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  • October 2019: Because of a risk of abuse and dependence, gabapentin and pregabalin are controlled under the Misuse of Drugs Act 1971 as class C substances and scheduled under the Misuse of Drugs Regulations 2001 as schedule 3 (as of 1 April 2019). In the PDF Tables have been amended and a footnote has been added to this guideline to reflect this change. April 2018: Footnotes and cautions in the guideline PDF have been added and amended to link to the MHRA's latest advice and resources on sodium valproate. Medicines containing valproate taken in pregnancy can cause malformations in 11% of babies and developmental disorders in 30 -40% of children after birth. Valproate treatment must not be used in girls and women including in young girls below the age of puberty, unless alternative treatments are not suitable and unless the terms of the pregnancy prevention programme are met. This programme includes: assessment of patients for the potential of becoming pregnant; pregnancy tests; counselling patients about the risks of valproate treatment; explaining the need for effective contraception throughout treatment; regular (at least annual) reviews of treatment by a specialist, and completion of a risk acknowledgement form. In pregnancy, valproate is contraindicated and an alternative treatment should be decided on, with appropriate specialist consultation. See the MHRA toolkit to ensure female patients are better informed about the risks of taking valproate during pregnancy. Appendices A and B (details of internal/external staff and committee members) were removed in the PDF as this information is now available elsewhere on the NICE website. February 2016: The Medicines and Healthcare Products Regulatory Agency (MHRA) has produced a toolkit to ensure female patients are better informed about the risks of taking valproate during pregnancy. Healthcare professionals are advised to use the NICE guideline in conjunction with the latest MHRA advice and resources. Footnotes and cautions in the guideline have also been added and amended to link to the MHRA's latest advice and resources in the PDF. January 2015: The Medicines and Healthcare Products Regulatory Agency (MHRA) has strengthened its warnings on the use of valproate in women of childbearing potential. NICE are assessing the impact of this on the guideline. In the meantime, healthcare professionals are advised to use the guideline in conjunction with the latest MHRA advice. November 2013: A footnote has been added to recommendation 1.9.1.4 highlighting new advice issued by the MHRA about oral anti-epileptic drugs (AEDs) in the PDF. (edited)

October 2019: Because of a risk of abuse and dependence, gabapentin and pregabalin are controlled under the Misuse of Drugs Act 1971 as class C substances and scheduled under the Misuse of Drugs Regulations 2001 as schedule 3 (as of 1 April 2019). In the PDF Tables have been amended and a footnote has been added to this guideline to reflect this change. April 2018: Footnotes and cautions in the guideline PDF have been added and amended to link to the MHRA's latest advice and resources on sodium valproate. Medicines containing valproate taken in pregnancy can cause malformations in 11% of babies and developmental disorders in 30 -40% of children after birth. Valproate treatment must not be used in girls and women including in young girls below the age of puberty, unless alternative treatments are not suitable and unless the terms of the pregnancy prevention programme are met. This programme includes: assessment of patients for the potential of becoming pregnant; pregnancy tests; counselling patients about the risks of valproate treatment; explaining the need for effective contraception throughout treatment; regular (at least annual) reviews of treatment by a specialist, and completion of a risk acknowledgement form. In pregnancy, valproate is contraindicated and an alternative treatment should be decided on, with appropriate specialist consultation. See the MHRA toolkit to ensure female patients are better informed about the risks of taking valproate during pregnancy. Appendices A and B (details of internal/external staff and committee members) were removed in the PDF as this information is now available elsewhere on the NICE website. February 2016: The Medicines and Healthcare Products Regulatory Agency (MHRA) has produced a toolkit to ensure female patients are better informed about the risks of taking valproate during pregnancy. Healthcare professionals are advised to use the NICE guideline in conjunction with the latest MHRA advice and resources. Footnotes and cautions in the guideline have also been added and amended to link to the MHRA's latest advice and resources in the PDF. January 2015: The Medicines and Healthcare Products Regulatory Agency (MHRA) has strengthened its warnings on the use of valproate in women of childbearing potential. NICE are assessing the impact of this on the guideline. In the meantime, healthcare professionals are advised to use the guideline in conjunction with the latest MHRA advice. November 2013: A footnote has been added to recommendation 1.9.1.4 highlighting new advice issued by the MHRA about oral anti-epileptic drugs (AEDs) in the PDF. (edited)

Cover of The Epilepsies

The Epilepsies

The Diagnosis and Management of the Epilepsies in Adults and Children in Primary and Secondary Care

Pharmacological Update of Clinical Guideline 20

NICE Clinical Guidelines, No. 137

.

Excerpt

This guideline is a partial update of ‘The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care’ (NICE clinical guideline 20, 2004). It updates the pharmacological management sections of the 2004 guideline and also includes the use of the ketogenic diet.

Contents

First published 2004

Copyright © 2012, National Clinical Guideline Centre.

Apart from any fair dealing for the purposes of research or private study, criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, no part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

The rights of National Clinical Guideline Centre to be identified as Author of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act, 1988.

Bookshelf ID: NBK247130PMID: 25340221

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