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Joint Formulary
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 Formulary Chapter 10: Musculoskeletal and joint diseases - Full Chapter
10.01.03  Expand sub section  Drugs which suppress the rheumatic disease process
10.01.03  Expand sub section  Gold
10.01.03  Expand sub section  Penicillamine
10.01.03  Expand sub section  Antimalarials
10.01.03  Expand sub section  Drugs affecting the immune response to top
Azathioprine
(Rheumatology)
View adult BNF View SPC online View childrens BNF 		Restricted Drug Restricted
GP - Amber
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NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • No restriction stated
  • RNOH:
    • Restricted to Rheumatology Consultants ONLY
    • See links below
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: DMARD Quick Reference Guide for Primary Care Prescribers
Link  RNOH + Herts CCG: Adult Rheumatology Shared Care - Principles and Responsibilities
Link  RNOH + Herts CCG: Azathioprine in Adult Rheumatology - Shared Care Information
Ciclosporin
(Rheumatology)
View adult BNF View SPC online View childrens BNF 		Restricted Drug Restricted
GP - Amber
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NOTE: There is more than one monograph for Ciclosporin, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • Deximune® is the preferred brand
  • RNOH:
    • Restricted to Rheumatology Consultants ONLY
    • See links below
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: DMARD Quick Reference Guide for Primary Care Prescribers
Link  RNOH + Herts CCG: Adult Rheumatology Shared Care - Principles and Responsibilities
Link  RNOH + Herts CCG: Ciclosporin in Adult Rheumatology - Shared Care Information
Cyclophosphamide
(Scleroderma, Vasculitis, SLE, Sarcoid)
View adult BNF View SPC online View childrens BNF 		Restricted Drug Restricted
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NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • Non-formulary
  • RFL:
    • Approved for use in Scleroderma (lung fibrosis), Vasculitis, SLE and Sarcoid
  • RNOH:
    • Non-formulary
  • UCLH:
    • Non-formulary
  • WH:
    • Non-formulary
 
Leflunomide
(Rheumatology)
View adult BNF View SPC online View childrens BNF 		Restricted Drug Restricted
GP - Amber
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Provider notes

  • NMUH: 
    • Restricted to Rheumatology Consultants ONLY
  • RFL:
    • No restriction stated
  • RNOH:
    • Restricted to Rheumatology Consultants ONLY
    • See links below
  • UCLH:
  • WH:
    • Restricted to Rheumatology Consultants ONLY
 
Link  NCL JFC: Rheumatoid arthritis DMARD and high-cost drug pathway
Link  RNOH + Herts CCG: Adult Rheumatology Shared Care - Principles and Responsibilities
Link  RNOH + Herts CCG: Leflunomide in Adult Rheumatology - Shared Care Information
Methotrexate SC / IM injection
(Rheumatology)
View adult BNF View SPC online View childrens BNF 		Restricted Drug Restricted
GP - Red
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NOTE: There is more than one monograph for this medicine, click here to search for formulary status and its use for other indications. 

The licensed routes of administration for parenteral preparations vary—further information can be found in the product literature for the individual preparations.

Provider notes

  • NMUH:
    • No restriction stated
  • RFL:
    • Metoject brand available in a variety of strengths
    • See pharmacy policy for the safe dispensing of methotrexate
  • RNOH:
    • Rheumatology Consultants ONLY
    • Metoject and Nordimet (if autoinjector required) brand
    • See links below
  • UCLH:
  • WH:
    • No restriction stated
 
Link  RNOH + Herts CCG: Adult Rheumatology Shared Care - Principles and Responsibilities
Link  RNOH + Herts CCG: Methotrexate in Adult Rheumatology - Shared Care Information
Methotrexate tablets
(Rheumatology)
View adult BNF View SPC online View childrens BNF 		Restricted Drug Restricted
GP - Amber
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NOTE: There is more than one monograph for Methotrexate, click here to search for formulary status and its use for other indications. 

Provider notes

  • NMUH:
    • See links below.
  • RFL:
    • 2.5mg tablets only
    • See pharmacy policy for safe dispensing of methotrexate
  • RNOH:
    • Restricted for Rheumatology Consultants ONLY
    • 2.5mg tablets ONLY
    • See links below
  • UCLH:
  • WH:
    • No restriction stated
 
Link  NCL JFC: Rheumatoid arthritis DMARD and high-cost drug pathway
Link  NCL JFC: Shared care Guideline - Prescribing and Monitoring of oral methotrexate for licensed and off-label indications
Link  RNOH + Herts CCG: Adult Rheumatology Shared Care - Principles and Responsibilities
Link  RNOH + Herts CCG: Methotrexate in Adult Rheumatology - Shared Care Information
 link Link    NICE TA199: Psoriatic arthritis - etanercept, infliximab and adalimumab
 link Link    NICE TA375: Rheumatoid arthritis - Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept
 link Link    NICE TA383: TNF-alpha inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritis
10.01.03  Expand sub section  Cytokine modulators
10.01.03  Expand sub section  Sulfasalazine
 ....
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
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 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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