• 2mg modified-release tablets (prescribe generically)
• 1mg, 2mg, 3mg, 4mg, 5mg tablets (Adaflex^®, crushed if necessary)
•  restricted use: 1mg/ml oral solution (Consilient brand)

NB: Slenyto is no longer approved. Patients should be reviewed at their next routine follow-up, see separate entry

Approved Indications

• Insomnia (short term use – Max 13 weeks) adults 55 years and over

• Delayed sleep phase syndrome and other circadian rhythm disorders (including visually impaired/blind people with disturbed sleep wake cycles)
• Patients with injurious parasomnia including REM sleep behaviour disorder (RBD) [e.g with degenerative conditions such as Parkinsonian disease or dementia]
• Sleep conditions in patients with learning disabilities and behaviour that challenges (where sleep hygiene measures have been insufficient)
• Neurological or behavioural disorders including:
  • Attention deficit hyperactivity disorder (ADHD)
  • Autism Spectrum Disorder (ASD)
  • Neurodevelopmental disabilities  
• Cluster headache 
• Prior to examinations as directed by paediatric specialists (such as a sleep encephalogram (EEG) & sedation prior to scans)

• Critical care short term sleep disturbance [Hospital use only]

Indications not listed on the formulary are not routinely supported for prescribing e.g. sleep disturbances related to shift work, Alzheimer's disease, chronic fatigue syndrome / myalgic encephalomyelitis / encephalopathy, sleep apnoea, as an adjunct to hypnotic withdrawal and jet lag (unless an approved indication co-exists)

• To be used in accordance with NICE criteria

• Alcohol withdrawal - chlordiazepoxide is preferred in the management of alcohol withdrawal.

• 25mg and 50mg tablets
• Approved for the treatment of long-term insomnia in line with NICE via NHS Sleep Clinics at
  • Northumbria Healthcare NHS Foundation Trust;
  • South Tees Hosptials NHS Foundation Trust; and 
  • The Newcastle upon Tyne Hospitals NHS Foundation Trust
  • First 3 months supply from secondary care with a review at 3 months. If effective, transfer to primary care with a further 1 month supply from secondary care to allow for handover

• Approved for the treatment of narcolepsy with cataplexy in children age 7 years and above only in accordance with NHS England clinical commissioning policy.
•  The Northern (NHS) Treatment Advisory Group recommends the use of sodium oxybate in adult patients who have received and benefited from treatment with sodium oxybate as commissioned by NHS England. i.e. continuing treatment for those >19 years old.
• The Northern (NHS) Treatment Advisory Group also recommends sodium oxybate for use in adults who have not received it as a child as per the RMOC criteria, noting that may sometimes be used in combination with other agents.
• The following criteria for use in adults who have not received sodium oxybate as child apply:
• Patients presenting with narcolepsy with cataplexy according to International Classification of sleep disorders 3 (ICSD) criteria for Narcolepsy Type 1 AND
• Patients ≥ 19 years old AND
• Where patients have co-morbidities, which are also affecting sleep, these should be managed and adequately treated (for example moderate to severe obstructive sleep apnoea or restless legs syndrome) AND
• Failure to respond to non-pharmacological treatments consisting of behavioural and environmental adaptations, for example planned naps AND
• Inadequate response (within 3 months) to, or intolerable adverse effects from, or contra-indicated use of, more than one stimulant for narcolepsy, and more than one anticataplectic agent AND
• Assessed as being able to benefit from sodium oxybate via a specialist sleep centre.
• Sodium oxybate is generally considered as a final treatment option for patient