GREEN after specialist initiation: Preferred buccal midazolam product in Derbyshire is Buccolam for use in children under 18 years and adults.
GREY*: Epistatus, when initiated by out-of-area providers. (Decision date - December 2020)
Existing patients on epistatus should be reviewed by the specialist and switched to the recommended buccolam preparation at their next review and the patients care plan should be updated accordingly. Do not stop the epistatus abruptly, without the patient receiving training for the buccolam preparation.
*The relaxation for epistatus traffic lights is due to JAPC recognising that it may not be practical due to formulary differences to refer to a specialist outside of Derbyshire for a patient already initiated on epistatus. Under these circumstances it will be at the discretion of the prescribing clinician to switch to buccolam with the patient and/or carer training and updated care plans, or to continue prescribing epistatus.
RED: midazolam (miprosed) use in children aged 6 months to 14 years for sedation and anxiolysis prior to diagnostic, surgical, therapeutic or endoscopic procedures, and premedication before induction of general anaesthesia. (Decision date - Oct 2021)