North East and North Cumbria
ICS Formulary
 
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10 Musculoskeletal and joint diseases
10-01-01 Non-steroidal anti-inflammatory drugs
Note: diclofenac use is restricted, it can be used short term use for post-operative pain
Long term use
  • Ibuprofen low dose - First line treatment
  • Naproxen low dose - Second line treatment
  • Naproxen high dose- Third line treatment
  • Diclofenac - Fourth line treatment
 

Ibuprofen
Formulary

Tablets: 200mg, 400mg, 600mg
Suspension (sugar-free available): 100mg/5mL 

Link  MHRA Drug Safety Update (June 2015): High-dose ibuprofen (≥2400mg/day): small increase in cardiovascular risk

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Naproxen tablets
Formulary

Tablets: 250mg, 500mg 

Note: a naproxen 125mg in 5ml suspension (unlicensedunlicensed) is also approved. 


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Diclofenac
Formulary

Tablets: 25mg, 50mg

The use of oral diclofenac is restricted. It can be used short-term for post operative pain, or as a fourth line choice for long-term use.

  • Topical formulations are NOT on the formulary
Link  MHRA Drug Safety Update (Dec 2007): NSAIDs and coxibs: balancing of cardiovascular and gastrointestinal risks
Link  MHRA Drug Safety Update (Jan 2015): Cox-2 selective inhibitors and non-steroidal anti-inflammatory drugs (NSAIDs): Cardiovascular safety.
Link  MHRA Drug Safety Update (June 2013): Diclofenac: new contraindications and warnings
Link  MHRA Drug safety Update (Oct 2012): Non-steroidal anti- inflammatory drugs (NSAIDs): cardiovascular risks

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Diclofenac Sodium
Formulary

Injection: 75 mg/3 ml

Link  MHRA Drug Safety Update (June 2013): Diclofenac: new contraindications and warnings

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Diclofenac Suppositories
Formulary

Diclofenac: new contraindications and warnings - GOV.UK (www.gov.uk)


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Flurbiprofen
Formulary

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Celecoxib
Formulary
  • Capsules: 100mg, 200mg

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Etodolac
Formulary
  • Capsules: 300mg
  • MR tablets: 600mg

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Etoricoxib
Formulary
  • Tablets: 30mg, 60mg, 90mg, 120mg

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Indometacin
Formulary
  • Capsules: 25 mg, 50 mg
  • SR Capsules: 75 mg
  • Suppositories: 100 mg

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Mefenamic Acid
Formulary
  • Capsules: 250 mg
  • Tablets: 500 mg
  • Suspension: 50 mg/5 mL

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Nabumetone
Formulary
  • 500mg tablets

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Phenylbutazone
Formulary

Tablets: 100mg

Indication: Ankylosing Spondylitis. 

Used only by a specialist in severe cases where other treatments have been found unsuitable.


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