netFormulary NHS
Sunderland Joint Formulary
NHS Sunderland Clinical Commissioning Group
South Tyneside and Sunderland NHS Foundation Trust
 Search
 Formulary Chapter 10: Musculoskeletal and joint diseases - Full Chapter
10.01  Expand sub section  Drugs used in rheumatic diseases and gout
10.01  Expand sub section  Rheumatoid arthritis and other inflammatory disorders
10.01  Expand sub section  Osteoarthritis and soft-tissue disorders
10.01.01  Expand sub section  Non-steroidal anti-inflammatory drugs
Ibuprofen
View adult BNF View SPC online
First Choice Tablets: 200mg, 400mg, 600mg
Suspension (sugar-free available): 100mg/5mL 
Naproxen
View adult BNF View SPC online
Second Choice Tablets: 250mg, 500mg 
   
Diclofenac sodium
View adult BNF View SPC online
Alternatives Tablets: 25mg, 50mg 
   
Celecoxib
View adult BNF View SPC online
Alternatives Capsules: 100mg, 200mg 
   
Etodolac
View adult BNF View SPC online
Alternatives Capsules: 300mg
MR tablets: 600mg 
   
Etoricoxib
View adult BNF View SPC online
Alternatives

Tablets: 30mg, 60mg, 90mg, 120mg


Indications:
Long-term for ankylosing spondylitis

 
   
Indometacin
View adult BNF View SPC online
Alternatives Capsules: 25 mg, 50 mg
SR Capsules: 75 mg
Suppositories: 100 mg
 
   
Mefenamic Acid
View adult BNF View SPC online
Alternatives Capsules: 250 mg
Tablets: 500 mg
Suspension: 50 mg/5 mL

Note: Obs & gynae use only
 
   
Diclofenac Sodium
View adult BNF View SPC online
Alternatives
Red

Injection: 75 mg/3 ml
To be used in secondary care only

 
   
Phenylbutazone
View adult BNF View SPC online
Alternatives
Red

Tablets: 100mg

Indication: Ankylosing Spondylitis. Only be used by a specialist in severe cases where other treatments have been found unsuitable
This is to be used for existing patients only. No new patients should be commenced on phenylbutazone.

 
   
Flurbiprofen
View adult BNF View SPC online
Alternatives
Red
Tablets: 50mg, 100mg
For use in Sunderland eye infirmary only 
   
10.01.01  Expand sub section  Aspirin to top
10.01.02  Expand sub section  Corticosteroids
10.01.02.01  Expand sub section  Systemic corticosteroids - see 6.3 Corticosteroids
 note  See section 6.3 Corticosteroids
10.01.02.02  Expand sub section  Local corticosteroids injections
Dexamethasone (as sodium phosphate)
View adult BNF View SPC online
Formulary Injection: 3.3 mg/1 mL, 4 mg/1 mL, 6.6 mg/2 mL, 8 mg/2 mL 
   
Hydrocortisone acetate (Hydrocortistab®)
View adult BNF View SPC online
Formulary Injection: 25mg/1ml (Hydrocortistab) 
   
Methylprednisolone Acetate (Depo-Medrone®)
View adult BNF View SPC online
Formulary Depot injection: 40 mg/mL (Depo-Medrone®) 
   
Methylprednisolone Acetate (Depo-Medrone® with Lidocaine)
View adult BNF View SPC online
Formulary Depot injection (with lidocaine): 40 mg (+ 10 mg)/1 mL, 80 mg (+ 20 mg)/2 mL (Depo-Medrone with Lidocaine®) 
   
Prednisolone Acetate (Deltastab®)
View adult BNF View SPC online
Formulary Depot injection: 25 mg/1 mL (Deltastab®)

See section 6.3.2 for other preparations 
   
Triamcinolone Acetonide (Adcortyl®)
View adult BNF View SPC online
Formulary Intra-articular injection: 10 mg/1 mL, 50 mg/5 mL (Adcortyl®) 
   
Triamcinolone Acetonide (Kenalog®)
View adult BNF View SPC online
Formulary Intra-articular injection: 40 mg/1 mL, 80mg/2 mL (Kenalog®) 
   
10.01.03  Expand sub section  Drugs which suppress the rheumatic disease process
Cytotoxic Drug Methotrexate
View adult BNF View SPC online
First Choice
Amber
Tablets: 2.5 mg
Prefilled pen (Metoject): 7.5mg, 10mg, 12.5mg, 15mg, 17.5mg, 20mg, 22.5mg, 25mg, 27.5mg, 30mg

Note: ONLY 2.5mg strength tablets to be prescribed. No other strengths to be prescribed 
Sulfasalazine
View adult BNF View SPC online
First Choice
Amber
EC Tablets: 500 mg
Oral suspension (sugar-free): 250 mg/5 mL
 
Hydroxychloroquine sulfate
View adult BNF View SPC online
First Choice
Amber
Tablets: 200 mg 
Leflunomide
View adult BNF View SPC online
Second Choice
Amber
Tablets: 10 mg, 20 mg 
   
Filgotinib (Jyseleca®)
View adult BNF View SPC online
Formulary
Red

Tablets: 100mg and 200mg

 
Link  NICE TA 676: Filgotinib for treating moderate to severe rheumatoid arthritis
   
Cytotoxic Drug Azathioprine
View adult BNF View SPC online
Alternatives
Amber
Tablets: 25 mg, 50 mg 
Link  NICE TA 480: Tofacitinib for moderate to severe rheumatoid arthritis
   
Ciclosporin (Neoral)
View adult BNF View SPC online
Alternatives
Amber

Capsules: 10 mg, 50 mg, 100 mg
Oral solution (sugar-free): 100 mg/1 mL

 
   
Penicillamine
View adult BNF View SPC online
Alternatives
Amber

Tablets: 125 mg, 250 mg

Note: this is as an alternative after biologics

*FOR NEUROLOGY INDICATIONS (SUCH AS WILSON'S), PENICILLAMINE SHOULD BE CONSIDERED A RED DRUG*

 
   
Sodium Aurothiomalate
View adult BNF View SPC online
Alternatives
Amber

Injection: 10 mg/0.5 mL, 50 mg/0.5 mL

Note: this is as an alternative after biologics

 
   
Tofacitinib
View adult BNF View SPC online
Alternatives
Red

Tablets: 5mg

 
Link  NICE TA 480: Tofacitinib for moderate to severe rheumatoid arthritis
Link  NICE TA 543: Tofacitinib for treating active psoriatic arthritis after inadequate response to DMARDs
Link  NICE TA 547: Tofacitinib for moderately to severely active ulcerative colitis
   
Sarilumab
View adult BNF View SPC online
Alternatives
Red

Pre-filled pen: 150mg, 200mg
Syringe: 150mg, 200mg

 
Link  NICE TA 485: Sarilumab for moderate to severe rheumatoid arthritis
   
Baricitinib (Olumiant)
View adult BNF View SPC online View SMC online
Alternatives
Red

Film coated tablets: 2mg, 4mg

 
Link  NICE TA 466: Baricitinib for moderate to severe rheumatoid arthritis
Link  NICE TA 681: Baricitinib for treating moderate to severe atopic dermatitis
   
Mycophenolate
View adult BNF View SPC online
Unlicensed Drug Unlicensed
Amber
Capsules: 250mg
Tablets: 500mg 
   
10.01.03  Expand sub section  Cytokine modulators to top
 note 

After failure with 2 DMARDS, including Methotrexate (if not tolerated) over a 6-month period and DAS > 5.1

Adalimumab (Amgevita®(biosimilar) or Humira®)
View adult BNF View SPC online
First Choice
Red
High Cost Medicine

Amgevita is the biosimilar which is recommended for use first line

 

Pre-filled syringe or pen: 40 mg
Injection (vial): 40 mg/0.8 mL

Note: Subcutaneous first choice with MTX

 
Infliximab
View adult BNF View SPC online
Second Choice
Red
High Cost Medicine
Solution for infusion: 100mg

Note: Intravenous 2nd line with MTX 
Link  NICE TA134: Infliximab for the treatment of adults with psoriasis
Link  NICE TA195: Rheumatoid arthritis - drugs for treatment after failure of a TNF inhibitor
Link  NICE TA199: Psoriatic arthritis - etanercept, infliximab and adalimumab
Link  NICE TA375: Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
Link  NICE TA383: TNF-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis
   
Certolizumab Pegol
View adult BNF View SPC online
Second Choice
Red
High Cost Medicine

Pre-filled syringe: 200 mg


Note: Option if anti-TNF withdrawn during 1st 6 months due to adverse effects

Also approved for:
-Adults with severe active Ankylosing Spondylitis who have had an inadequate response to, or are intolerant to NSAIDs
-In combination with MTX, is indicated for the treatment of active psoriatic arthritis in adults when the response to previous DMARD therapy has been inadequate

 
Link  NICE TA375: Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
Link  NICE TA383: TNF-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis
Link  NICE TA415: Certolizumab pegol for treating rheumatoid arthritis after inadequate response to a TNF-alpha inhibitor
   
Golimumab
View adult BNF View SPC online
Second Choice
Red
High Cost Medicine
Injection (pre-filled pen, pre-filled syringe): 50 mg

Note: Option if anti-TNF withdrawn during 1st 6 months due to adverse effects 
Link  NICE TA 497: Golimumab for treating non-radiographic axial spondyloarthritis
Link  NICE TA220: Psoriatic arthritis - golimumab
Link  NICE TA225: Rheumatoid arthritis - golimumab
Link  NICE TA375: Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
Link  NICE TA383: TNF-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis
   
Rituximab
View adult BNF View SPC online
Second Choice
Red
High Cost Medicine

Concentrate for solution for infusion: 100 mg/10 mL, 500 mg/50 mL

Note: 2nd line with MTX on failure after 6 months of 1st line; or monotherapy if MTX contraindicated due to pulmonary fibrosis)


NTAG approved in combination with methotrexate as first-line biological therapy in cases where there is an absolute contraindication to tumour necrosis factor inhibitors


NTAG approved for combination with other (non-methotrexate) disease modifying antirheumatic drugs and as monotherapy in cases in which conventional treatment with tumour necrosis factor inhibitors or methotrexate is deemed unsafe

 
Link  NICE TA195: Rheumatoid arthritis - drugs for treatment after failure of a TNF inhibitor
Link  NICE TA308: Rituximab in combination with glucocorticoids for treating anti-neutrophil cytoplasmic antibody-associated vasculitis
   
Etanercept
(Etanercept (subcutaneous 1st line with MTX))
View adult BNF View SPC online
Formulary
Red

Injection (pre-filled syringe) (Enbrel) 25mg, 50mg

Injection (pre-filled syringe) (Benepali) 50mg

Injection (vial) (Enbrel) 25mg

Injection (paediatric) (Enbrel) 10mg, 25mg

 
Link  TA103 - For the treatment of adults with psoriasis
Link  TA 195 - For the treatment of rheumatoid arthritis after the failure of a TNF inhibitor
Link  TA 199 - For the treatment of psoriatic arthritis
Link  TA 373 - For the treatment of juvenile idiopathic arthritis
Link  TA 375 - For the treatment of rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
Link  TA 383 - For the treatment of ankylosing spondylitis and non-radiographic axial spondyloarthritis
   
Ixekizumab (Taltz®)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
 
Link  NICE TA 537 Ixekizumab for treating active psoriatic arthritis after inadequate response to DMARDs
   
Upadacitinib (Rinvoq®)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine

MR tablet: 15 mg

 
Link  NICE TA 665: Upadacitinib for treating moderate to severe rheumatoid arthritis
   
Tocilizumab
View adult BNF View SPC online
Alternatives
Red
High Cost Medicine

Concentrate for intravenous infusion: 80 mg/4 mL, 200 mg/10 mL, 400 mg/20 mL
Subcutaneous injection: 162mg/0.9mL (for rheumatoid arthritis only)

Note: 3rd line with MTX on failure after 6 months of 2nd line; or monotherapy if MTX contraindicated due to pulmonary fibrosis

 
Link  NICE TA238: Arthritis (juvenile idiopathic, systemic) - tocilizumab
Link  NICE TA247: Rheumatoid arthritis - tocilizumab (rapid review TA198)
Link  NICE TA373: Abatacept, adalimumab, etanercept and tocilizumab for treating juvenile idiopathic arthritis
Link  NICE TA375: Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
Link  Tocilizumab for treating giant cell arteritis (TA518) 18.4.18
   
Abatacept
View adult BNF View SPC online
Alternatives
Red
High Cost Medicine

IV infusion: 250 mg
Injection (pre-filled syringe): 125 mg (for rheumatoid arthritis only)

Note: 4th line with MTX on failure after 6 months of 3rd line

 
Link  NICE TA195:Adalimumab, etanercept, infliximab, rituximab and abatacept for the treatment of rheumatoid arthritis after the failure of a TNF inhibitor
Link  NICE TA373: Abatacept, adalimumab, etanercept and tocilizumab for treating juvenile idiopathic arthritis
Link  NICE TA375: Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for rheumatoid arthritis not previously treated with DMARDs or after conventional DMARDs only have failed
   
Ustenkinumab
View adult BNF View SPC online
Alternatives
Red
Solution for injection: 45mg 
Link  NICE TA180: Ustekinumab for the treatment of adults with moderate to severe psoriasis
Link  NICE TA340: Ustekinumab for treating active psoriatic arthritis
   
Secukinumab (Consentyx ®)
View adult BNF View SPC online
Alternatives
Red
Injection: 150 mg/mL,
Pre-filled pen or pre-filled syringe: 150-mg  
Link  NICE TA350: Secukinumab for treating moderate to severe plaque psoriasis
Link  NICE TA407: Secukinumab for active ankylosing spondylitis after treatment with non-steroidal anti-inflammatory drugs or TNF-alpha inhibitors
   
Apremilast
View adult BNF View SPC online
Alternatives
Red

Tablets: 30mg

 
Link  NICE TA433: Apremilast for treating active psoriatic arthritis
   
Belimumab (Benlysta® )
View adult BNF View SPC online
Alternatives
Red
High Cost Medicine

Vial for intravenous infusion: 120mg

 
Link  NICE TA397: Belimumab for treating active autoantibody-positive systemic lupus erythematosus
   
10.01.03  Expand sub section  Sulfasalazine
10.01.04  Expand sub section  Gout and cytotoxic-induced hyperuricaemia
10.01.04  Expand sub section  Acute attacks of gout
Naproxen
View adult BNF View SPC online
Formulary Tablets: 250 mg, 500 mg 
   
Colchicine
View adult BNF View SPC online
Formulary Tablets: 500 micrograms
Note: When treating acute gout, max. 6 mg per course; course not to be repeated within 3 days 
   
Etoricoxib
View adult BNF View SPC online
Formulary

Tablets: 120 mg

Note: Maximum of 8 days treatment for gout

 
   
Prednisolone
View adult BNF View SPC online
Formulary
Green +
Injection: 25 mg/mL (Deltastab)

See section 6.3.2
Can be used as an alternative for those who cannot tolerate NSAIDs or who are resistant to other treatments

See section 6.3.2 for other preparations 
   
Anakinra
View adult BNF View SPC online
Alternatives
Red
High Cost Medicine
unlicensedunlicensed

Solution for injection (pre-filled syringe): 100mg/0.67mL

Note: for the indication of acute gout in hospital setting only 
   
10.01.04  Expand sub section  Long-term control of gout
Allopurinol
View adult BNF View SPC online
First Choice Tablets: 100 mg, 300 mg 
Febuxostat
View adult BNF View SPC online
Second Choice

Tablets: 80 mg, 120 mg

 
Link  Febuxostat for the management of hyperuricaemia in people with gout (TA164)
   
Probenecid
View adult BNF View SPC online
Alternatives
Green +

Tablets: 500mg


unlicensedunlicensed



Note: This drug has been discontinued (community supplies may not be possible)

 
   
Sulfinpyrazone
View adult BNF View SPC online
Alternatives
Green +

Tablets: 100mg, 200mg


 


unlicensedunlicensed

 
   
Benzbromarone
View adult BNF View SPC online
Alternatives
Red

Tablets: 100mg

 
   
10.01.04  Expand sub section  Hyperuricaemia associated with cytotoxic drugs to top
Allopurinol
View adult BNF View SPC online
First Choice

Tablets: 100mg, 300mg

 
Rasburicase (Fastertec®)
View adult BNF View SPC online
Alternatives
Red
High Cost Medicine
Solution for infusion: 1.5 mg/mL
Commissioned by NHS England
 
   
10.01.05  Expand sub section  Other drugs for rheumatic diseases
10.02  Expand sub section  Drugs used in neuromuscular disorders
Nusinersen
View adult BNF View SPC online
Formulary
Red

Nusinersen is recommended as an option for treating 5q spinal muscular atrophy (SMA) only if:

  • people have pre-symptomatic SMA, or SMA types 1, 2 or 3 and

  • the conditions in the managed access agreement are followed.

 
Link  NICE TA 588: Nusinersen for treating spinal muscular atrophy
   
Mexiletine (NaMuscla®)
View adult BNF View SPC online
Formulary
Red

Capsules: 167mg (NaMuscla® 167mg equivalent to 200mg mexiletine HCl) 

ONLY APPROVED FOR USE ON THE FORMULARY FOR THE FOLLOWING INDICATIONS. HOSPITAL ONLY DRUG FOR ALL INDICATIONS

* Myotonia in non-dystrophic myotonic disorders

* Neuropathic pain (unlicensed indication)

* Ventricular arrhythmia (unlicensed indication) 
   
10.02.01  Expand sub section  Drugs which enhance neuromuscular transmission
10.02.01  Expand sub section  Anticholinesterases
Neostigmine
View adult BNF View SPC online
Formulary
Green +
Tablets: 15 mg
Injection: 2.5 mg/1 mL
 
   
Edrophonium Chloride
View adult BNF View SPC online
Alternatives
Red

Injection: 10 mg/1 mL
Hospital use only. This is only used as a diagnostic test in some suspected cases of MG. It has a brief effect to improve the symptoms.

 
   
Pyridostigmine Bromide (Mestinon®)
View adult BNF View SPC online
Alternatives
Green +
Tablets: 60 mg
Used as the standard initial symptomatic treatment for MG. Maximum beneficial dose is usually 360mg daily. Steroids and other immunosuppressant drugs are used to obtain remission those with more severe disease who do not respond sufficiently well to pyridostigmine. 
   
10.02.01  Expand sub section  Immunosuppressant therapy to top
10.02.01  Expand sub section  Acetylcholine-release enhancers
Diaminopyridine
View adult BNF View SPC online
Formulary
Red
Tablets: 20mg 
   
10.02.02  Expand sub section  Skeletal muscle relaxants
Baclofen
View adult BNF View SPC online
Formulary Tablets: 10 mg
Oral solution (sugar-free available): 5 mg/5 mL
 
   
Controlled Drug Cannabis extract (Sativex®)
View adult BNF View SPC online
Formulary
Amber

Oromucosal spray: cannabidiol 2.5mg/dronabinol 2.7mg per dose

Approved to treat moderate to severe spasticity in adults with multiple sclerosis in line with NICE NG144

 
Link  NICE NG144: Cannabis-based medicinal products
   
Dantrolene
View adult BNF View SPC online
Formulary
Green +
Capsules: 25 mg, 100 mg 
   
Diazepam
View adult BNF View SPC online
Formulary

Tablets: 2 mg, 5 mg
Oral solution (sugar-free available): 2 mg/5 mL

 
   
Tizanidine
View adult BNF View SPC online
Formulary
Green +
Tablets: 2 mg, 4 mg 
   
10.02.02  Expand sub section  Other muscle relaxants
10.02.02  Expand sub section  Nocturnal leg cramps
Quinine
View adult BNF View SPC online
Formulary

Tablets: 300mg

The MHRA advises:

  • Quinine should not be used routinely for nocturnal leg cramps
  • Only consider use when cramps cause regular disruption of sleep.
  • Trial for 4 weeks and discontinue if no benefit.
  • Reassess after 3 months. 
 
   
10.03  Expand sub section  Drugs for the treatment of soft-tissue disorders and topical pain relief to top
10.03  Expand sub section  Extravasation
10.03.01  Expand sub section  Enzymes
Hyaluronidase
View adult BNF View SPC online
Formulary
Red
Ampoules: 1,500units 
   
10.03.02  Expand sub section  Rubefacients, topical NSAIDs, capsaicin, and poultices
Deep heat
View adult BNF View SPC online
Formulary Rub: 35gram
Hospital use only 
   
10.03.02  Expand sub section  Topical NSAIDs and counter-irritants
Ibuprofen
View adult BNF View SPC online
Formulary Gel: 5%, 10% 
   
Piroxicam
View adult BNF View SPC online
Formulary Gel: 0.5% 
   
10.03.02  Expand sub section  Capsaicin to top
Capsaicin
View adult BNF View SPC online
Formulary Cream: 0.025% (Zacin®)
For osteoarthritis
 
   
10.03.02  Expand sub section  Poultices
 ....
 Non Formulary Items
Aceclofenac

View adult BNF View SPC online
Non Formulary
 
Acelofenac  (Preservex®)

View adult BNF View SPC online
Non Formulary
 
Acemetacin  (Emflex®)

View adult BNF View SPC online
Non Formulary
 
Algesal

View adult BNF View SPC online
Non Formulary
 
Amifampridine  (Firdapse)

View adult BNF View SPC online
Non Formulary
High Cost Medicine
 
Ataluren  (Translarna®)

View adult BNF View SPC online
Non Formulary
 
Axsain®

View adult BNF View SPC online
Non Formulary
 
Azapropazone  (Rheumox®)

View adult BNF View SPC online
Non Formulary
 
Betamethasone  (Betnesol®)

View adult BNF View SPC online
Non Formulary
 
Carisoprodol  (Carisoma®)

View adult BNF View SPC online
Non Formulary
 
Dexibuprofen  (Seractil®)

View adult BNF View SPC online
Non Formulary
 
Dexketoprofen  (Keral®)

View adult BNF View SPC online
Non Formulary
 
Diclofenac  (Mobigel®, Voltarol Emugel 1% and 2%®, Voltarol Gel Patch®, Pennsaid)

View adult BNF View SPC online
Non Formulary
 
Diclofenac with Misoprostol  (Arthrotec 50 and 75®)

View adult BNF View SPC online
Non Formulary
 
Dicolfenac Sodium  (Voltarol® Radid)

View adult BNF View SPC online
Non Formulary
 
Distigmine Bromide

View adult BNF View SPC online
Non Formulary
 
Felbinac  (Traxam®)

View adult BNF View SPC online
Non Formulary
 
Fenbufen

View adult BNF View SPC online
Non Formulary
 
Glucosamine

View adult BNF View SPC online
Non Formulary
 
Hyaluronic acid  (Hyalgan®)

View adult BNF View SPC online
Non Formulary
 
Hylan G-F 20  (Synvisc®)

View adult BNF View SPC online
Non Formulary
 
Ibuprofen and famotidine  (Duexis®)

View adult BNF View SPC online
Non Formulary
 
Kaolin Poultice

View adult BNF View SPC online
Non Formulary
 
Kaolin Poultice  (Kaolin Poultice K/L Pack®)

View adult BNF View SPC online
Non Formulary
 
Ketoprofen

View adult BNF View SPC online
Non Formulary
 
Ketoprofen  (Axorid®)

View adult BNF View SPC online
Non Formulary
 
Ketoprofen  (Orudis®)

View adult BNF View SPC online
Non Formulary
 
Ketoprofen  (Oruvail®)

View adult BNF View SPC online
Non Formulary
 
Ketoprofen  (Oruvail® MR)

View adult BNF View SPC online
Non Formulary
 
Ketoprofen 2.5%  (Oruvail ®, Powergel®)

View adult BNF View SPC online
Non Formulary
 
Lumiracoxib  (Prexige®)

View adult BNF View SPC online
Non Formulary
 
Meloxicam  (Mobic®)

View adult BNF View SPC online
Non Formulary
 
Methocarbamol  (Robaxin®)

View adult BNF View SPC online
Non Formulary
 
Movelat  (Topical gel / cream)

View adult BNF View SPC online
Non Formulary
 
Nabumetone

View adult BNF View SPC online
Non Formulary
 
Nabumetone  (Relifex®)

View adult BNF View SPC online
Non Formulary
 
Naproxen & esomeprazole  (Vimovo®)

View adult BNF View SPC online
Non Formulary
 
Naproxen with Misoprostol  (Napratec®)

View adult BNF View SPC online
Non Formulary
 
Piroxicam

View adult BNF View SPC online
Non Formulary
 
Piroxicam  (Brexidol®)

View adult BNF View SPC online
Non Formulary
 
Piroxicam  (Feldene®)

View adult BNF View SPC online
Non Formulary
 
Sodium hyaluronate and triamcinolone hexacetonide  (Cingal)

View adult BNF View SPC online
Non Formulary
 
Sulindac

View adult BNF View SPC online
Non Formulary
 
Sulindac  (Clinoril®)

View adult BNF View SPC online
Non Formulary
 
Tenoxicam  (Mobiflex®)

View adult BNF View SPC online
Non Formulary
 
Tiaprofenic Acid

View adult BNF View SPC online
Non Formulary
 
Tiaprofenic Acid  (Surgam®)

View adult BNF View SPC online
Non Formulary
 
Transvasin

View adult BNF View SPC online
Non Formulary
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red

Drugs for hospital use or use by a specialist within specialist centre only. Initiation and monitoring of treatment should remain under the total responsibility of the appropriate hospital clinician or specialist. These drugs should only be prescribed under the direct supervision of that clinician or specialist and are not suitable for shared care arrangements. The drug should be supplied via the hospital or specialist centre for the duration of treatment.   

Amber

These are specialist drugs which must be initiated by secondary care specialist prescribers, but with the potential to transfer prescribing to primary care within written and agreed shared care protocols and according to the agreed process for transfer of care. For these drugs, in order to ensure patient safety, some aspects of care must remain with the specialist due to their complexity e.g. monitoring of disease or drug response. Other more routine aspects can be transferred to the GP e.g. monitoring of adverse effects and supply of the medicine. The specific responsibilities of the specialist and GP are defined in the shared care agreement for each drug. Shared care agreements are still under development for some amber drugs. Until these are available, it would be expected that any shared care request from secondary care to a GP would be accompanied by written information which defines prescribing and monitoring responsibilities. The hospital specialist should also provide the GP with enough information and support to allow the safe transfer and ongoing management of prescribing into primary care.   

Green +

Drugs which should usually be initiated in secondary care, or by a specialist clinician, but can be safely maintained in primary care with very little or no monitoring required. In some cases there may be a further restriction for use outlined - these will be defined in each case.  

Green

These are defined as new and established drugs, which may be prescribed, initiated, changed or maintained on FP10 by the GP and, if appropriate, discontinued without recourse to secondary care. N.B. DRUGS NOT IDENTIFIED IN THE FORMULARY BY A RED, AMBER OR GREEN+ SYMBOL ARE CLASSIFIED AS GREEN.   

netFormulary