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Joint Formulary
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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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Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • For Rheumatology use only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Diclofenac sodium
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Restricted Drug Restricted
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Provider notes

  • NMUH:
    • See MHRA Drug Safety Update
  • RFL:
    • Restricted to Rheumatology, Obstetricians / Gynaecology and Paediatrics (suppositories or injection)
    • Injection, Suppositories 12.5mg/25mg/100mg, EC tablets 25mg/50mg 
  • RNOH:
    • 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:
  • WH:
    • See MHRA Drug Safety Update
 
Diclofenac sodium + Misoprostol
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Restricted Drug Restricted
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Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • 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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Provider notes

  • NMUH:
    • Non-formulary
    • Check MHRA Drug Safety Updates 
  • RFL:
    • Restricted to only Rheumatology and Obs / Gynae
    • M/R tablets 75mg and 100mg available
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • See MHRA Drug Safety Update
 
Etodolac
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Restricted Drug Restricted
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Provider notes

  • NMUH:
    • Restricted to use by Rheumatology Consultants only
  • RFL:
    • Restricted to use by Rheumatology only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Restricted to Rheumatology only
 
Etodolac modified release
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Restricted Drug Restricted
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Provider notes

  • NMUH:
    • Restricted to use by Rheumatology Consultants only
  • RFL:
    • Restricted to use by Rheumatology only
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Restricted to Rheumatology only
 
Etoricoxib
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Formulary
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Provider notes

  • NMUH:
    • Non-formulary
    • Check MHRA Drug Safety Updates 
  • RFL:
    • Restricted to use in Rheumatology indications only in patients with low cardiovascular risk after two standard non-selective, non-steroidal anti-inflammatory drug (NSAID; for example, ibuprofen and naproxen), has failed to achieve symptom relief, as per NCL JFC position statement February 2021
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Non-formulary
 
Ibuprofen immediate release
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Formulary
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Provider notes

  • NMUH:
    • See MHRA Drug Safety Update
  • RFL:
    • No restriction stated
  • RNOH:
    • First choice NSAID
  • UCLH:
  • WH:
    • Intravenous injection restricted to Consultant level
 
Indometacin immediate release caps
(Analgesic)
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Formulary
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Provider notes

  • NMUH:
    • Access Trust guideline via intranet
  • RFL:
    • Restricted to Neurology
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
Indometacin modified release caps
(Analgesic)
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Restricted Drug Restricted
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Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • Restricted to Neurology
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • Restricted to Rheumatology only
 
Mefenamic acid
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Restricted Drug Restricted
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Provider notes

  • NMUH:
    • Non-formulary
    • See link below
  • RFL:
    • Restricted to Gynaecology
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NMUH: Treatment Options for Primary Dysmenorrhoea and Menorrhagia
Meloxicam
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Restricted Drug Restricted
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Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Restricted to use by Rheumatology only
  • RNOH:
    • No restriction stated
  • UCLH:
  • WH:
    • Restricted to Rheumatology only
 
Naproxen
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Formulary
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Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Second choice NSAID
  • UCLH:
  • WH:
    • No restriction stated
 
Piroxicam
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Formulary
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Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Restricted to Rheumatology only
    • 10mg capsules available.
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • Only piroxicam 0.5% gel
 
Sulindac
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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)

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • No restriction stated
  • RNOH:
    • Non-formulary  
  • UCLH:
  • WH:
    • No restriction stated
 
Acemetacin
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Restricted Drug Restricted
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Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Non-formulary
  • RNOH:
    • Non-formulary
  • UCLH:
  • WH:
    • Restricted to Rheumatology only.
 
10.01.01  Expand sub section  Aspirin
 ....
 Non Formulary Items
Aceclofenac

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Non Formulary
Azapropazone

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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
Fenoprofen

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Non Formulary
Flurbiprofen tablets

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Non Formulary
Ibuprofen modified release

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Non Formulary
Ketoprofen

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Non Formulary
Ketoprofen + Omeprazole

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Non Formulary
Ketoprofen modified release

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Non Formulary
Nabumetone

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Non Formulary
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
Homecare
Homecare

Traffic Light Status Information

Status Description

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.

See link for the complete NCL Red List https://www.ncl-mon.nhs.uk/wp-content/uploads/2017/08/ncl_red_list.pdf

  

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.

  

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