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 Formulary Chapter 10: Musculoskeletal and joint diseases - Full Chapter
10.01.01  Expand sub section  Non-steroidal anti-inflammatory drugs
Celecoxib
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • For Rheumatology use only
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
   
Diclofenac Sodium
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • See MHRA Drug Safety Update
  • RFL approvals:
    • Restricted to Rheumatology and Obstetricians / Gynaecology
  • RNOH approvals
    • Restricted: Diclofenac treatment should only be initiated after careful consideration for patients with significant risk factors for cardiovascular events (eg, hypertension, hyperlipidaemia, diabetes mellitus, smoking).
  • UCLH approvals:
  • WH approvals:
    • See MHRA Drug Safety Update
 
   
Diclofenac sodium + Misoprostol
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Nil
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Must not be given to women of child-bearing potential
 
   
Diclofenac sodium Modified release
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Not applicable
    • Check MHRA Drug Safety Updates 
  • RFL approvals:
    • Restricted to only Rheumatology and Obs / Gynae
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • See MHRA Drug Safety Update
 
   
Etodolac
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Restricted to use by Rheumatology Consultants only
  • RFL approvals:
    • Not applicable
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Restricted to Rheumatology only
 
   
Etodolac Modified Release
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Restricted to use by Rheumatology Consultants only
  • RFL approvals:
    • Nil
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Restricted to Rheumatology only
 
   
Flurbiprofen
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Formulary
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Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Nil
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
   
Ibuprofen
(Oral)
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Formulary
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Secondary care notes

  • NMUH approvals:
    • See MHRA Drug Safety Update
  • RFL approvals:
    • Nil
  • RNOH approvals
    • First choice NSAID
  • UCLH approvals:
  • WH approvals:
    • Intravenous injection restricted to Consultant level
 
   
Indometacin
(Analgesic)
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Formulary
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Secondary care notes

  • NMUH approvals:
    • See link below
  • RFL approvals:
    • Nil
  • RNOH approvals:
    • Nil
  • UCLH approvals:
  • WH approvals:
    • Nil
 
Link  NMUH: Guideliens on Management of Acute and Chronic Gout
   
Indometacin Modified Release
(Analgesic)
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Nil
  • RFL approvals:
    • Not applicable
  • RNOH approvals:
    • Nil
  • UCLH approvals:
  • WH approvals:
    • Restricted to Rheumatology only
 
   
Mefenamic Acid
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Secondary care notes

  • NMUH approvals:
    • Not applicable
    • See link below
  • RFL approvals:
    • Only tablets available at Royal Free Hospital
  • RNOH approvals:
    • Nil
  • UCLH approvals:
  • WH approvals:
    • Nil
 
Link  NMUH: Treatment Options for Primary Dysmenorrhoea and Menorrhagia
   
Meloxicam
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Not applicable
  • RNOH approvals:
    • Nil
  • UCLH approvals:
  • WH approvals:
    • Restricted to Rheumatology only
 
   
Nabumetone
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Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Restricted to Rheumatology and Haematology.
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
   
Naproxen
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Formulary
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Secondary care notes

  • NMUH approvals:
    • Nil
  • RFL approvals:
    • Nil
  • RNOH approvals:
    • Second choice NSAID
  • UCLH approvals:
  • WH approvals:
    • Nil
 
Link  NMUH: Trust guidelines on Management of Acute and Chronic Gout
   
Piroxicam
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Formulary
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Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Only 10mg capsules stocked at the Royal Free Hospital.
  • RNOH approvals:
    • Not applicable  
  • UCLH approvals:
  • WH approvals:
    • Only piroxicam 0.5% gel
 
   
Sulindac
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Restricted Drug Restricted
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Approved as first line treatment for oestrogen receptor-negative, desmoid-type fibromatosis for patients with slowly progressive, unresectable disease. Specialist initiation only (July 2014)

Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Nil
  • RNOH approvals:
    • Not applicable  
  • UCLH approvals:
  • WH approvals:
    • Nil
 
   
Acemetacin
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Restricted Drug Restricted
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Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Not applicable
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Restricted to Rheumatology only.
 
   
10.01.01  Expand sub section  Aspirin
 ....
 Non Formulary Items
Aceclofenac

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Non Formulary

Secondary care notes

  • NMUH approvals:
    • Not applicable
    • Check MHRA Drug Safety Updates
  • RFL approvals:
    •  Not applicable
  • RNOH approvals
    •  Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
Azapropazone  (Rheumox)

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Non Formulary
 
Dexibuprofen

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Non Formulary
 
Dexketoprofen

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Non Formulary
 
Diclofenac Potassium

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Non Formulary

Secondary care notes

  • NMUH approvals:
    • Not applicable
    • Check MHRA Drug Safety Updates 
  • RFL approvals:
    •  Not applicable
  • RNOH approvals
    •  Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
Etoricoxib

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Non Formulary

Secondary care notes

  • NMUH approvals:
    •  Not applicable
    •  Check MHRA Drug Safety Updates 
  • RFL approvals:
    •  Not applicable
  • RNOH approvals
    •  Not applicable
  • UCLH approvals:
  • WH approvals:
    •  Not applicable
 
Fenoprofen

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Non Formulary

Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Not applicable
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
Ibuprofen
(Modified release)

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Non Formulary

Secondary care notes

  • NMUH approvals:
    •  Not applicable
    •  Check MHRA Drug Safety Updates 
  • RFL approvals:
    •  Not applicable
  • RNOH approvals
    •  Not applicable
  • UCLH approvals:
  • WH approvals:
    •  Not applicable
 
Ketoprofen

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Non Formulary

Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Not applicable
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
Ketoprofen + Omeprazole

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Non Formulary
 
Ketoprofen Modified Release

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Non Formulary

Secondary care notes

  • NMUH approvals:
    • Not applicable
  • RFL approvals:
    • Not applicable
  • RNOH approvals:
    • Not applicable
  • UCLH approvals:
  • WH approvals:
    • Not applicable
 
Naproxen + Esomeprazole

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Non Formulary
 
Naproxen + Misoprostol

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Non Formulary
 
Tenoxicam

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Non Formulary
 
Tiaprofenic Acid

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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 children's BNF
click to search medicines.org.uk
Link to SPCs
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

GP - 1st

Medicines suitable for first-line use within primary care.

Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.

  

GP - 2nd

Medicines suitable for second-line use within primary care.

Can be initiated within primary care within their licensed indication, in accordance with nationally recognised formularies, for example the BNF, BNF for Children, Medicines for Children or Palliative Care Formulary. Primary care prescribers take full responsibility for prescribing.

  

GP - Amber

Medicines that should be initiated by a specialist. Prescribing can be transferred to primary care once the patient has been stabilised.

Shared care: For drugs with regular, ongoing need for monitoring and/or assessment of efficacy or toxicity. Prior agreement must be obtained by the specialist from the primary care provider before prescribing responsibility is transferred. The shared care protocol must have been agreed by the relevant secondary care trust Drugs and Therapeutics Committee(s) (DTC) and approved by the North Central London JFC.

Fact sheet: For drugs with some concerns surrounding safety or efficacy but do not require regular monitoring and/or monitoring of effectiveness/toxicity.

  

GP - Red

Medicines which should normally be prescribed by specialists only (hospital only).

For patients already receiving prescriptions in primary care - continue. No new patients to receive prescriptions in primary care.

  

GP - Grey

Medicines on hospital formularies which have not been reviewed for suitability in primary care.  

Black

Medicines not recommended for routine use in primary or secondary care.

Medicines, which the North Central London JFC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data.

  

netFormulary