All for specialist recommendation or initiation based on individual circumstances, local guidance and shared care agreements (SCA) listed below.
Excessive daytime sleepiness and sudden onset of sleep can occur with levodopa substitutes and dopamine receptor agonists.
Cheaper than co-careldopa and should be tried first as there is no evidence of benefit of one over the other.
Simple amber for treatment of Parkinsonís disease and restless leg syndrome.
Ropinirole XL is available as a generic preparation. UHL will prescribe generically, primary care may specify a brand according to price.
Treatment of Parkinsonís disease and restless leg syndrome.
Modified release (MR)is much more expensive than intermediate release (IR). It is restricted to initiation only on consultant recommendation after a trial with the immediate release pramipexole has not been tolerated. Treatment should then be reviewed to establish additional benefits and if none are apparent then the patient should revert to the IR. Patients established on therapy who have demonstrated benefit on MR should not be switched to IR.
Available as individual component and as combined product. Stalevo and Stanek both contain same quantities of carbidopa/entacapone/levodopa. UHL currently stocks Stanek
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Traffic Light Status Information
Drugs not recommended for use in the Leicestershire Health Community because of lack of evidence of clinical effectiveness, cost prioritization or concerns over safety.
All new drugs will be black until they have been through the appropriate approval process - then they will appear as a specific entry
Drugs which should be prescribed only by hospital specialists (clinical review by specialist as appropriate and annually as a minimum).
Drugs which would initially be prescribed by a hospital specialist and then by a GP where full agreement to share the care of each specific patient has been reached under a LMSG Shared Care Agreement (SCA). Specific patient monitoring or intervention required.
Drugs suitable to be initiated and prescribed in primary care only after specialist assessment and recommendation. A shared care agreement is not required.
Drugs for which GPs would normally take full responsibility for prescribing and monitoring. Drugs included in this list have been specifically considered by LMSG.
Drugs not yet reviewed
Drugs for which GPs are able to take full responsibility for prescribing and monitoring subject to specified conditions e.g. prescribing in line with agreed LMSG guidance or able to demonstrate suitable competence. See comments under individual entries