Formulary
This chapter of the formulary is under continual development, please let the team know if you have any comments about the contents: mlcsu.lscformulary@nhs.net.
For more information about the formulary development process, please see: https://www.lancsmmg.nhs.uk/lancashire-and-south-cumbria-icb-formulary-development/
CSM advice: Benzodiazepines should be used to treat insomnia only when it is severe, disabling or subjecting the individual to extreme distress
Hypnotics may be prescribed for in-patients as required. They should not normally be prescribed on discharge for patients not previously taking a sleeping tablet and will not be dispensed by pharmacy except in exceptional circumstances. For patients taking a sleeping tablet regularly prior to admission it will be assumed that they have a supply at home (or if brought into hospital that these will be returned to the patient on discharge), prescribers must notify pharmacy of any patient taking a sleeping tablet prior to admission who is not returning to their own home and may therefore need a supply on discharge.
| Daridorexant |
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Formulary
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Tablets 25mg, 50mg Treatment of long-term insomnia |
 NICE TA922: Daridorexant for treating long-term insomnia |
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| Melatonin |
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Formulary
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Children with learning disabilities Children with ADHD Children and adolescents with Autism Spectrum Disorder (ASD) and / or Smith-Magenis syndrome Cerebral palsy Children with complex neurodevelopmental disorders that the specialist considers eligible
Initiation of melatonin must be by a specialist in the indication being prescribed for and have a clear plan for review. Prescribing and review of melatonin in children must follow the principles outlined in the Melatonin Pathway (Children) |
 LSCMMG: Melatonin Pathway (Children) |
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| Melatonin |
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Formulary
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For the Treatment of Rapid Eye Movement (REM) Sleep Behaviour Disorder (RBD) in Parkinson’s Disease and Lewy Body Dementia Adults with learning disabilities Sleep disturbance in adults with ADHD Sleep disorders in the blind Adults with complex neurodevelopmental disorders that the specialist considers eligible
Initiation of melatonin must be by a specialist in the indication being prescribed for and have a clear plan for review. Prescribing and review of melatonin in adults must follow the principles outlined in the Melatonin Pathway (adults) **Under development**. Melatonin is suitable for prescribing for the treatment of REM RBD in PD and LBD when clonazepam is not considered to be appropriate. |
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LSCMMG: Melatonin |
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| Melatonin |
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Formulary
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Primary insomnia in those over 55 Sleep problems in patients with dementia associated with Alzheimer’s Colonis liquid 1mg/ml and 3mg tablets for all indications, including insomnia and jet lag |
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LSCMMG: Melatonin |
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Links
- LSCMMG: Melatonin
- LSCMMG: Melatonin
- LSCMMG: Melatonin Pathway (Children)
- MHRA Drug Safety Update March 2020: Benzodiazepines and opioids: reminder of risk of potentially fatal respiratory depression
- MHRA Drug Safety Update Oct 2021:Chloral hydrate, cloral betaine (Welldorm): restriction of paediatric indication
- MHRA: Changes to drug driving law
- MHRA: Chloral hydrate, cloral betaine (Welldorm): restriction of paediatric indication
- MHRA: Drugs and driving: blood concentration limits to be set for certain controlled drugs in a new legal offence
- MHRA: Risk of drowsiness and reduced driving ability
- MHRA: Zolpidem: risk of drowsiness and reduced driving ability
- NICE Evidence summary: Melatonin for sleep disorders in children with ADHD
- NICE TA77: Guidance on the use of zaleplon, zolpidem and zopiclone for the short-term management of insomnia
- NICE TA922: Daridorexant for treating long-term insomnia
- NICE TAG 77 : Zaleplon, zolpidem and zopiclone for the management of insomnia
- NICE TAG 77 :Zaleplon, zolpidem and zopiclone for the management of insomnia