4.1.1 Hypnotics - for short term use only
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Try to avoid. If needed, use for 1-3 days only. Do not give on discharge from hospital. Hypnotics are only licensed for short term use. On specialist advice only, some patients with long term psychiatric problems may require long term use.
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GREEN Temazepam
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| tablets 10mg |
| elixir 10mg/5mL |
| AMBER Nitrazepam |
| tablets 5mg |
| oral suspension 2.5mg/5mL |
| GREEN Zopiclone tablets 3.75mg, 7.5mg |
| GREEN Zolpidem tablets 5mg, 10mg - in line with NICE TA 77- short term use only. |
| RED Melatonin 2mg MR tablets - for use in ICU only |
| BLACK Promethazine tablets 10mg, 25mg, liquid 5mg/5mL |
| NOTE: Promethazine should not be prescribed as a hypnotic. This is a non-formulary indication (BLACK) consistent |
with the advice in the BNF that has determined that promethazine is “less suitable for prescribing"
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| Chloral Hydrate for paediatric sedation |
| RED Chloral hydrate liquid 500mg/5mL |
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| Melatonin [Circardin® tablets] - See Shared Care Guideline |
| Melatonin PR tablets, off license use, for the treatment of sleep disorders in children aged 2 - 18 years with |
neurodevelopmental disorders.
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| The long term safety and efficacy of melatonin is unclear. |
| AMBER Shared Care Melatonin 2mg [Circardin® prolonged release tablets] [off label use] |
| |
| Melatonin in the Treatment of Rapid Eye Movement [REM] Sleep Behaviour Disorder [RBD] in Parkinson's Disease and |
Lewy Body Dementia
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| Melatonin prolonged release tablets [Circardin®] are suitable for prescribing in primary care following initiation or |
| recommendation by a specialist when clonazepam is not considered appropriate. |
| AMBER Melatonin prolonged release tablets 2mg [Circardin®] |
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| Sodium oxybate for treatment of narcolepsy with cataplexy in adults (under expert supervision) |
| RED Sodium oxybate 500mg/mL oral solution [Xyrem®] |
| Specialist medicine |
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| BACK to main chapter |
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4.1.2 Anxiolytics
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Use at lowest dose for shortest time possible. Long term use should be avoided except on specialist advice.
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Chlordiazepoxide is also used in a reducing dose regimen for the management of acute alcohol withdrawal.
| GREEN Chlordiazepoxide | capsules 5mg, 10mg
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| GREEN Diazepam |
| tablets 2mg, 5mg, 10mg |
| syrup 2mg/5mL |
| injection 10mg/2mL |
| suppositories 10mg |
| GREEN Lorazepam tablets 1mg |
| RED Lorazepam injection 4mg/mL |
| RED Promethazine tablets 10mg, 25mg, liquid 5mg/5mL [for short term use in anxiety only] |
| NOTE: Promethazine should not be prescribed as a hypnotic. This is a non-formulary indication (BLACK) consistent | | with the advice in the BNF that has determined that promethazine is “less suitable for prescribing" | |
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| BACK to main chapter |
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