) £34.66 (100) | |||
| 175mg/43.75mg/200mg tablets: £10.35 (30) £34.66 (100) | Maximum 8 tablets per day. | ||
| 200mg/50mg/200mg tablets: £10.35 (30) £34.66 (100) | Maximum 7 tablets per day. | ||
| Dopamine receptor agonists | Amantadine | 100mg capsule: £13.67 (56) 10 mg per 1 ml oral solution sugar free: £140 (150ml) | NHS Somerset classify as an Amber drug as per Traffic light guidance Maximum 400mg daily. |
| Ropinirole Immediate release | 250 mcg tablet: £3.99 (12) | Maximum 24mg daily. | |
| 500 mcg tablet: £7.08 | |||
| 1 mg tablet: £49.84 (84) | |||
| 2 mg tablet: £19.14 | |||
| 5 mg tablet: £214.25 (84) | |||
| Modified release | 2 mg tablet: £12.54 | ||
| 4mg tablet: £25.09 | |||
| 6mg tablet: £15.32 | |||
| 8mg tablet: £42.11 | |||
| Pramipexole Immediate release | 88 mcg tablet: £2.10 (30) | Maximum 3.3 mg base daily. | |
| 180 mcg tablet : £1.49 (30) | |||
| 350 mcg tablet: £15.03 (30) | |||
| 700 mcg tablet: £1.80 (30) | |||
| Modified release | 260 mcg tablet: £30.81 (30) | Maximum 3.15 mg base daily. | |
| 520 mcg tablet: £60.11 (30) | |||
| 1.05 mg tablet : £119.76 (30) | |||
| 1.57 mg tablet: £191.90 (30) | |||
| 2.1 mg tablet: £246.46 (30) | |||
| 2.62 mg tablet: £312.10 (30) | |||
| 3.15 mg tablet: £369.71 (30) | |||
| NHS Somerset classify Cabergoline as a Red drug (specialist prescribing only) as per Traffic light guidance | |||
| Rotigotine | 2 mg per 24 hour transdermal patch: £81.10 | Maximum 16mg daily. Apply the patch to a different place on your skin every day – use the body map as a guide to locate appropriate areas to place the patch. |
|
| 4 mg per 24 hour transdermal patch: £123.60 | |||
| 6 mg per 24 hour transdermal patch: £149.93 | |||
| 8 mg per 24 hour transdermal patch: £149.93 | |||
| NHS Somerset classify Apomorphine as a Red drug (specialist prescribing only) as per Traffic light guidance | |||
| Monoamine oxidase B inhibitors | Rasagiline | 1mg tablet: £3.81 | NHS Somerset classify as an Amber drug as per Traffic light guidance Maximum 1mg daily. |
| Selegiline | 5mg tablet: £16.52 (100) | NHS Somerset classify as an Amber drug as per Traffic light guidance Maximum 10mg daily. |
|
| Safinamide is classified by NHS Somerset as a Black drug (Not recommended) as per Traffic light guidance |
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| Sympathomimetic- Vasoconstrictor | Midodrine | 2.5mg tablet: £28.73 (100) 5mg tablet: £41.66 (100) 10mg tablet: £83.32 (100) | NHS Somerset classify as an Amber drug for orthostatic hypotension as per Traffic light guidance The usual initial dosage is 2.5 mg, 2-3 times daily (every 3-4 hours). The dose should be increased at weekly intervals in small increments until an optimal response is obtained (max 30 mg/day) and taken during daytime when the person performs daily activities in upright position. The last dose should be taken at least four hours before bedtime to reduce the risk of supine hypertension. Blood pressure in supine and sitting position should be regularly monitored at the beginning of the treatment (at least twice a week). Treatment should be stopped if supine hypertension is significantly excessive. |
